Inspection on 07/06/05 for Bankfield Premier Care

This inspection was carried out on 7th June 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bankfield Premier Care 13/01/09

Bankfield Premier Care 12/05/08

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 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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE BANKFIELD PREMIER CARE Gigg Lane Bury Lancs BL9 9HQ Lead Inspector Grace Tarney Announced 7 June 2005 th 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 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 F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bankfield Premier Care Address Gigg Lane Bury Lancs BL9 9HQ 0161 764 8552 0161 761 3689 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr David Hopkins Vacant CRH Care Home Only 47 Category(ies) of OP Old age registration, with number of places BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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. Date of last inspection 14th September 2004 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 ensuite 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 F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was made aware that this inspection was to take place. Several weeks before the inspection questionnaires were sent out to doctors, social workers and district nurses, as well as to the residents of the home and their relatives. The questionnaires asked what people thought of the care and services provided by the home. The Inspector spent 8 hours at the home. During this time she looked at care records to ensure that health and care needs were met. She also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training. The Inspector also spent time speaking to 1 resident whilst she had lunch with her, and a further 3 residents during the afternoon. She also spoke to 1 relative, 3 care staff and the acting manager. The inspector also looked at the food stocks in the kitchen and whilst there, spoke to the kitchen assistant about the ordering of food stocks. Not all the National Minimum Standards were looked at on this visit. During the next inspection, which will be unannounced, the Inspector will look at the rest of the Standards that are considered to be important for resident safety and wellbeing. These are the Standards that have to be inspected at least once a year. What the service does well: What has improved since the last inspection? BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 6 The storage area for medicines had improved and the care staff responsible for giving out the medicines had received training in the management of medicines. This meant that the way that they looked after, and gave out the medicines, was much safer. Although all of the building was not looked at in detail on this inspection, the Inspector saw that there was an ongoing programme of redecoration. Several bedrooms had been redecorated and the carpets and curtains had been cleaned. The reception and corridor areas had also been redecorated. These improvements had made a big difference to the residents living there and some residents said how pleased they were with their bedrooms. Staff and residents said that the area manager was giving them good support and that the home was a much happier and better place. The previous requirements and recommendations from the last inspection had been complied with. 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. BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3. The system for assessing a residents needs was not detailed enough and because of this does not give an assurance to either staff, residents or relatives that the home can meet their needs. EVIDENCE: Before any resident was admitted to the home an assessment of their needs was undertaken, either by a senior member of staff from the home or from the professional i.e. care manager, requesting their admission. The assessments were not kept within the residents’ actual care plans. They were kept in the residents’ individual folders. These folders contained personal information about the residents, for example their next of kin, their prescriptions for spectacles, hospital visits etc. The home has recently introduced a new assessment form that was detailed but still did not contain all the necessary information needed to you ensure that a full assessment of the residents needs could be made. The assessment form of a recently admitted resident was looked at. A lot of the information that was requested on the form had not been completed. A full assessment of a residents needs is necessary to ensure that a detailed care plan can then be drawn up. BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 9 BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 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 standard(s) 7,8,10 &11. The information written in the care plans ensured that only basic care needs were met. The lack of attention paid to the reasons for, and the importance of risk assessments, could result in risks going unnoticed, resulting in possible harm to residents. EVIDENCE: Each resident had a care plan. The care plans were kept in two large folders. The care plans of 3 residents were examined. The care plans had basic information about the residents needs. This information was written on one page. The Inspector asked what would happen if the resident had a new problem, where would this be written. The group manager said that the whole care plan would be written out again. She said that she knew that it wasnt an ideal situation but she was presently teaching the care staff about the importance of care planning and that once there was a greater understanding of care plans then she may look at a better system. It was difficult to find important information in the files because several documents were placed in one plastic cover. The daily