Inspection on 12/01/06 for Bankfield House Care Home

This inspection was carried out on 12th January 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bankfield House Care Home 22/08/07

Bankfield House Care Home 21/07/06

Bankfield House Care Home 01/06/05

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 Bankfield House Care Home Bankfield Road Woodley Stockport Cheshire SK6 1RQ Lead Inspector Sylvia Brown Announced Inspection 12th January 2006 08:00 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 Bankfield House Care Home DS0000062991.V270060.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. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bankfield House Care Home Address Bankfield Road Woodley Stockport Cheshire SK6 1RQ 0161 406 6468 0161 406 6467 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) Freshfield Care Ltd Mrs Susan Pyatt Care Home 24 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (24), of places Physical disability (4) Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 24 service users to include: *up to 4 service users in the category of DE(E) (Dementia over 65 years of age). *up to 4 service users in the category of PD (Physical disability). *up to 24 service users in the category of OP (Old age not falling within any other category). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 1st June 2005 2. Date of last inspection Brief Description of the Service: Bankfield House is a large, detached, property standing in its own grounds in the Woodley area of Hyde. Its placement is secluded and private, offering residents peaceful surroundings. The home currently provides accommodation for 24 residents over the age of 65 years. There is a small conservatory for those residents wishing to smoke. Two lounges and an additional conservatory are non smoking. The dining room is used at meal times and throughout the day for visiting and activities. Bedroom accommodation offers single and double rooms. Externally, there are large gardens and lawned areas for residents use during fine weather. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Bankfield was announced and took place over one day, commencing at 8am and finishing at 4pm. The inspection itself was centred on the home’s administration systems and its development since April when the new owners took over the home. The inspector case-tracked two residents who had moved into the home through the rapid response system. Both residents were short term placements and were expecting to return to their own homes in the near future. The inspector was able to consult with the two residents and obtained their opinion on how they were being supported. Prior to the inspection questionnaires were sent to residents, relatives and professional visitors to the home. Three were returned by residents, six by relatives and one by a medical practice. Furthermore, one relative wrote a letter to the inspector praising the home and staff team for their dedication and service, the letter details many positive aspects of service provision which were observed at the inspection. Some of the comments received from the comment cards and letter are included within the summary and body of the report. The home also completed a pre-inspection questionnaire, the details of which have been included in the report, where applicable and relevant. Since the last inspection one of the CSCI pharmacist inspectors has visited the home and undertaken an inspection of the management, recording, safekeeping and disposal of medication and an additional report was sent to the home following the inspection. Feedback was provided at the conclusion of the inspection to the registered owners who were present throughout the inspection. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Whilst the inspector appreciated that the home has been working hard to maintain a consistent standard in care delivery, some administration processes require development to ensure record keeping is consistently maintained to the correct standard. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 7 The home had been informed that it should issue terms and conditions of residency to all persons as near as possible to admission, regardless of the fee structure or period of residency. Short stay admissions should identify clear aims and objectives of the placement and ensure that systems are in place to support and evaluate residents’ progress or decline as they attempt to rehabilitate. Recruitment and selection processes need to be more stringent to protect the vulnerable adults. Further consultation with the fire authority is required and/ or action should be taken to ensure full compliance with the fire safety report issued in June. 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. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 8 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 Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 5 & 6 Residents receive information about the home and are able to visit prior to making any decisions about their future, however there is a lack of information for short-stay residents regarding the continuous assessment process and it may affect their return home.. EVIDENCE: Inspection of records confirmed that residents receive some information about the home prior to moving in. They are also invited to visit the premises and evaluate the day to day routines of residents and staff and tour the building prior to making any decisions about their future. The home’s statement of purpose and service user guide are currently under review. Once updated, copies of both documents will be submitted to the CSCI and be made available to the public. Currently, older versions are on display within the home. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 10 Evaluation of the residents’ files identified that two short stay residents did not have copies of the home’s terms and conditions of residency on their files. It was unclear if they had been issued and not returned, or not issued. It is essential that residents are fully aware of the home’s terms and conditions of residency and agree to them prior to being accommodated. Both residents had Social Services’ service contracts on file. It was evident that both short-stay residents had stayed beyond the contract dates. The residents had not been appropriately informed why they were not returning home or why their stays were being extended and for how long. Such processes leave residents confused and anxious, which is detrimental to their health and wellbeing. Though basic, both residents had brief assessments on file completed by the hospital social worker prior to their admission. Further assessments had been completed by the home. The home does not provided ‘full’ intermediate care services, however they do care for residents who are admitted from hospital and who once fully recovered do return home. The inspector could not identify how the home was informed of the aims and objectives of each placement and what goals were set to monitor the residents’ recovery and self caring abilities. