Inspection on 12/05/08 for Bankfield Premier Care

This inspection was carried out on 12th May 2008.

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

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 Premier Care 13/01/09

Bankfield Premier Care 04/12/07

Bankfield Premier Care 12/07/07

Bankfield Premier Care 23/06/06

Bankfield Premier Care 01/11/05

Bankfield Premier Care 07/06/05

Bankfield Premier Care 14/09/04

Bankfield Premier Care 20/04/04

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 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Bankfield Premier Care Gigg Lane Bury Lancs BL9 9HQ Lead Inspector Julie Bodell Unannounced Inspection 12th May 2008 07:00 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 Premier Care DS0000008398.V363852.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. Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bankfield Premier Care Address Gigg Lane Bury Lancs BL9 9HQ 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 8552 0161 761 3689 deniserimmer@bankfield.org www.bankfield.org Mr David Arthur Hopkins Denise Rimmer Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (47) of places Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 47 service users to include:*Up to 47 service users in the category of OP (old age not falling within any other category). 4th December 2007 Date of last inspection Brief Description of the Service: Bankfield Premier Care Home is a care home providing personal care for older people over 65 years of age. It is a large purpose-built detached home situated in a residential area of Bury, close to Bury football club. It is close to main bus routes and is approximately 3 miles away from Bury town centre. There is limited parking to the front of the home for the use of staff and visitors. There is a large enclosed courtyard at the back of the home. This has a well-stocked garden area and plenty of seating for the residents. The home is registered to care for 47 residents and provides accommodation on the ground and first floor. Most of the bedrooms are single rooms and 22 of the single rooms have an en-suite facility of toilet and wash hand basin. The bedrooms on the first floor are reached either by stairs or a passenger lift. There is one large dining room and several lounge areas. Several of the toilets and bathrooms have aids to assist any resident with a disability or mobility problem. Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This inspection took place over one day and involved two inspectors. The home did not know that we (the commission) were going to visit. During the inspection time was spent, talking to people that live at the home, the registered manager, the deputy manager and five members of the staff team. We also looked at paperwork and parts of the home. As part of the inspection process the registered manager completed a quality review of the service (AQAA) as requested. Feedback surveys were received from five people living at the home, seven relatives and friends and ten members of the staff team. What the service does well: What has improved since the last inspection? People receive their medication as prescribed and records are maintained accurately and show that people are given their medicines properly and can be fully accounted for. The registered manager and the deputy manager have received up-to-date training in local safeguarding adults procedures to ensure that if an allegation is made about abuse they are clear about what action is to be taken to protect people who live at the home. Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 6 Most of the support staff team i.e. domestics, laundry assistants etc, have received training in control of infection practice, which will help to reduce the opportunity of cross infection. The registered manager and the staff team have worked hard to improve standards at the home but these improvements must be maintained, particularly around health and safety practices. There are now clear lines of accountability within the home and with external management to ensure that the home runs smoothly and in the best interest of the people who live there. The organisation has a new head of care. This person is very approachable and offers a good level of support to the registered manager. She is also reviewing the organisations policies and procedures to ensure that they are up-to-date and effective to use. 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. Bankfield Premier Care DS0000008398.V363852.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 Bankfield Premier Care DS0000008398.V363852.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): 1 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient information needs to be available to people about the home so that they are clear about what service they will receive. EVIDENCE: The statement of purpose needs to be reviewed and revised to reflect recent changes to the service. A service user guide needs to be developed that gives clear relevant information about what people can expect if they choose to live at the home. It should be in a format, which people will easily understand, for example appropriate language, large font, pictures etc. The head of care is in the process of completing this task. People are not admitted to the home until a community care assessment has been undertaken by a qualified social worker. Where the assessment has been undertaken through care management arrangements, the home receives a Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 9 copy of the assessment. Since the last inspection one new person has come to live at the home. We checked the care records for this person and a community care assessment had been carried out by a placing social worker prior to admission. A relative stated in a returned survey that, “Mum