progress reports were kept with the care plans. This is good practice as it encourages care staff to refer to the care plan when they are writing about how a resident has been cared for. The night progress BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 11 reports however were kept separately. The group manager said that this was an area that, in the future, she will be looking to improve on. Each of the three care plans had a risk assessment for nutrition, moving and handling and pressure sores. The assessment for one of the residents showed that she had a history of falling. There was however no risk assessment in relation to falls. To reduce the risk of falling this must be in place. The pressure sore risk assessment for another resident showed that no pressure care was needed but the care plan stated that a pressure mattress was in place. The nutritional risk assessment for 1 of the residents did not state how often she was to be weighed, although she was being weighed monthly. The nutritional risk assessments of another resident stated that she was to be weighed weekly. There was nothing in the file to show that this had been happening. Residents must be weighed according to their assessment. The care plan of another resident showed that she was a diabetic but it gave very little information about how her diabetes was controlled and cared for. This resident did have a very good plan that showed how to care for, and prevent pressure sores. A discussion with the residents showed that they had access to other healthcare professionals, such as dentists, opticians, chiropodist and district nurses. Evidence of these visits was kept in the residents’ individual files. The area manager told the Inspector that the homes’ relationship with the district nurses was extremely good. Whilst the home had plenty of pressure-relieving equipment of its own, the district nurses would supply any further equipment that was required for pressure relief. The medication system was not inspected in detail during this visit. The Inspector did look however, at the improvements that had been made since the last inspection. The storage area for medicines had changed and medicines were now stored in a larger room. An extra medicine trolley had been provided and medicine management training had been provided for the care staff responsible for giving out the medicines. The residents said that the staff treat them with kindness and respect. Of the 2 questionnaires received from the residents both stated that their privacy was respected. Staff spoken to gave good examples of how privacy and dignity were promoted. They also gave good practice examples of how they would care for a resident who was terminally ill. . BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 &15. The social activities in the home provided the residents with some enjoyment and interest but this could be further improved by arranging trips out. The dietary needs of the residents were catered for but this could be improved by more use of fresh fruit and vegetables. EVIDENCE: The residents spoken to said that they were satisfied with the way they were allowed to spend their day, more or less as they pleased. They said that although they were satisfied with the range of activities provided by the home they wished that they could go out on some trips. The group manager agreed that more trips out were needed and that it was something that she was looking into. The home has not employed an activities person but for three afternoons of the week, an extra care assistant is on duty. This care assistant is there only to involve the residents with activities. The programme of activities was displayed in the reception area so the residents were aware of what was going on. It was a beautiful sunny day whilst the Inspector was at the home and many of the residents were sat in the rear courtyard, enjoying the sunshine and listening to “old time music”. The care assistants were entertaining the residents by singing and dancing to them and it was clear that the residents and the staff were thoroughly enjoying themselves. The Inspector had her lunch with the residents and a choice of menu was available. The residents were asked the day before, what they would like to eat. Staff said that if the resident had changed their mind about their choice, BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 13 then they could have the alternative. All but one of the tables was nicely set with tablecloths, place mats, cruet sets, individual teapots, sugar and milk jugs. Some residents who needed assistance with eating were sat at a table that had nothing on it except knives, forks and spoons. The table looked very bare and institutionalised. Staff were told to put on a tablecloth, which they did. The meal served was chicken casserole, new potatoes, carrots and peas. The meal was hot and the casserole was very tasty. The vegetables however were not fresh. The potatoes were tinned and the vegetables were frozen. The pudding was blackcurrant crumble and custard. This was hot and very tasty. Hot and cold drinks were served. All the residents spoken to said that the food was good. The Inspector went into the kitchen to look at the food stocks, in particular fresh vegetables, and to look at what was being served for the evening meal. Very few fresh vegetables were available. Despite being told that some of the residents were having salad for their evening meal, no salad vegetables were available The Inspector was told that fresh fruit and vegetables were ordered and delivered once a week. The evening meal for the residents who had a soft diet, was meat paste sandwiches only. A meat paste sandwich contains very little protein, vitamins and fibre. All of which are necessary for a well balanced diet. BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 17 &18 The complaint system in place enabled the residents to