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 11 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 Residents have their personal and health care needs met through care planning and delivery in a respectful manner. EVIDENCE: All residents have written care plans in place. The registered manager evidenced that the care planning process was under review and new care records were shortly to be introduced which should ensure improved recording systems. As stated previously, the two files evaluated failed to have clear goals set out or information on how staff were to specifically assist and support the residents to achieve sufficient independence to enable their return home. The records also failed to evidence that residents had been consulted about their care or that they had agreed to the support programme. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 12 The returned questionnaires clearly demonstrated that relatives were, in the main, informed, with one relative stating, that they “found staff helpful and always ready to talk about their parent”. All residents’ comment cards identified that residents felt well cared for and respected, with one saying “staff are caring and efficient and I would not like to live anywhere else”. Residents spoken to stated that staff were pleasant and, when asked, confirmed that should they require assistance in the night, staff responded promptly when the call bell was activated. Residents’ health care needs are met, with records maintained of all visiting professionals. Residents who required physiotherapy were receiving the required treatments and were encouraged by care staff to continue with their physio routines. Following the inspection by the pharmacist inspector, the home received a report which detailed required and recommended improvements. In response the home returned confirmation that they had complied with all requirements and recommendations made. During the present inspection, the inspector evaluated the work undertaken and can confirm that, in the main, the home was maintaining the required standard. Further advice was sought from staff and the registered manager regarding the process of recording temperatures for medication which required refrigeration and the full process for witnessing the administration of controlled medication. Development of self-administration of medicines for residents returning to their own homes is necessary. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 13 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 Residents live self directed lifestyles which enable them to make their own decisions, as far as possible. EVIDENCE: The pre-inspection questionnaire detailed a variety of activities which are undertaken at the home for residents’ pleasure. During the inspection a number of notices were displayed regarding activities for the month of January and future events. Of the three residents’ comment cards received, one stated there were sufficient activities, another stated they were insufficient and the other stated that it varied. Records prior to September were fairly well maintained regarding activities undertaken; they included who had taken part and feedback from residents, however there was little information from September onwards. The registered owners stated that the activities organiser had changed and that there had been some difficulties maintaining recording standards. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 14 At the time of the inspection a ‘Pat Dog’ was on the premises with its owner spending time with individuals chatting to them whilst they petted the dog. The home has also purchased its own mini-bus which the inspector was informed had been used. Admission records detailed that residents are asked their preferred rising and retiring routines. Residents were observed to be rising when they wished and receiving their cooked breakfasts freshly made as they desired. A variety of hot foods were prepared in various forms to meet residents’ requests. A number of residents prefer to remain up late watching television together. They stated that they receive food and drink as they wish throughout the evening. Records demonstrated that residents’ preferred retiring times were maintained. In the main, residents spoke well of the food. One resident, who moved in late on Christmas Eve, was so pleased with the Christmas meal she was still impressed with the service and informed the inspector “It was truly lovely”. She stated it had helped ease her distress at having to move in over Christmas and enabled her family to be less anxious because she was not missing out. “It was so beautiful”, she stated. Nutritional assessments are completed and records maintained regarding what individuals have received. Residents’ meetings are in place and arrangements have been made to commence friends and family meetings in February. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 15 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 The home’s complaint procedure is known by residents and has been used appropriately. EVIDENCE: The pre-inspection questionnaire stated that two complaints have been recorded within the previous 12 months, one of which was referred directly to the CSCI. The home’s complaint procedure is displayed in the home and information is provided to residents and families prior to and at the time of admission. The residents’ comment cards identified that they had no cause for complaint and felt well cared for. Relatives’ comment cards confirmed they were aware of the home’s complaints procedure. Two of the relatives stated they had accessed the complaints procedure when required. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 16 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, 23, 24, 25 & 26 Residents live in pleasant surroundings which require some upgrading but which are safe. EVIDENCE: Planning permission has been granted for Bankfield House to be substantially upgraded and refurbished. Significant structural work is planned in order to extend the home. Additional lounges are also expected, as are facilities which will enable residents and visitors to independently make light snacks and drinks. