Inspection on 15/11/07 for Bank House Nursing Home

This inspection was carried out on 15th November 2007.

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 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 04/11/08

Bank House Nursing Home 14/09/06

Bank House Nursing Home 02/03/06

Bank House Nursing Home 11/08/05

Bank House Nursing Home 10/01/05

Bank House Nursing Home 05/05/04

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 Brandlesholme Road Bury Lancashire BL8 1DJ Lead Inspector Mike Murphy Unannounced Inspection 09:30 15 November 2007 th 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 DS0000017315.V337591.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 DS0000017315.V337591.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bank House Nursing Home Address Brandlesholme Road Bury Lancashire BL8 1DJ 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) 0161 764 4358 0161 762 9825 enquiries@bankhousecarehome.co.uk Mr Alan Stott ** Post Vacant *** Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43), Physical disability (1) of places Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 43 service users to include: *up to 43 service users in the category of OP (old age not falling in any other category) *up to 1 service user in the category of PD (physical disability) 7th February 2007 Date of last inspection Brief Description of the Service: Bank House Nursing home is situated just outside the centre of Bury and is readily accessible by car and public transport. The home is registered with The CSCI to provide general nursing and personal care for up to 43 service users. The manager of the home is a qualified nurse, and qualified nurses are on duty 24 hours a day. Fees at time of this inspection; £355.11 to £472.00 (information provided by the home). Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 15th of November 2007. The inspection took place over seven hours. The inspector spoke in detail to 4 of the 37 residents and 2 relatives, toured the premises, and inspected care and other records maintained at the home, and spoke with the senior nurse on duty and the registered provider. Residents at the home appeared to be looked after appropriately and generally content in their environment. A number of issues requiring attention were identified and these are detailed below and in the main body of the report. What the service does well: What has improved since the last inspection? What they could do better: Although they are trying to recruit a suitable candidate the home requires a manager to be appointed who will also need to apply to be registered with the CSCI (as required by the Care Standards Act (2000). Care plans and risk assessments need to be regularly formally evaluated. And some attention to how resident’s medicines are managed is also required. Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 Page 6 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 DS0000017315.V337591.R01.S.doc Version 5.2 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 Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply to this service. Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service Prospective residents are appropriately assessed prior to admission to ensure the home can meet their care and support needs. EVIDENCE: The pre-admission assessment records of 3 residents admitted since the last inspection were looked at. Prior to residents being admitted to the home an assessment of the prospective resident’s needs is carried out in consultation with the resident, their relatives and relevant health and social care professionals such as doctors and social workers. The purpose of such an assessment is to assist the prospective resident (and their relatives) in their considerations of how appropriate a placement at the home would be and enable the nurse conducting the assessment to determine if the home will be able to meet the prospective resident’s needs appropriately. The initial assessment helps to form the basis of the plan of care to be followed following Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 Page 9 admission to the home. The 3 residents care records inspected contained detailed pre and post admission assessments. Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of residents is monitored and action and intervention is taken, though there are some issues in respect of the care and medication administration records that require attention to ensure residents needs are fully met. EVIDENCE: The care records of 3 residents were inspected. These contained care plans that were initially based on the pre-admission assessment that is referred to earlier in this report. The way care is planned and recorded has been reviewed and improved since the last inspection. Care plans addressed the health and personal care needs of residents adequately but not all were formally evaluated at least on a monthly basis – as good practice recommends they should. Risk assessments, that seek to protect resident’s health and welfare were recorded in respect of residents skin integrity (assessing the risk of Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 Page 11 pressure sores) , moving and handling, nutrition had also been completed. However these have not all been formally evaluated at least on a monthly basis – as good practice recommends. Also the recording of resident’s body weights was erratic – again good practice recommends the body weight of residents should be recorded at least monthly. All residents are registered with a local GP and it was evident that all were enabled to access opticians, chiropodists, district nurses, tissue viability nurses, control of infection nurses, dieticians and other specialist services as individual residents needed. The practices for the receipt, recording, storage, handling, administration and disposal of resident’s medicines were inspected and found to be generally adequate – although it is recommended that 2 staff sign all handwritten entries on resident’s medication administration records and that a record is maintained when residents monthly medicines are received/checked. The qualified nurses are responsible for managing medication in the home. Discussion with residents, relatives and staff revealed that residents were treated with respect and that their right to privacy was upheld. Comments made included; ‘the staff are very decent people who all look after me very well’, ‘the nurses and staff make sure I am alright and treat me with respect, ‘I am able to choose if I go to the lounge or stay in my room if I want to’. At the time of this inspection staff were observed to interact very positively with residents and treat them with respect, protect their dignity and assist them appropriately throughout the day. Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are being supported by staff to participate in social activities and are able to retain the ability to make personal choices. There was a general satisfaction with meals provision at the home. EVIDENCE: Discussion with residents and relatives (and observations made on the day of inspection) indicate that the routines of daily life in the home are as flexible as possible in a communal setting. Residents stated that they are able to choose what time they get up and go to bed, what activities to engage in and feel that staff inform and consult them about the care and support they need. Clearly this is very important in enabling residents to retain as much control over their life as possible. The arrangements for providing social and leisure activities are satisfactory. Activities at the home are organised by the home’s activities co-ordinator. A varied programme of activities/pastimes/outings is provided. The programme of activities has been reviewed in recent months (following consultation with residents). Entertainers are booked on a regular basis. Residents and relatives Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 Page 13 spoken to on the day of inspection were of the view that the range of activities provided was good and had improved in quality and quantity in recent months. Residents wishing to maintain their religious links are enabled to do so. The home has an open visiting policy. There are no restrictions on the time people visit. The only time restrictions would be imposed is when requested by residents. Relatives spoken to during the inspection said they were always made welcome at the home and were able to see their relatives in the privacy of their own room or in the ‘quite’ lounge. Residents spoken to expressed satisfaction with care provided and organisation of life at the home. Observation of care practice and information in care plans indicated residents are encouraged to make choices. For example what time they like to get up/go to bed. While some residents chose to sit in the lounge a number were observed to spend their time in their own rooms. Meals are cooked on site in the home’s kitchen. Menus are varied and balanced and residents spoken to say they are provided with a reasonable choice. Meals are served in a designated dining area within the large main lounge. This is an appropriately furnished room that provides a comfortable area for residents to have their meals. Residents’ meal times are as reasonable and as flexible as they can be in a communal setting. Lunch was observed on the day of inspection. This was a hot and substantial meal and staff supported and served residents with their meals appropriately. Discussion with residents revealed a general satisfaction with the meals provided. Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives knew how to make a complaint if they felt it necessary. Written guidance and training arrangements ensure that staff members have knowledge of abuse and protection arrangements and safeguards were in place to protect the welfare of residents. EVIDENCE: The complaints procedure was prominently displayed in the home and included details of how to contact the CSCI – however this information needs to be amended to reflect the recent change in these contact details. Residents and relatives spoken to on the day of inspection and in completed pre-inspection surveys said any issues brought to the home’s attention are responded to quickly and don’t become formal complaints. Policies and practices aimed at protecting residents from abuse are in place. Also Bury’s inter agency protection procedure is held on site. Training records indicated that approximately half the staff had received recent adult protection training at the time of this inspection. The inspector was informed that plans had been be made for the remaining staff to receive such training in the near future. Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and appropriate environment to accommodate, care for and support residents. EVIDENCE: A tour of the premises revealed that the home was very clean and free of malodour. Discussion with residents and their relatives revealed that the home is regularly cleaned to a high standard. The lounges and dining area provide appropriate and comfortable communal areas for residents. These areas have been maintained to a good standard and it was evident an ongoing programme of redecoration and refurbishment was in place. Most bedrooms were inspected on this occasion – these were clean, Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 Page 16 warm, suitably ventilated, personalised and comfortable. A significant number of bedrooms have been refurbished and this too is an ongoing project. Residents are encouraged to bring personal items into the home and this creates a more personalised atmosphere in resident’s own rooms. Appropriate measures to prevent the spread of infection were in place – including adequate hand washing/cleaning facilities, laundry and sluicing arrangements, provision of disposable gloves and aprons for staff, adequate provision of house keeping staff and appropriate arrangements for the disposal of waste. Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are generally satisfied with the care they receive to meet there needs. Recruitment and training systems that are in place seek to protect residents EVIDENCE: Staffing records indicated that a qualified nurse was on duty at all times and that, in addition to care staff, the home employs cooks, kitchen assistants and a maintenance worker to ensure that residents needs can be met appropriately. Inspection of staffing records, discussion with residents, the senior nurse on duty revealed the care and support needs, of the 37 residents living at the home at the time of this inspection were being met. The home has made good progress in the provision of NVQ 2 and 3 training although at the time of inspection under 50 of the care staff had received such training. The home is striving to achieve a minimum of 50 by providing appropriate training. 3 staff recruitment files were inspected. They contained evidence of CRB checks (including POVA first checks), 2 written references, health declarations, Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 Page 18 criminal convictions declarations, proof of identity, (including a photograph) and completed application forms. Discussion with staff indicated that they were provided with induction training on commencing employment. There was also evidence of moving and handling, fire safety, first aid, protection of vulnerable adults and other training provision for all staff at the home. The home has been working in conjunction with Bury adult training to ensure that the induction and ongoing training provided by the home meets the common foundation standards and other requirements of ‘Skills for Care’ (part of the Sector Skills Council). Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31.33.35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was being adequately managed in a way that enables residents, their relatives and staff to feel that they are being supported properly. However the post of registered manager was vacant at the time of this inspection. EVIDENCE: The post of registered manager was vacant at the time of this inspection. The home is legally required under the Care Standards Act (2000) to appoint such a manager. However discussion with the registered owner of the home and his colleagues revealed that the person who was to be nominated for that role had recently left to develop their career. The registered owner was aware of the Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 Page 20 need to appoint a manger that will be ultimately registered with the CSCI and was clearly actively seeking to recruit such a person by advertising widely. Currently the home is being managed by the deputy manager and qualified nursing staff that in turn are supervised and supported by the registered owner and his colleagues. These arrangements appear to be reasonable until an appropriate manager is recruited. The home has developed and operates a quality assurance system to measure residents, their relative’s and visiting health/social care professionals satisfaction, with the level of care and accommodation provided. This is essential as such information will enable a quality improvement plan to be fully developed and implemented to further improve the quality of life for residents. This system could be further improved by introducing regular audits (by an appropriately qualified person) of care records and residents medicines as well as other important areas in the home such as social activities, catering, complaints/protection, the home environment, staff training and management processes generally to ensure practices in the home are of as a high a standard as possible. Measures were in place to ensure that residents’ financial interests are safeguarded. Residents are encouraged to control their own money. However where they are unable (or choose not to) personal allowances are managed by the home. The arrangements for this were secure and appropriately documented. The health, safety and welfare of residents and others is promoted and protected. For example staff are provided with regular training and appropriate equipment to ensure resident’s moving and handling needs are met. An example of this would be for a resident who needs to be safely moved with the aid of a hoist. Fire safety training is regularly provided. Information provided by the home indicates that electrical/gas/other equipment safety inspections/servicing has been carried out. Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 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 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 X X X 3 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 2 X 3 X 3 X X 3 Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 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 OP8 Regulation 15 17 Requirement That the CSCI is informed in writing that all residents care plans and risk assessments (including monitoring of residents body weight) are being formally evaluated at least monthly. Timescale for action 31/12/07 2 OP9 3 OP16 4 OP31 That the CSCI is informed in 31/12/07 writing that the procedure for the receipt of resident’s medicines into the home has been reviewed and a record of all medicines received is maintained. 22(6) Confirm in writing to the CSCI 31/12/07 that the complaints procedure operated by the home has been amended to detail the current contact details for the CSCI. Section 11 That the CSCI is informed in 31/12/07 Care writing what progress has been Standards made in recruiting a registered Act 2000 manager for the home. 13(2) Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 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 OP9 Good Practice Recommendations That all handwritten entries on resident’s medication administration records are checked and signed by 2 people. The purpose of this is to protect residents (and staff) by minimising the risk of a mistake being made. Bank House Nursing Home DS0000017315.V337591.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 DS0000017315.V337591.R01.S.doc Version 5.2 Page 25 - 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. 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