has been at Bankfield for over five and a half years and we have never regretted our choice on her behalf.” Another stated that, “We looked at fifty homes before choosing Bankfield.” The home also carries out their own assessment before agreeing to admit a person to ensure that they can meet their needs. The registered manager or an experienced member of staff undertakes the assessment. The assessment involves the individual and their family or representative, where appropriate. The assessment format used by the home covers all personal care needs including, physical wellbeing, personal hygiene, breathing, mobilisation, eating and diet, elimination, continence, vision, hearing, dentures, chiropody, history of falls, personal safety and risk, weight, hobbies and orientation. We had some concerns about the home’s ability to meet the needs of a person who had recently returned to the home following a period of time in hospital. Their care needs were very high. We were informed that it had been the expressed wish of the person and their family to return to the home. District nurses were supporting the care staff team to care for this person. This situation needs to be kept under review. Bankfield Premier Care DS0000008398.V363852.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 good. This judgement has been made using available evidence including a visit to this service. Care planning and the safety of the medication system were good but some attention to detail is still needed when completing healthcare risk assessments to ensure information is accurate so that people can be cared for effectively and safely. EVIDENCE: From the assessment information a care plan is developed. A new care planning system has been introduced at the home. The new system has helped to improve the written information available to carer’s supporting people. Where appropriate a relative of the person using the service signs the plan. Risk assessments are also undertaken across a number of areas. For people whose care records were examined risk assessments were in place for moving and handling, risk of falls, the MUST tool, including weight checks, and prevention and management of pressure areas. We looked at the risk Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 11 assessments of four people. We found some minor discrepancies on the scoring on risk assessments against the information available. Attention to detail needs to be taken to ensure that all relevant information about a person is transferred onto risk assessments for example, moving and handling assessments so that people are given the right level of support. A member of the care staff in a returned survey commented that the present arrangements around the chiropody service provided could be improved. The managers’ of the home closely monitor the medication system and action is taken to address any issues arising with individual staff members through the auditing process. The supplying pharmacy undertook an audit of the system on 12.02.08. No issues were identified. All staff members who administer medication have been trained to do so. A signature sheet was in place. Medication is held in two trolleys, which are securely held, in a locked room, when not in use. We observed drinks being given to people to help them take their medication. A lot of time was spent observing people to ensure that they had taken their medication. Hand written transcribes were double signed and PRN details about when and how often medication was to be given were in place. Records were kept to show what was given and when medication was refused. Controlled drug records were good and the stock was correct. Medication is administered in the dining room. We were concerned that medication was being given until late into the morning and finished at 11am, which was close to the lunchtime administration time. We were also concerned that a number of people who required hoisting into a more comfortable chair were left sat in the dining room for long periods of time after they had finished their breakfast. The registered manager informed us that it had been recognised that this situation needed to improve. Plans to change the rota so that morning care staff members start at 7am instead of 8am had now been agreed. This will increase the overall staffing numbers at breakfast time. People were observed being treated in a courteous manner throughout this inspection. The care staff team were seen to be very busy, but interactions were observed to be good and they were very attentive and caring towards people. The atmosphere was relaxed. Care was taken to ensure that people’s privacy and dignity was maintained whilst involved in personal care tasks. People looked well cared for. Care staff members were seen to be polite and patient when assisting with mobilizing people and explained to them what was happening. Relatives in returned surveys stated that, “The staff are cheerful and try to be accommodating. They do a good job considering how many residents they take care of. They are kind and careful and my mum is very happy and tells me they are all very nice.” Another relative stated, “All the staff are caring cheerful, approachable and professional.” And “We are always struck by the dignity afforded to all the residents by the staff who support them.” Bankfield Premier Care DS0000008398.V363852.