Inspection on 04/11/08 for Bank House Nursing Home

This inspection was carried out on 4th November 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bank House Nursing Home 15/11/07

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 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bank House Nursing Home Brandlesholme Road Bury Lancashire BL8 1DJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Murphy     Date: 0 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Bank House Nursing Home Brandlesholme Road Bury Lancashire BL8 1DJ 01617644358 01617629825 enquiries@bankhousecarehome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Alan Stott Type of registration: Number of places registered: care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: 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) Date of last inspection Brief description of the care home 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; 364.95 pounds to 500.00 pounds (information provided by the home). Further information can be obtained by contacting the home manager. Details of previous inspection reports can be accessed through www.csci.org.uk Care Homes for Older People Page 4 of 26 Over 65 43 0 0 1 Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection included an unannounced visit to the home on the 4th of November 2008 between 9am and 430pm. During the visit we talked to residents, relatives, staff, the home manager and the owners of the home. We also looked at documents and records the home have to keep such as residents care records, medicine records, written policies and other records. We were accompanied on the inspection by an expert by experience. This is a person who has experience using or has experience of care services and participates in the inspection by seeking the views of those who use the service about how well they feel they are being cared for and supported. Before the inspection, we also asked the registered manager to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of Care Homes for Older People Page 6 of 26 the home sees the service they provide the same way that we see the service. We felt this form had been completed in sufficient detail and provided useful information. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Before being admitted to the home residents have their care and support needs assessed to ensure the home is able to meet their needs. Evidence: All residents have a pre-admission assessment before being admitted to the home. This is conducted by the home manager who is a registered nurse and has many years experience in managing care homes for older people. The purpose of this assessment is to decide if the home will be able to meet the potential residents care and support needs properly. It also helps prospective residents and their relatives in their decision of how appropriate the home would be for them. A record of the pre-admission assessment is kept in each residents care records and identifies what care and support they will need. Other pre-admission assessments conducted by social workers and health care workers were also kept in the care records. Discussion with residents indicated that their views were taken into account before admission to the home. Care Homes for Older People Page 10 of 26 Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of residents including specialist health needs were being appropriately met. However the reorganization of care records needs to be completed to ensure residents are confident their care and support needs are being properly addressed Evidence: The care records of four residents were inspected on this occasion. All had care plans and risk assessments in place that describe how residents are to be cared for and supported. The new manager was in the process of re-organizing and reviewing all residents care records. We inspected two that had been newly completed and two that were still on the previous sytem. Those on the new system were much better organized, care plans and risk assessments were written in a plain way making them much easier for staff to use, and it was evident that residents and their relatives were involved in their development and review. The care records of all residents should be to this standard. Discussion with the manager indicated that this was what the home was moving towards. Care Homes for Older People Page 12 of 26 Evidence: The arrangements to look after residents medicines have been completely reviewed by the new manager. The new system is well organized, safe and is checked on a regular basis by the manager. All residents are registered with a local GP and are able to acess the services of chiropodists, opticians, dentists and other providers of health care. Residents spoken to said staff spoke to them respectfully and maintained their dignity, particularly when personal care was being given. Comments made included the staff are very polite and treat me nicely, they always knock before they come in and chat to me while they are helping me, they are kind and considerate and very caring. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are able to enjoy a stimulating lifestyle with an extensive variety of social and leisure activities to engage in. Residents are helped to make as many personal choices in their daily lives as possible, and the general view of food provision is very positive. Evidence: We were accompanied on the inspection by an expert by experience. This is a person who has experience using or has experience of care services and participates in the inspection by seeking the views of those who use the service about how well they feel they are being cared for and supported. The visiting expert by experience observed that the welcome to the home was warm and friendly and she was shown around the home and introduced to people by the home manager. Residents appeared to be well cared for, well groomed and suitably dressed. Those who were not wearing socks or stockings said this was of their own choice and that the home was always warm. It was evident from conversations with residents that there was regular access to a visiting hairdresser. A number of residents were having their hair done during the inspection. Our expert by experience was of the view that the home appeared to be suitably equipped and adapted for the benefit of Care Homes for Older People Page 14 of 26 Evidence: residents and that staff helped them sensitively and appropriately. Also residents rooms were suitably furnished, comfortable and personalized with residents own belongings. It was noted that residents were provided with hot and cold drinks and biscuits during the morning. A number of the residents were quite frail and several choose not to join in activities because of this or simply because they do not want too. There is a programme of activities that take place in the afternoon, trips out (for example a recent trip to Blackpool illuminations), and entertainers also come to the home about once a month. The manager has recently consulted residents and relatives about activities in the home and is in the process of reviewing this provision. The expert by experience took lunch with some of the residents. Tables were well set. However it is suggested the provision of napkins would enhance this. Staff served and assisted residents appropriately and attentively. The food was described as being very good, and portions were suitable and attractively presented. Our expert by experience described lunch as a pleasant experience for me and the others sharing my table. Menus are prominently displayed, are varied and provide choice. One person visiting the home commented their relative was being cared for well at the home. A chaplin visits the home each week. And a minister was visiting the home on the day of inspection. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People 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: People spoken to said they were aware of how to complain if they felt it was necessary. They said the owners and manager of the home have high profile in home and are readily available and constantly engage with residents, relatives and staff and encourage people to raise issues so they can be dealt with without the need to become formal complaints. There is a formal complaints procedure in place and this was prominently displayed in the home. A record of complaints made is kept by the manager. There had been 1 complaint since the last key inspection. The record showed details of the complaint, how it was investigated, what action was taken and the outcome of the investigation and how the outcome was communicated to the person making the complaint. There are proper arrangements in place to ensure that residents are kept safe and protected from abuse. There are good policies in place to guide staff how to respond to suspicions or evidence of abuse. The home manages any such incidents appropriately. Staff spoken to were aware of the nature and importance of keeping residents at the Care Homes for Older People Page 16 of 26 Evidence: home safe. They confirmed they had been provided with training in safeguarding residents. This was confirmed by discussion with the manager and inspection of training records. The way the home recruits new staff also seeks to protect residents from abuse. Police and other checks help to make sure residents are being cared for and supported by suitable people. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a clean, pleasant, comfortable and suitably adapted environment for residents. Evidence: The building appeared to be in a good state of repair and decoration. The lounges and dining areas were clean, appropriately and adequately heated, comfortably and appropriately furnished and provided a suitable and safe environment for residents to be cared for and supported properly. Televisions, music centres and other leisure equipment were available throughout the home. Suitably adapted bathing and toilet areas were provided. The home has generally been suitably adapted and equipped to meet the needs of residents. For example there is an adequate provision of hoists, grab rails, passenger and stair-lifts and other equipment. Individual residents specialist needs are met after referral to the appropriate health care worker fro assessment. Residents bedrooms that were inspected were clean, suitably furnished and equipped and personalized. The home was very clean and odours were managed well. Suitable arrangements were in place to manage residents laundry needs. And appropriate measures were being taken to minimize the potential spread of infection within the home such as adequate hand washing facilities and the provision of protective clothing for staff as well as Care Homes for Older People Page 18 of 26 Evidence: appropriate cleaning practices within the home. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing arrangements, staff recruitment process and the training arrangements at the home seek to ensure residents are cared for and supported safely and appropriately. Evidence: Staffing arrangements at the home were supporting residents and ensuring their needs were met. There is always a qualified nurse on duty who leads a team of carers. Discussion with residents revealed they were of the view sufficient staff were available to make sure they were looked after. There are also appropriate arrangements were in place to ensure there were sufficient staff in respect of the administration, catering, laundry and housekeeping functions of the home. There is a proper process in place in respect of recruiting staff. This important to ensure residents are being cared for and supported by suitable people. The recruitment process included making police checks and another check regarding the suitability of the applicant working with vulnerable people. The arrangements for training staff ensure that residents care and support needs are being met by competent staff. Discussion with the manager, staff and inspection of training records revealed that a well organized and suitable training programme is in place in respect of all staff employed at the home. Training is provided at the home (the manager holds a teaching qualification) and through the local authority training Care Homes for Older People Page 20 of 26 Evidence: partnership. Training records were detailed and up to date. Over 60 of the care staff have obtained a national qualification in care (NVQ). The remaining carers were undergoing this training or expected to do so in the near future. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was being managed in the best interests of residents. However the home manager needs to (as legally required) make an application for registration to the CSCI Evidence: The home manager has been in post since May 2008. She is a qualified nurse and has had many years experience managing care homes for older people. We were informed that it is intended to the home manager to be the registered manager of the home. This means that the manager will apply to be registered as the manager of the home with the CSCI. This is a legal requirement and the process should begin as soon as possible. Discussion with residents, relatives and staff indicate that the manager makes herself available, is approachable, listens and manages the home properly. The home manager has introduced checks to ensure the home is being managed properly. For example she checks and documents how good or effective things like Care Homes for Older People Page 22 of 26 Evidence: care records are, how safe medicines are being handled and how safe and comfortable the environment is for residents. The manager also meets regularly with residents, relatives and staff to establish their views. This is important as these people need to be confident their opinions are listened to and acted upon. Residents are encouraged to manage their own money. However where this is done by the home the arrangements are secure and appropriately documented. There are arrangements in place to ensure as far as is practicable the health, safety and welfare of residents, staff and visitors. For example action has been taken to ensure the safe storage and disposal of hazardous substances, regular servicing of boilers and the central heating system and other equipment, and the proper maintenance of electrical and gas systems in the home. Also safe practices are encouraged by the use of proper moving and handling techniques and equipment, fire safety provision, first aid training for care staff, food hygiene training and measures to prevent the spread of infection. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 31 8 That action is taken to ensure that the home manager is registered with the CSCI. To comply with the requirements of the Care Standards Act (2000) in respect of having a registered manager. 13/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 That the the re-organization of all residents care records is completed to ensure such records are all of the standard of those already completed. Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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