feel that their views were listened to and acted upon. Staff had a good knowledge and understanding of adult protection procedures thereby reducing the possible risk of harm or abuse. EVIDENCE: A discussion with residents and inspection of responses in the pre inspection questionnaires showed that there was a general awareness of how to make a complaint. The complaints procedure was displayed in each bedroom and in the reception area. The complaints procedure gave clear guidance about how to make a complaint and to whom, but it did state at the top of the page that all complaints must be made formally to the manager. Following a discussion with the group manager it was agreed that this was not acceptable and the group manager agreed to have it removed from the complaints procedure. Management told the Inspector that during the recent general election the residents used their postal vote or went down to the polling station. Residents confirmed this. A copy of the Local Authorities Vulnerable Adults Procedure was in place and a discussion with the senior staff identified that they were very aware of the procedure to follow in the event of any allegation of abuse. Since the last inspection 14 of the staff members had undergone training in the protection of vulnerable adults. BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None. EVIDENCE: Standards 19 and 26 will be looked at during the next inspection. BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 28 & 29 The residents were cared for by sufficient numbers of staff that were suitably trained and therefore had the knowledge and skills to meet the residents’ needs. The inadequate recruitment procedure was placing residents at potential risk. EVIDENCE: Examination of the duty rotas and a discussion with staff showed that there was enough staff on duty to meet the needs of the 44 residents. The Inspector was told that having only 5 care staff on in the evenings meant that sometimes, it was difficult to care for the residents as they would like to. Due to the high dependency of the residents presently in the home, the staffing levels, particularly for the evening, must be kept under continual review. Of the 7 relative questionnaires returned all said that they felt there was enough staff on duty. The home continues to provide training in NVQ care. Presently 33 of the care staff have achieved NVQ level 2. A further 33 of the staff had been enrolled on the course. Further training continues to be provided in first aid, moving and handling, medication management and protection of vulnerable adults The home had a recruitment policy but it was not in accordance with legal requirements. This must be updated. The3 staff files inspected contained the necessary references and there was evidence that the criminal records bureau (CRB) disclosures had been sent for but not received. These 3 staff members had only recently been employed so, in the absence of a CRB check they should have had a Protection of Vulnerable Adults (POVA ) check before they BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 17 started working for the company. Management were given an Immediate Requirement Notice. This required them to obtain the POVA checks as a matter of urgency. This was dealt with the following day. A discussion took place with the management about the application form that is presently in use. They were advised to make changes to the form by making the “previous employment” section bigger. In order to ensure the protection of residents all potentially new staff should be asked to disclose a full employment history. BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None EVIDENCE: Standards 33 35 and 38 will be looked at during the next inspection. BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 2 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x x x x x x BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 20 Are there any outstanding requirements from the last inspection? 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 3 Regulation 14 Requirement A full assessment of the residents needs must be undertaken. The assessment document should be in accordance with the requirements of Standard3.3 Risk assessments for falls must be in place. Residents must be weighed at least monthly ,but also in accordance with their nutritional risk assessment. A more varied and nutritious diet must be provided. This must include the provision of more fresh fruit and vegetables. The recruitment policy must be in accordance with legislation. Staff must not be employed unless a POVA check has been applied for and the outcome received. Timescale for action .31/8/05 2. 3. 7 8 13(4)(c) 13(4)(c) 31/8/05 31/8/05 4. 15 16(2)(i) 31/7/05 5. 6. 29 29 17(2) & Schedule 2 19 31/7/05 8/6/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 21 No. 1. 2. 3. 4. 5. 6. Refer to Standard 7 7 12 15 16 29 Good Practice Recommendations To ensure that all health, personal and social care needs are met the care plans should include the positive aspects and capabilities of the resident. Consideration needs to be given to rearranging the care records so that the information can be easily found. Consideration needs to be given to providing more trips out for the residents. All the dining tables should be nicely set with tablecloths and napkins. Residents who need assistance with eating should not be treated any differently. The directive on the complaints procedure that states all complaints must be made formally to the area manager should be removed. The previous employment section on the application form should be made bigger to enable prospective staff to disclose a full employment history. BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI BANKFIELD PREMIER CARE F56 F06 S8398 Bankfield V219202 070605 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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