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. People are able to maintain contact with their families and friends but more opportunities for people to become involved in activities to encourage stimulation and interaction on a day-to-day basis are needed. EVIDENCE: At the last inspection an improvement in the activities programme for the home was noted. However findings at this inspection suggest that the improvements made and intended had not been maintained or progressed. Although the activities organiser was very keen, had attended an “Activity Management Course” and produced a timetable of activities, her ability to take a consistent approach to the task appear to have been hampered because her substantive post has yet to be filled. In returned surveys from relatives a number of people stated that they thought that activities were an area that could be improved and people using the service ticked that activities were only sometimes available. This issue has been raised previously in the homes own quality assurance feedback from relatives. Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 13 The radio was playing gently in the background and some people were reading the daily newspaper and magazines. Plans were in place for some people to go to a show at a local civic hall that week and for some people to go to Blackpool for the day on 26th June to the Bond Hotel. People had recently watched “Seven Brides for Seven Brothers” and enjoyed a sing a long with songs from the war time period, which had been a good talking point for people. A member of the care staff in a returned survey commented that the recent arrangements around the hairdressing service provided could be improved. There were many visitors at the home throughout the day and people could either go to people’s bedrooms or to quiet areas of the home such as the conservatory, to talk privately. People are encouraged to bring personal possessions into the home. Many of the bedrooms were personalised with small pieces of their own furniture, pictures, photographs and ornaments etc. A relative stated that, “My father prefers the quiet and privacy of his own room for parts of the day and the home has been very flexible and understanding in respecting his wishes to have his own space, while at the same time ensuring his safety.” We spoke with one of the two cooks at the home. The cook had been employed at the home for many years. A kitchen assistant was also on duty. The kitchen was found to be clean and tidy. In line with good practice the Safer Food Better Business the kitchen staff were completing documentation. People were asked earlier on in the day for their choice of meals from the menu. Some people had their meals in their rooms. People in returned surveys stated that they usually enjoyed the meals. The cook said that she would accommodate people’s individual requests for example one person had requested a Lasagne. A relative said that they would like to see fruit being offered more regularly to people as a snack. Bankfield Premier Care DS0000008398.V363852.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. People know who to speak to if they had a complaint and the majority of the staff team have received training in safeguarding awareness and are clear about their responsibilities in protecting vulnerable adults. EVIDENCE: There have been no complaints made to CSCI, or internally, about the home since the last inspection. The complaints policy and procedure has been reviewed and revised to ensure that it complies with legislation. In returned surveys people stated that they knew who to speak to if they had a complaint. There is an internal safeguarding policy and procedure that links to the local authority procedure. The home has a copy of the new local safeguarding procedures. Both the registered manager and the deputy manager have attended a two-day course in safeguarding procedures at an investigation level. There has been one allegation of abuse since the last inspection. The registered manager followed the correct safeguarding procedures by informing the local authority safeguarding co-ordinator and attending a strategy meeting to discuss the allegation. As part of the inspection we undertook a thematic probe and we discussed safeguarding with the registered manager and three members of the staff team. All those we spoke with had received training, were aware of the different sorts of abuse and they also understood what they should do if they suspected that someone was being abused. Bankfield Premier Care DS0000008398.V363852.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 21 24 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Bankfield provides a clean comfortable and homely environment for the people living there but ongoing planned improvements must continue to ensure that good standards are achieved. EVIDENCE: We looked around parts of the building with the registered manager. It was noted that ongoing work to improve standards at the home were being undertaken but had not gone as far as we had anticipated. Corridor areas have been repainted to improve their visual appearance. People living at the home have the use of any of two lounges, two conservatories and a large dining room, which has recently had a new floor covering laid. These rooms were pleasant and very homely. Now that decorating has been completed some corridor carpets need to be replaced to stop them presenting as a trip Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 16 hazard for people and improve the general appearance of the building. Some lounge chairs need to be replaced, particularly the “Kurtain” chairs and some that were omitting a malodour. The home has a detailed maintenance and refurbishment plan in place. The registered manager also undertakes regular checks of the home and compiles a list of areas of action for the housekeeping and maintenance staff. There is an enclosed courtyard and garden area that is safe for people to use. There are plans to develop this area into a sensory garden with raised flowerbeds. Toilets are within close proximity of communal spaces. Each toilet and bathroom had a lock on the door to ensure privacy and the facilities were all clearly marked. Following recent dementia awareness training, pictures have been put onto the bathroom doors to help