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Inspection on 23/06/06 for Bankfield Premier Care

Also see our care home review for Bankfield Premier Care for more information

This inspection was carried out on 23rd June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Before residents went into the home, the manager or one of the senior carers visited them in their own homes or in hospital to make sure that the care they needed could be provided by the home. The staff ensured that the residents were well cared for. Comments on questionnaires from visiting professionals were: A district nurse said that she found the staff very professional, well-organised friendly and caring. Anything they were asked to do they carried it out efficiently. A visiting chiropodist stated that it was always a pleasure to visit the home. The staff were very organised, very pleasant and helpful. One resident said " I like being here" Relative comments were: "The staff without exception, make this a place where my relatives are safe and well cared for, always cheerful and welcoming" Another relative stated " the staff are very friendly, very patient and kind" The home realises the importance of ongoing staff training.

What has improved since the last inspection?

The care plans had improved. They gave a much clearer picture of how the health and social care needs of the residents were to be met. More attention is now being paid to making sure that the residents are weighed on a regular basis and the weight is being recorded in their care plan. Action is taken when weight loss has occurred. The senior care staff now make sure that they continually look at anything that may be a risk to the residents. They then make sure that they write down in the residents care plan when they have done this, and what action they have taken to reduce the risk. There has been an improvement in the way that the medicines have been managed. There continues to be an ongoing programme of redecoration and refurbishment throughout the home. In particular the downstairs toilets near the lounge /dining areas have been suitably upgraded.

CARE HOMES FOR OLDER PEOPLE Bankfield Premier Care Gigg Lane Bury Lancs BL9 9HQ Lead Inspector Grace Tarney Unannounced Inspection 10:00 23rd June 2006 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.V291036.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 Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 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 www.bankfield.org Mr David Arthur Hopkins Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (47) of places Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the maximum registered number 47, there can be up to: 47 Older People (OP) The service should employ a suitably qualified experienced manager who is registered with the Commission for Social Care Inspection. 1st November 2005 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.V291036.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was not told that this inspection was to take place although the home was aware that an inspection was due. This was because several weeks before the inspection questionnaires were sent out to the residents their relatives and to the home itself. These questionnaires asked what people thought of the quality of the service and facilities provided. The inspector spent a total of 8 hours at the home. During this time the Inspector looked at care and medicine records to ensure that the health and care needs of the residents were being met. She also looked at how many staff were provided on each shift to make sure the residents needs were being met, and also looked at how management recruit and train their staff. The Inspector also looked at the food stocks, the menus and what the residents had for their lunch and evening meal. To make sure that the home and the equipment in it was safe, the Inspector looked at the maintenance and service records of the equipment within the home. She also looked at how the management handle the residents’ spending money. The Inspector then looked around the building at the bedrooms, bathrooms toilets and sitting areas to check if they were clean and well decorated. In order to get further information about the home the Inspector also spent time speaking to 1 resident, 1 relative, 2 care assistants, the kitchen assistant and the manager. A copy of the last inspection report is available and displayed in the reception area. The provider informed the inspector that the fees within the home ranged from £345.00 –£370.00 per week This information was received on the 8th May 2006. What the service does well: Before residents went into the home, the manager or one of the senior carers visited them in their own homes or in hospital to make sure that the care they needed could be provided by the home. The staff ensured that the residents were well cared for. Comments on questionnaires from visiting professionals were: A district nurse said that she found the staff very professional, well-organised friendly and caring. Anything they were asked to do they carried it out efficiently. A visiting chiropodist stated that it was always a pleasure to visit the home. The staff were very organised, very pleasant and helpful. One resident said “ I like being here” Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 6 Relative comments were: “The staff without exception, make this a place where my relatives are safe and well cared for, always cheerful and welcoming” Another relative stated “ the staff are very friendly, very patient and