Inspection on 01/08/07 for Bank House Nursing Home

This inspection was carried out on 1st August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bank House Nursing Home 15/09/08

Bank House Nursing Home 26/04/06

Bank House Nursing Home 15/11/05

Bank House Nursing Home 20/12/04

Bank House Nursing Home 26/04/04

Bank House Nursing Home 18/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Bank House Nursing Home Shard Lane Hambleton Near Blackpool Lancashire FY6 9BX Lead Inspector Mrs Christine Marshall Unannounced Inspection 1st August 2007 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 House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 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 Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bank House Nursing Home Address Shard Lane Hambleton Near Blackpool Lancashire FY6 9BX 01253 701635 01253 701751 ogdenv@bupa.com www.bupa.co.uk BUPA Care Homes (Partnerships) Limited 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) Mrs Vivien Ogden Care Home 50 Category(ies) of Dementia (15), Old age, not falling within any registration, with number other category (35) of places Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service is registered for a maximum of 50 service users to include; up to 35 service users in the category of OP (older people over the age of 65 years) up to 15 service users in the category of DE (dementia) up to five persons under the age of 65 years within the category of PD (Physical Disability) within the maximum number of 50 26th April 2006 Date of last inspection Brief Description of the Service: Bank House Nursing Home is situated within its own grounds, very close to the village of Hambleton, where there are shops and local facilities such as a garage and a public house. The home provides accommodation for 50 people and offers nursing and dementia care. There is a Statement of Purpose, Service Users Guide and Information Pack that is given to all prospective residents; this is a set of written information that tells you about the care service that is offered, who the owners, manager and staff are and what the resident can expect if he or she decides to live at the home. The most recent inspection report is available in the reception area of the home. All accommodation is in single bedrooms that meet the minimum space requirements. Each room is furnished to a good standard. Nine bedrooms have en-suite facilities. There are adequate bathrooms and toilets throughout the home. The home comprises of ground and first floor accommodation and the lounge and dining areas are decorated and furnished to a good standard. There are three dining/lounge areas, two on the general nursing unit and one on the dementia unit. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 5 There is a passenger lift and wheelchair access throughout the home. The gardens are well maintained. There is adequate car parking space. At the time of this visit (01/08/07) the fees for care were from £359 to £575 with some extra costs for hairdressing, newspapers and chiropody. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Bank House included a site visit to the home that was done between mid morning and late afternoon; the visit was unannounced, which means that the owners, staff and residents did not know it was taking place until the inspector arrived. The people who live at the home said that they preferred to be called residents. Time was spent sitting and talking with people who use the service, alongside their friends and relatives, and observing the day-to-day routines of the home and care staff, as they provided support. The inspector also used a Short Observational Framework of Inspection (SOFI) method on the dementia unit Garden Court; this is a special observational technique where the residents are continually watched by the inspector for two hours, and their wellbeing recorded. The manager completed a pre-inspection questionnaire called an Annual Quality Assurance Assessment (AQAA) and forwarded it to the commission. This document contained a very good level of information about the home and helped in the planning of the visit. A tour of the home included looking at bedrooms, lounges and dining area, kitchen and laundry rooms. This was to assess whether the home provided a comfortable, homely environment for the enjoyment of everyone, and to ensure the residents’ safety. Comment cards were sent to the home for residents and relatives to fill in; and those that were returned showed a good level of satisfaction with the care at the home. Some of the views expressed were – “I am very well looked after.” “Everybody is very nice, they really take care of me.” Relatives’ comments included – ‘’I am so pleased with the way things are on Garden Court (the dementia unit) now. The new manager is absolutely wonderful.’’ ‘’The difference in this place (Garden Court) is amazing everyone is so much happier.’’ Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 7 Discussions took place with the manager Mrs Viv Ogden and administration records were looked at. Care staff were also spoken with and said that they were happy and supported in their work. Everyone at the home was friendly, welcoming and co-operative throughout the visit. What the service does well: What has improved since the last inspection? Care plans are being completely reviewed and transferred to a new format. These are comprehensive and include all aspects of health and social care needs. The daily life and social activities and general environment on the dementia unit (Garden Court) have greatly improved yet again, providing a good quality of care for the people who live there. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 8 National Vocational Qualification (NVQ) training levels for care staff have been raised and now almost reach the required 50 . This means that the care staff can be confident and competent when doing their job. 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. The summary of this inspection report can be made available in other formats on request. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 9 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 Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 (Standard 6 does not apply to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is gathered about prospective residents, so that their needs can be met and so that they are given a good quality of life. EVIDENCE: The pre-admission assessments were looked at for the most recently welcomed residents and these were all completed; they were comprehensive and included aspects of physical, social and psychological care, making sure that any needs were identified, and that the home could provide the care that was needed. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 11 These assessments were done by the manager or the nurse in charge, and agreed by the resident and/or their family. The residents were unable to confirm these assessments due to varying levels of confusion. Generally all residents are assessed by the same tool, thus promoting equality of assessment and care provision. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ health and social care needs are met and people are treated with dignity and respect: They are supported in their daily lives. EVIDENCE: Care plans are written records that describe the care that is given to each resident. The home is currently revising their care plan system and transferring all information on to a new format. Six care plans were looked at, three of which were on the new format. All were and found to be informative and individual. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 13 All aspects of care are being considered, including a social history and Preferred Place of Care for those who may be in the final stages of their lives. None of the residents were able to say that they knew about their care plans, but two visiting relatives confirmed that they knew about them and that they were happy with things. There is evidence that residents have the GP of their choice and equally that they had regular visits by the chiropodist, dentist, optician and also hearing aid services. For any resident who has a pressure ulcer, there are systems in place for the treatment and prevention of further problems; these include special pressure relieving beds and staff training in pressure area care. The home also has involvement with the tissue viability nurse, who is a specialist in skin care and pressure ulcers. The medication policies and procedures make sure that the residents are safe. Trained nurses give out the medicines, and to promote equality and choice, any resident who wishes to take responsibility for taking their own medicine is able to do so after a risk assessment, and signing a disclaimer for this. The oxygen cylinders in the treatment room were not chained to the wall in line with the Royal Pharmaceutical Society guidelines and one hand written medication record did not have the drug dosage or two signatures in place for accuracy and safety. Advice was given on these two issues and the manager responded immediately. The residents were seen to be treated equally with respect, privacy and dignity, and there were good personal interactions with the nurses and carers. Residents’ comments included “I am very well looked after.” “They (the staff) are very good to me.” Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit by being supported, so as to promote the quality of their daily lives. They are given choices of daily living and provided with a wellbalanced and nourishing menu. EVIDENCE: Many more improvements have been made to the living area of Garden Court, which make it very homely and comfortable. Furnishings, pictures and ornaments, and the reminiscence room, promote the well-being and comfort for the residents. There is a sensory garden that benefits the residents and access to a small side garden to also give them a regular feeling of being outdoors. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 15 Equality of care is given to the residents on this unit in that social and therapeutic activities are provided to make daily life stimulating and content. There were a number of activities being carried out both on the general nursing side of the home, and Garden Court. There was a French theme, with cheese and wine and sing-a-longs on the general nursing side and on Garden Court the morning coffee time was made into a social activity where the staff gently talked to residents and manicures were given. Other activities on this unit include multi sensory activities such as ‘the rummage box’, reminiscence time, scented garden time, a pro-active therapy (PAT) dog, which the residents enjoy very much and music therapy. A special observation method of assessing the well being of the residents on Garden Court was used and showed that there were good levels of well being; interaction between staff and residents was good and each person’s individual strengths and needs were considered and attended to. Discussions with staff showed that they welcomed the opportunity to be involved in the planning and implementation of social and therapeutic activities. Relatives are able to visit at any time and contact with the local community is encouraged, such as visits from religious ministers and local school children. The food provided at the home is appetizing and nutritious and there is plenty of choice. On the general nursing side of the home the dining room is light and very nicely furnished, with nice table settings. The residents were able to say they the food was good and that they were happy with the choices that were on offer. On Garden Court the lunchtime was very relaxed. The dining area is light and basically but pleasantly furnished. Residents were offered the daily choice of food and the staff were very aware of the likes and dislikes of those who were unable to make their own choice. After the meal, the residents were settled in their comfy chairs and enjoyed a cup of tea. The Environmental Health Officer visited the home in January of this year and everything was found to be satisfactory. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to voice their opinions and relatives know who to speak to if they have any concerns. Adult protection and quality checks are in place, which means that residents live in a safe environment where their satisfaction is assured. EVIDENCE: There is a written complaints procedure for the residents and their relatives and this is included in the home’s information pack. The residents who were spoken to said that they had no complaints at all. Residents who were able also said that they could get in touch with their relatives, solicitors or anyone else that they might need for help, if they wished. There are advocacy information leaflets and advice available, which is for anyone who is without relatives and needs someone to speak on their behalf. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 17 There are policies in place for the protection of vulnerable people and the care staff are given training on abuse awareness. Evidence was found to confirm that where complaints or safeguarding adult issues are raised, the management team at the home deal with them in accordance with agreed polices and procedures and in an effective and efficient manner. Systems for recording any such issues are comprehensive and adequately detailed. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are provided with very clean, homely and pleasantly furnished surroundings and bedrooms are personalised and very comfortable; this means that people feel at home with their photographs and belongings around them. EVIDENCE: All lounges, dining areas and bedrooms are very comfortable and furnished to a very good standard: There is very good ongoing refurbishment programme in place. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 19 Residents who were able said that they were happy with their bedrooms and the lounges and dining areas. Bedrooms are very clean, very nicely furnished with personal affects and with any equipment that is needed for the comfort of the resident. There are aids and adaptations such as grab rails in toilets and special lifting and bathing hoists for the residents who need help with their mobility. There are also assisted baths for residents that cannot get in and out of the bath without help. Laundry systems are of a good standard and make sure that there are no problems with cross-infection; and the laundry area is kept clean and tidy. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ care needs are met through good levels of staff, who have the appropriate qualifications and experience necessary to give a good care service. Staff recruitment procedures make sure that the members are safe. EVIDENCE: The list of staff on duty showed that there are good levels of nurses, carers and domestic staff on duty at the home. The carers were friendly and helpful and showed that there is a good mix of people in place. National Vocational Qualifications (NVQ) training programs are in place for the carers, and there are written plans for the completion of over 50 of staff have achieved this. Currently 43 have achieved the NVQ and a further 23 are scheduled to complete within the next three months or so. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 21 The Annual Quality Assurance Assessment (AQAA) questionnaire showed that the recruitment policies and procedures are reviewed annually and that there are robust pre-employment checks that make sure that the residents are in safe hands. The AQAA also showed that staff training programmes are in place and the carers and the trained nurses also confirmed that there are training opportunities offered to them. Overseas carers are well supported and one member of staff had been provided with an electronic language translator to help improve his English and to promote his confidence when communicating with the residents. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager makes sure that the best interests of all of the residents are protected in that their health and safety is promoted. EVIDENCE: The manager is a Registered Nurse who holds the Registered Managers Award. She has managed nursing homes for many years and has been at Bank House Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 23 for the last two years; she is seen to be respected by the residents, their friends and relatives, and the staff. Equality of care is evident throughout in the policies and procedures for all aspects of care at the home. The manager has worked very hard to make sure that the people who live at the home, particularly those who live on the dementia unit, Garden Court, have contented and fulfilling lives. The unit manager of Garden Court has also worked extremely hard to bring the unit up to a high quality standard of care. This is commendable. There is a policy and procedure for a quality monitoring system in place. Monthly audits are carried out to promote the quality of care at the home. The external and nationally recognised quality system Investors in People (IIP) is also held by the home. Policies are in place for the protection of residents from any financial abuse. All records are stored in locked filing cabinets and staff only look at them when they need to find out about that particular person’s care needs. The home gave good information to the Commission about the protection of the residents in that there are Health & Safety policies and procedures, and current safety equipment servicing certificates. The Fire Safety Officer inspected the home in July of this year and found everything to be satisfactory. Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 24 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 4 Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 25 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. 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. 1 Refer to Standard OP9 Good Practice Recommendations The manager should ensure that the oxygen cylinders are chained to the wall in the treatment room, so that they are stored safely and in accordance with the royal Pharmaceutical Society guidelines. Trained nurses should also be reminded that hand written medication records must include the drug dosage instructions alongside two signature for accuracy and safety. The manager should continue with and complete the written programme for 50 of the care staff to achieve the NVQ. This will ensure that the people who live at the home are looked after by staff who have been the skills and knowledge that is need for them to do their job. 2 OP28 Bank House Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Nursing Home DS0000006023.V337801.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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