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 17 Discussions have been held between the registered owners and the CSCI regarding how the work will be completed. It has been agreed that the work will be carried out in phases, over a lengthy period of time, in order to minimise disruption to residents, as far as possible. Plans of the proposed upgrading are displayed in the home and the registered owners intend to hold regular meetings with residents and visitors to keep them informed of progress, whilst at the same time enabling them to feed back on how or if the work being undertaken is causing difficulties. It is therefore recognised that Bankfield House will for some time look as though it needs redecorating and upgrading to meet best current standards. Notwithstanding that, the home was clean and fairly well presented at the time of the inspection. In addition to professional services, a handy person supports the home to maintain safety standards and attend to day to day repairs as they arise. When spoken to, residents indicated their satisfaction with their rooms and the general comfort of the home. Toileting and bathing facilities are in place, all of which are fitted with a call system to enable residents and staff to summon assistance when required. Currently, three lounges enable residents to meet communally during the day and evening. There is a conservatory designated for residents who wish to smoke. All rooms are well lit with ample windows which provide lots of natural light. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Residents receive timely support from trained staff and have their needs met, however their safety is compromised by staff who commence duty before statutory checks are in place. EVIDENCE: One relative’s comment card stated that, on occasions, staffing levels are not as stated. The registered owners confirmed that, on occasions, staff have not turned up for duty as planned. As a consequence, either contracted staff have taken on additional hours or they themselves have completed the duty. Both owners were able to demonstrate duties completed, including night-times. Residents stated that staff attended to them promptly when required and did not find any significant issues arising because of staff shortages. The home has had some staffing changes since the previous inspection. Currently, the home is advertising for one night and two daytime care positions. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 19 Evaluation of staff files identified that staff contracts had not been returned to confirm they had been issued, seen and agreed. Systems should be introduced to ensure that contracts, temporary or otherwise, are issued at the time of employment. One file failed to contain an up to date photograph. Furthermore, due to some significant delay on behalf of the Criminal Records Bureau, checks had not been received for some staff prior to them commencing employment. Although the registered manager stated these people did not work alone, it is imperative for the safety of residents that checks are in place before employment commences. Advice was given regarding POVA First checks and how they can be obtained quickly. Staff continue with their training. NVQ training is seen as a priority for all staff, however infection control and first aid had not been undertaken by all staff, particularly ancillary staff. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 20 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): 34, 35, 36 & 38 Service users’ rights and health and safety are protected by effective policies and procedures. Staff induction and foundation training require implementation, as does formal supervision. EVIDENCE: Bankfield House does not undertake to manage any of the residents’ finances. When expenditure occurs, residents have their own finances or are invoiced for goods purchased. Currently, residents are consulted on what they require and systems ensure that shopping is obtained daily. However, future plans are to incorporate a ‘shop’ within the home once refurbishment has been completed. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 21 Advocacy services are available and information is provided when independent professional advice is required for legal matters. Though staff receive day to day supervision and guidance, it was evident that formal supervision was not completed at the required frequency. Furthermore, though new staff complete the home’s induction training, induction and foundation training standards set by Skills for Care was not met. In June 2005 the home was inspected by the fire authority. This inspection identified action required to meet safety standards. After evaluation it was evident that further consultation was required with the fire authority for clarification on some matters and some action by the home was outstanding to ensure compliance. Some health and safety records were evaluated and found to be maintained correctly. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 3 X 3 2 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 3 2 X 2 Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP7OP6 Regulation 14, 17 & Sch 3 Requirement Timescale for action 01/04/06 2 OP29 7, 9, 19 & Sch 2 3 OP30 13(3) 4 OP36 18(2) The registered person must ensure that goal setting and plans of support are evident for those residents who are undertaking forms of rehabilitation, including the promotion of independence. 12/01/06 The registered person must ensure that rigorous recruitment and selection procedures in place are followed at all times. (Previous timescale of 01/06/05 not met). The registered person must 06/06/06 ensure that all levels of staff have up to date infection control and first aid training. The registered person must 01/04/06 ensure that care staff receive formal supervision no less than six times a year and more frequently if required. Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 24 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. 5 Standard OP38 Regulation 23(4) Requirement The registered person must consult further with Fire Safety officers regarding the report of the June inspection and comply with all requirements and recommendations made. (Previous timescale of 05/07/05 not met). Timescale for action 01/04/06 Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 25 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 OP2 Good Practice Recommendations The registered person should ensure that all residents receive and agree the home’s terms and conditions of residency prior to, at the point of, or as close to admission as possible. The registered person should introduce systems for informing short-stay residents about their stay when extended by the Local Authority. Clear processes should be evident as to why the extension is required. The registered manager should introduce an accurate process of assessment which clearly identifies residents’ achievements and/or deterioration when working towards rehabilitation and set goals. The registered person should ensure recording systems include residents’ participation in activities. 2 OP2 3 OP7OP6 4 OP12 Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Bankfield House Care Home DS0000062991.V270060.R01.S.doc Version 5.1 Page 27 - 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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