kind” The home realises the importance of ongoing staff training. What has improved since the last inspection? What they could do better: Management must make sure that the way they recruit staff is done safely. They must make sure that staff do not start work for them unless they have sent off for a Criminal Records Bureau (police) check and they have been informed that the employee is not a risk to the residents. Management and all the staff employed within the home must be aware of their responsibilities in relation to health and safety issues. They must make sure that they have a safe system in place to control any cross infection and any hazards such as unguarded radiators. Management must ensure that the requirements from the last inspection have been complied with. Please contact the provider for advice of actions taken in response to this Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bankfield Premier Care DS0000008398.V291036.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 Premier Care DS0000008398.V291036.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): 3 & 6. Quality in this outcome area is good. The system for ensuring that all prospective residents had a detailed assessment undertaken prior to admission to the home gave an assurance both to residents, relatives and staff that a resident was only admitted if the home could meet their needs. This judgment has been made using available evidence including a visit to this service. EVIDENCE: Inspection of three resident care files showed that assessments had been undertaken prior to admission. Before any resident was admitted to the home a senior member of the staff from the home undertook an assessment of their needs. Assessments undertaken by other professionals requesting a residents’ admission i.e. care manager/social worker were also in place. All of the questionnaires received from residents stated that they had received enough information about the home before they moved in. Standard 6 does not apply. The home does not provide intermediate care. Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7.8.9 &10 Quality in this outcome area is good. Although the care plans contained a lot of important information they did not fully reflect the support needs of some of the residents. Care practices ensured that the residents were treated with respect, their dignity preserved, and they received their medicines safely. This judgment has been made using available evidence including a visit to this service. EVIDENCE: Each resident had a care plan. The daily report is kept separately from the more detailed care plan but a brief care plan and risk assessments are kept with the daily report. The care plans of 3 of the residents were inspected. The care plans gave a lot of good information and clear instruction and guidance on how some of the care needs of the residents were to be met when problems had been identified, but there was not enough information in relation to how to care for one of the residents with diabetes and what problems staff would need to watch out for. The care plan did state that the resident was under the care of the district nurse and was receiving insulin and the blood sugar was being monitored but there were no instructions about what to do in the event of the blood sugar levels being too low Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 11 There was not enough information about the care of the residents’ eyes such as regular check ups with the optician. There was an eating and drinking care plan and this did state that the resident was to have a “diabetic diet and no sugar”. A discussion with staff showed that they didnt have a lot of understanding about what a person with diabetes could eat although the Inspector was told that there had been some training in relation to diabetes care. One of the care plans inspected showed that the resident had a catheter in the bladder to enable the resident to pass urine. There was quite a detailed care plan for the catheter but there was not enough information about how often the urine drainage bags were to be changed and how the catheter and surrounding areas were to be cleaned and looked after. Staff were regularly looking at any changes in the residents conditions and were writing down when they had assessed it and if there were any changes, what they did about it. This is called an evaluation of the care being provided. There was no evidence to show that either the residents or their families were involved in the drawing up of the care plan. To ensure that an accurate and agreed care plan is in place the resident and/or their families should be involved. The Inspector did see some letters however that were being sent out to families inviting them to the home to discuss their relatives care plan. The staff also looked at whether or not there was any risk in relation to the residents developing pressure sores and also if they were at risk due to problems with their diet and fluid intake. These are called risk assessments. They also assessed if it was safe to use bed rails. These assessments however need to have more detailed information on them. They also looked at and they wrote down, how the residents were to be assisted with being moved around and by how many members of staff and what equipment, if any, was to be used to assist in safe moving and handling. From the care plans inspected it was evident the residents were weighed at least on a monthly basis and any weight loss identified and acted upon. Inspection of the care files identified that the residents