people locate them more easily. Two toilets close to bedrooms have recently been refurbished. Plans are ongoing to upgrade the bathrooms and preparation work has already started. New specialist baths have been considered but locating a new bath to the upstairs bathroom has proved to be a more difficult task than anticipated. This matter needs to be addressed quickly to ensure that all people regardless of their physical condition can have a bath. We discussed again that given the substantial investment being made, the benefits of asking advise from a suitably qualified person, about the positioning of new baths to ensure that space was sufficient for moving and handling people by staff members to ensure that the baths could be used effectively. A new shower room is also planned. The bedroom doors were fitted with locks and each bedroom had a lockable space. The bedrooms were in many cases nicely arranged, particularly those overlooking the courtyard and some were highly personalised by families, some with fresh flowers. Many had televisions and a number had private phones. There are plans in place to replace some bedroom furniture. We were informed that this furniture had now been ordered. The home was clean and tidy throughout. It was noted that the home was short of domestics due to long-term sickness. Temporary cover is needed to ensure that good standards are maintained. We were informed that all staff members have now received control of infection training. The home has a laundry system that kills all known germs including MRSA. However, it was suggested by a staff member, that cross infection practices could be further improved by using the red bag system for transferring soiled items and sanitised plastic bags for incontinence pads. People commented in returned surveys that clothing sometimes went missing and that this was an area that could be improved. As requested previously the registered manager has checked out the suitability of cleaning products provided for the home, which are marked as office cleaning products in some cases. This has been done and Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 17 the registered manager is satisfied that they will achieve good hygienic standard and safe control of infection measures. Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff vacancies must be filled to ensure that there are enough to provide effective care and support to people. Progress must continue to ensure that the staff team receive the health and safety training they need to support people, safely. EVIDENCE: The rota’s for three weeks were examined and showed that there is generally five or six care staff members on duty in the morning and the afternoon, including the registered manager and the deputy, and four care staff members in the evening. There are three carers on duty at night. Cooks, a kitchen assistant, laundry assistants, a domestic, a receptionist and business administration support care staff members. The registered manager informed us that there had been a high turnover of staff at the home. There are currently a number of vacancies at the home including two part time care posts on nights, two part time care posts on days, two kitchen assistants and two temporary domestics. It was observed that the staff team were very busy throughout the day caring, in some cases, for people with very high levels of need. Some staff commented in return surveys that this combined with the fact that managers Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 19 are included in the rota and were often called away and the need to cover domestic support posts, meant that at times the staff team were very stretched and had little time to spend with people just to engage in conversation let alone activities. Feedback from staff members spoken with confirmed that they felt they were a good team of carer’s. In a returned survey a staff member commented that “Carer’s are dedicated and friendly and work hard to meet the needs of the service users.” Another commented that, “At Bankfield the service that is good is the carer’s, as we are respectful and give dignity and independence to all are residents and have good relationships with their family’s.” The registered manager informed us that there are currently 20 permanent members of day and night care staff at the home and of those, 15 hold an NVQ 2 or above. This figure exceeds the national minimum standard of 50 . We checked the recruitment files for two new members of the care staff team. They were found to meet legal requirements. The head of care has recently reviewed recruitment practices for the organisation. She has introduced a set of questions for registered manager’s to use when interviewing new staff. Questions include the prospective employees understanding of the importance of good health and safety practices, confidentiality, control of infection etc. For existing staff the head of care has put in place for carer’s who have been absent to due to ill health a return to work interview. For those staff leaving the home an exit interview to find out why the person is leaving with the intention of looking at ways to improve retention of staff in the future. The registered manager is a partner member of Bury Adult Care Partnership and is keen to make the most of the training available through the scheme. New staff members go straight onto the common induction programme that is linked to Skills for Care, through the Partnership. This will help keep staff training up to date and make the wider links with other agencies. The training skills plan at the home identifies that progress has been made but there are still some gaps in mandatory training required by care staff members. We requested an up-to-date copy of a training matrix to examine the progress made in more detail but we had not received this at the time of writing this report. Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager has worked hard to improve standards at the home but improvements must continue, particularly around supervision practices. EVIDENCE: The registered manager has 30 years experience of providing care to older people within the private sector and the NHS. She has been with the company for 5 years and has been the manager at Bankfield for 2 years and holds the Registered Manager’s Award. The registered manager plans to undertake three outstanding units of NVQ Level 4 in the near future. The registered manager is very committed to improving standards at the home. She said that she was more confident in her role and was delegating tasks more than she Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 21 had done previously. Some areas of improvement had not happened as quickly as she had liked but she was sure that what was planned would get done. A relative commented in a returned survey that, “Management and staff were always available and approachable.” The registered manager is supported by a middle management team, which includes a new head of care, a general manager and business administrator. The registered manager said that the new head of care was very approachable and dealt with any issues that were brought to her attention, quickly. The registered manager produces a weekly report that covers building maintenance, repairs, staffing issues etc, for the head of care. There are also regular meetings for the registered managers within the group, including deputy managers. The new head of care has started to undertake the monthly Regulation 26 monitoring visits. She has also introduced new quality monitoring forms for people living at the home and their relatives and friends. Supervision arrangements for the staff team from the registered manager received a mixed response from staff members we spoke with and from returned surveys. From discussions with the registered manager there was evidence that staff were raising any concerns they had with her and that they were being dealt with by the senior management team. The registered manager told us that she is carrying out more unannounced visits out of office hours and more staff meetings are being held. Formal supervision practices need to be developed as a positive experience to consolidate leadership and direction, improve communication and promote continuous professional development and best practice. Maintenance and servicing records were checked and were generally found to be in good order. There is evidence to confirm that ongoing improvements have been made in some areas of the service. The registered manager needs to ensure that these improvements are sustained. We will consider carrying out a random inspection in the future to check that this is the case. Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 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 2 X 3 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 3 2 X 2 X X X X 3 STAFFING Standard No Score 27 2 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 2 X 3 Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 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 OP1 Regulation 5 Requirement Timescale for action 31/07/08 2. OP8 13 3. OP12 12 4. OP19 23 The statement of purpose needs to be reviewed and revised to reflect recent changes. A service user guide needs to be developed that gives clear relevant information about what people can expect if they choose to live at the home. It should be in a format, which people will easily understand, for example appropriate language and pictures. Attention to detail is needed 30/06/08 when completing and reviewing healthcare risk assessments to ensure that people are rated at the right level of support. Plans to improve the 31/07/08 arrangements for the provision of activities need to be completed to ensure that there is a consistent opportunity for people to become involved in stimulating activities. The ongoing programme of 30/09/08 redecoration and refurbishment being carried out throughout the home must continue to improve the living conditions for people DS0000008398.V363852.R01.S.doc Version 5.2 Bankfield Premier Care Page 24 5. OP21 23 6. OP27 18 7. OP30 18 8. OP36 18 living at the home. The bathing facilities at the home must be improved to ensure that all people at the home are able to have a bath or shower, if they choose. The vacancies within the staff team need to be filled as soon as possible to ensure that there are enough people to provide care and support to people. To ensure that the people that live at the home are in safe hands the shortfalls in mandatory health and safety training identified on the skills audit must be addressed. (Outstanding in part 30/09/07 and 30/03/08) The registered manager must ensure that members of the staff team receive regular supervision and that this is evidence as part of ongoing continuous professional development and to consolidate direction and recent training received by the staff team. 30/09/08 31/07/08 30/09/08 31/07/08 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. 2. Refer to Standard OP4 OP26 Good Practice Recommendations It is strongly recommended that the registered manager keep under close review the staff team’s capacity to meet the needs of the identified person. To improve cross infection practices at the home it is recommended that the home uses the red bag system for transferring soiled items for washing and deodorised plastic disposable bags for incontinence pads. Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 25 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 Bankfield Premier Care DS0000008398.V363852.R01.S.doc Version 5.2 Page 26 - 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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