had access to health care professionals, such as dentists, opticians, chiropodists and district nurses. Some equipment necessary for the prevention and treatment of pressure sores was readily available within the home and the Inspector was informed that the district nurses could provide more specialist equipment if needed Comments cards received from GPs showed that the home communicated and worked in partnership with them. The medicines were not inspected in detail during this visit. This was because the CSCI pharmacist Inspector visited the home on the 22nd of May 2006 and undertook a thorough inspection of the medication system. The pharmacist Inspector made 6 requirements and 1 recommendation. These had been met. The residents said that the staff treat them with kindness and respect. During the inspection staff members spoke with residents in a kindly and respectful Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 12 way. Staff spoken to gave examples of how privacy and dignity were promoted. They told the inspector that they were told how to ensure that the privacy and dignity of residents was maintained when they started working at the home. They realised the importance of knocking on bedroom, bathroom and toilet doors and waiting for a response before entering. Bankfield Premier Care DS0000008398.V291036.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 Quality in this outcome area is good. The home enables residents to exercise as much personal freedom and choice as possible although more activities could be provided for their enjoyment. The dietary needs of the residents are well catered for. This judgment has been made using available evidence including a visit to this service EVIDENCE: A discussion with a resident and replies received from the resident and relative questionnaires showed that the residents were satisfied with the personal choices and freedom they were able to enjoy. The home does not employ an activities organiser so the care staff provide the activities within the home, when they have the time to do so. A notice was displayed in the reception area detailing any forthcoming events. These included trips out to places such as Rivington Barn and the Blue Planet Aquarium. The home had also organised a summer fair and barbecue to be held in the month of August. Comments received from 5 of the residents in relation to activities, showed that they could only take part in some of the activities but not all. Upstairs the home has a well-stocked library with many large print books. 1 resident had “ talking books” brought into her on a regular basis. There were no residents of an ethnic minority within the home and the majority of residents had a Church of England or Roman Catholic religious Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 14 faith. The Inspector was informed that a Eucharistic Minister (Roman Catholic) visits the home on a weekly basis to give communion. The local vicar visits on a monthly basis to hold a religious service and give communion to those residents who want it. Of the 6 relative questionnaires received all said that they could see their relative in private. The relative spoken to by the inspector said that the staff always make her welcome and she is allowed to bring in her dog, which she had on that day. Residents are encouraged to bring personal possessions into the home. Many of their bedrooms were highly personalised with small pieces of their own furniture, pictures, photographs and ornaments etc. The inspector did not dine with the residents but discussed the food, menus and food stocks with the kitchen assistant. Food stocks were plentiful. The residents were asked earlier on in the day for their choice of menu. Staff informed the Inspector that if the residents changed their minds or did not like what was being served to them, then there was no problem in giving them an alternative. Of the 6 resident questionnaires received, 5 said that they usually like the meals at the home and 1 said that she always liked them. One comment was “The cook is very good”. Staff ensure that the residents have a light snack for their supper and milky drinks, in addition to tea and coffee are always available. Bankfield Premier Care DS0000008398.V291036.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 & 18. Quality in this outcome area is good. The complaint system in place enabled residents to feel that their views were listened to and acted upon. Staff had a good knowledge and understanding of what abuse was, thereby reducing the possible risk of harm or abuse. This judgment has been made using available evidence including a visit to this service EVIDENCE: Replies from the questionnaires showed that the residents and relatives knew how to make a complaint if they had to. Staff spoken to also knew what to do if someone complained to them. A detailed complaints procedure was in place and was displayed. It gave an assurance that complaints would be responded to within 28 days. The procedure however was more like a directive for staff than information for residents/relatives. The complaints procedure attached to the Service User Guide continued to state all complaints must be made formally to the manager. Following a discussion with the group manager during the inspection in June 2005 it was agreed that this was not acceptable and the group manager agreed to have it removed from the complaints procedure. No complaints have been made to the CSCI in relation to care during the last 12 months A discussion with the manager and 2 care staff showed that they were very aware of the different forms of abuse and the procedure to follow in the event of any allegation of abuse. A copy of the Local Authorities Vulnerable Adults Procedure however was not available. It has been seen in the home during Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 16 previous inspections. To ensure that the correct procedure is always followed, it is important that the procedure is always available. Staff were also aware of the whistle blowing policy within the home and they continue to receive training in abuse awareness. Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 17 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 24 25 &26 Quality in this outcome area is adequate. The residents live in clean and comfortable surroundings but continuing health and safety issues must be seen to, so that the home is a safe place in which to live and work. This judgment has been made using available evidence including a visit to the service EVIDENCE: The Inspector walked around most of the building and looked at several bedrooms, the lounges, the dining room, corridors and the laundry. It was evident that there was an ongoing programme of redecoration and refurbishment. The home was clean and mainly free from any unpleasant smells. The residents have the use of any of the 2 lounges, the conservatories and the large dining room. These rooms were very pleasant, well decorated and appeared very homely. The conservatories have a very pleasant outlook onto the enclosed courtyard. The courtyard was filled with beautiful hanging baskets and was an extremely pleasant and safe environment for the residents to sit or walk around in. Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 18 One of the conservatories remains without a guarded radiator. Three of the lounges and a conservatory remain without a call bell system. The carpet in the smaller “ quiet” lounge also remains stained and rucked in parts. Toilets were 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. Most bathrooms and toilets were suitably adapted for disabled use. The toilet seats in toilet 1, (close to bedroom 43) and bathroom K, remain damaged and in need of replacing. The bedroom doors were fitted with locks and each bedroom had a lockable space. The bedrooms were clean, well decorated and most were highly personalised. The manager was aware that three of the bedrooms smelt of urine and she was dealing with this. The bedrooms were individually and naturally ventilated, they were all centrally heated and radiators were covered. The radiators on the corridor near bedroom 33, and as previously stated, the small conservatory remained unguarded. Hand washing facilities were not in place in residents’ bedrooms. This was a previous requirement. To prevent cross infection/contamination they must be provided where any resident is receiving personal care. Alcohol gel and vinyl/plastic gloves are no substitute for hand washing. The laundry was clean and looked organised. Adequate equipment was in place and protective clothing was available. The home has recently installed a new laundry system that “produces ozone and injects it into the wash process to achieve a total bug kill on every wash cycle” Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 19 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 Quality in this outcome area is adequate. The residents were cared for by sufficient numbers of staff that were suitably experienced and trained, and therefore had the knowledge and skills to meet the residents’ needs. The unsafe recruitment procedure however,was placing residents at potential risk of harm This judgment has been made using available evidence including a visit to the service EVIDENCE: Examination of the duty rotas and a discussion with staff showed that there was sufficient care staff on duty to meet the needs of the 42 residents. There was always a senior care staff member on every shift. Resident and relative questionnaires showed that they were satisfied with the numbers of staff on duty. Of the 26 care staff employed 15 have obtained their NVQ level 2 or above in care. This is a percentage of 60 and therefore the home has met the Standard. The personnel files of 5 staff members were inspected. 2 of these staff had not been properly and safely employed. They had been employed before a Criminal Records Bureau (CRB) disclosure check and Protection of Vulnerable Adults check (known as a POVA 1st) had been applied for. This is unsafe practice, is not in accordance with the law and puts residents at risk of harm. This is the 2nd time that this has been identified during Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 20 inspection. Management were given an immediate requirement notice. This informed them that the practice must cease immediately. All members of staff received induction training within six weeks of appointment to their post and further training within the first six months of appointment. The induction and foundation training was in accordance with the National Training Organisation (NTO) specifications . Training records were in place in the staff files inspected. training had been undertaken in the following areas: Moving and Handling. Fire Safety. First Aid. Food Hygiene. Infection Control. Health & Safety Abuse awareness. Dementia. These showed Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 21 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): 31 33 35 & 38 Quality in this outcome area is good The experience and qualifications of the acting manager ensures there is effective leadership and guidance to the staff thereby ensuring that the residents receive consistent quality care. A satisfactory accounting system was in place that ensured the residents’ financial interests were protected. Some current practices did not promote and safeguard the health, safety and welfare of the people using the service. This judgment has been made using available evidence including a visit to the service EVIDENCE: The manager has 30 years extensive experience of providing care within the private sector and the NHS. She has been with the company for 4 years and has been at Bankfield as the acting manager for over 12 months. She has also obtained the Registered Managers Award. She has applied to the CSCI to be the registered manager and her application is being processed. Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 22 Staff spoke very positively about the managers attitude and experience. They said that she was very approachable and listens to any concerns that they have. The Inspector was advised that the home have not yet developed a formal quality assurance system. Questionnaires have been developed and given out to residents and relatives and visiting professionals such as District Nurses and GPs. The home has the Investors in People award and is due to be re-assessed in August 2006. The systems in place for the management of residents’ money were good. The home had a satisfactory accounting system in place. Receipts were retained for all financial transactions and the home had a safe for the safekeeping of money. Most of the equipment and services within the home were serviced on a regular basis in accordance with the individual requirements. . There was evidence to show that the water temperatures were being checked in house on a monthly basis but there was no evidence to show that the thermostatic control valves had been serviced. There was also no evidence to show that the gas equipment had been serviced. Fire risk assessments and risk assessments for all safe working practices were performed and outcomes recorded. The fire logbook was up-to-date. All staff received Induction Training with regard to food hygiene, fire safety, moving and handling and infection control. Fire training was undertaken on an annual basis. Several shortfalls in relation to health and safety matters were identified. These were: Radiators were unguarded in the small conservatory, and on the corridor near bedroom 33. Staff handwashing facilities were not in place in residents’ bedrooms. Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 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 2 17 x 18 2 2 2 3 x x 3 1 1 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x x 2 Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 24 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 OP7 Regulation 15 Requirement A care plan must be in place that details how the resident with diabetes is to be cared for. This must include the care of the skin and eyes, and what to do in the event of an emergency situation, such as hypoglycaemia. A more detailed care plan must be in place for the resident with a urinary catheter. There must be evidence of resident/representative involvement in the drawing up of the care plan. The risk assessments for bed rails must be more detailed. They must provide more information about the risk involved. (Previous timescale of 31/12/05 not complied with) Call bells and call bell leads identified in this report as being missing, must be provided (Previous timescale of 31/12/05 not complied with) The carpet in the quiet lounge must be replaced (Previous timescale of 31/12/05 DS0000008398.V291036.R01.S.doc Timescale for action 31/07/06 2. 3. OP7 OP7 15 15 31/07/06 31/07/06 4. OP7 13 31/07/06 5 OP19 23 31/08/06 6 OP19 16 31/08/06 Bankfield Premier Care Version 5.1 Page 25 7 8. OP21 OP25 23 13 not complied with The toilet seats identified in this report must be replaced The radiators identified in this report as being unguarded must be suitably protected or low surface temperature radiators fitted. (Previous timescale of 4/12/05 not complied with) An immediate requirement form was issued in respect of this. To reduce the risk of cross infection staff hand washing facilities must be provided in the residents’ bedrooms. (Previous timescale of 31/01/06 not complied with) Staff must not be employed until their CRB disclosure check has been returned or a satisfactory POVA first has been applied for and received. An immediate requirement form was issued in respect of this. Evidence of the servicing of gas appliances must be forwarded to the CSCI The thermostatic control valves must be serviced in accordance with requirements. Evidence of this must be forwarded to the CSCI. (Previous timescale of 31/01/06 not complied with) 31/08/06 24/07/06 9. OP26 13 31/08/06 11. OP29 19 23/06/06 12. 13 OP38 OP38 13 13 31/08/06 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 26 1. 2. OP12 OP16 Serious consideration should be given to employing an activities organiser The directive on the complaints procedure that states all complaints must be made formally to the area manager should be removed. The home should ensure that a copy of the local authority Protection of Vulnerable Adults Procedure is always accessible. Quality assurance surveys should be published in the Service User Guide. 3. 4. OP18 OP33 Bankfield Premier Care DS0000008398.V291036.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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. 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