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Inspection on 17/11/06 for Bankfield Residential Home

Also see our care home review for Bankfield Residential Home for more information

This inspection was carried out on 17th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

The home is well maintained and comfortable for residents. Bedrooms are well furnished and each one is personalised. The home has suitable equipment to assist people with their moving and handling needs. The equipment is regularly serviced to make sure it is safe to use. The domestic team keep all areas of the home clean and fresh. Residents said they enjoyed the food provided and they said there was plenty of choice on the menu. The staff know the residents well and understand the needs of individuals, although this is not always adequately reflected in the records. Health care records are good and show that residents have contact with a range of health care providers. The daily routines carried out by staff do not impinge on the preferred routines of residents. Visitors to the home say they are made to feel welcome.

What has improved since the last inspection?

The management team have identified areas, which can be strengthened and improved upon. They have an action plan in place to address these issues. Consultation with residents and relatives has begun, quality assurance questionnaires have recently been sent out and responses will be analysed. Meetings with relatives have taken place to hear what they have to say about the service provided.

What the care home could do better:

New residents must be given a statement of the terms and conditions of their residence before they move into the home. The care plans need to be overhauled. There is inconsistency in the level of detail in the plans and evidence that some plans need to be reviewed. Residents and their representatives need to be involved more so that they understand what the plans are about. Staff files need to be checked to make sure all the required documentation is available. There is little on offer in the way of stimulating activities, this area needs to be improved upon, people need to be asked what they want to do. Some residents would benefit from the opportunity to go out with staff support. Some visitors to the home said they feel that staff morale hasn`t been too good lately and the atmosphere was "flat". They feel confident that there are recent signs of improvement. Residents and relatives need to be reassured that any concerns they raise will be taken seriously and investigated.

CARE HOMES FOR OLDER PEOPLE Bankfield Residential Home Hollins Lane Sowerby Bridge West Yorkshire HX6 2RS Lead Inspector Lynda Jones Unannounced Inspection 17th November 2006 10:00 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 Residential Home DS0000057396.V320052.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 Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bankfield Residential Home Address Hollins Lane Sowerby Bridge West Yorkshire HX6 2RS 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) 01422 831333 01422 836331 Philip Bennet (Bankfield New Co) Ltd Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd January 2006 Brief Description of the Service: Bankfield provides personal care and support for up to 37 older people. The house is a detached Victorian property located approximately a quarter of a mile outside the centre of Sowerby Bridge. There is a steep drive up to the house. At the front of the house there is a garden with panoramic views of the surrounding countryside. Bedrooms are at ground, first and second floor level. All parts of the house can be accessed by a passenger lift. Most bedrooms are single, only two are double. 23 rooms have en suite facilities; the remainder have a hand washbasin with toilets and bathrooms nearby. The weekly fee is between £339 and £445. Residents pay extra for hairdressing, chiropody, aromatherapy and for newspapers and magazines of their choice. Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk A pre-inspection questionnaire was completed by the home and this information has been used as part of the inspection process. Information from surveys, which were sent to residents and their relatives, has also been included in this report. Two inspectors carried out a site visit. Each inspector spent 6.5 hours at the home. During the visit the inspectors looked around the home, and spoke to residents, staff, and four visitors. Records were looked at including; residents’ care plans, risk assessments, admission assessments, food records, staff recruitment and training records. This report indicates that the home has not performed to its usual good standard in all areas. Three complaints have been made to the Commission about the quality of care provided and about the attitude of some staff. These were investigated by the operations manager for the home. Although two complainants were not entirely satisfied with the response they received, they made further representations and the issues were resolved. There has been a change in the management of the home recently; the new manager is being supported to review and address the home’s performance. Relatives have indicated that they are happy with the changes they have seen so far. Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 7 New residents must be given a statement of the terms and conditions of their residence before they move into the home. The care plans need to be overhauled. There is inconsistency in the level of detail in the plans and evidence that some plans need to be reviewed. Residents and their representatives need to be involved more so that they understand what the plans are about. Staff files need to be checked to make sure all the required documentation is available. There is little on offer in the way of stimulating activities, this area needs to be improved upon, people need to be asked what they want to do. Some residents would benefit from the opportunity to go out with staff support. Some visitors to the home said they feel that staff morale hasn’t been too good lately and the atmosphere was “flat”. They feel confident that there are recent signs of improvement. Residents and relatives need to be reassured that any concerns they raise will be taken seriously and investigated. 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 Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 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 Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are appropriately assessed before they move into the home. However, they do not always receive information about the terms and conditions of their stay before they move in. EVIDENCE: Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 10 There is a good, well-presented service user guide, which gives information about Bankfield to help people decide if the home is suitable for them. The information is written in plain English and is in large print. Copies are available on request from Bankfield. Evidence indicates that all prospective residents are assessed before they move in; this is to make sure that their needs can be met at the home. Everyone is invited to visit the home to meet other residents and staff before making a decision about moving in. Relatives are very welcome to call at the home to view the facilities. Inspectors spoke to one person who had moved into the home recently. He said he had not looked round, a friend of his had visited Bankfield and had talked to him about the facilities. Residents records were checked to see if they had been issued with a contract or a statement outlining the terms and conditions of residence. Only one contract/statement of terms and conditions could be found on the four sets of records examined. These should be provided before admission or on the day of admission. Intermediate care is not provided at Bankfield. Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some care plans are not up to date and do not clearly state what staff must do to meet the needs of residents. Daily records are often repetitive and don’t reflect the care and support provided. Health care needs are met in the main, and these records are good. EVIDENCE: The care planning format that is used at the home has the scope to cover the health, personal and social care needs of residents. Four care plans were examined, these related to two residents who had lived at the home for some time and two who were relatively new to Bankfield. Inspectors found inconsistency in the level of detail in the plans, plans were not being reviewed regularly and they were not always updated to reflect changes in the needs of residents. In general, health care needs were identified and were being met. The records of contact with doctors, district nurses and other health care Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 12 providers were good and there was evidence that staff were seeking appropriate advice when required. From speaking to staff it is clear that they have a good understanding of the needs of residents. The care and support they provide is more often based on their direct knowledge of residents and their communications with each other, rather than what is written in the care plans. From the information in some of the records, it would not be possible to provide care and support with any consistency. On one of the plans examined, information about personal hygiene needs had been crossed out, with no explanation. New information had been added, which had not been signed and dated. The new information stated that the resident “needs help in all daily living tasks”; nothing was recorded to suggest what form of help was required nor what the daily living tasks were. A nutritional assessment specified, “diet to be encouraged” but there was nothing to indicate what action staff should take. One of the moving and handling plans was not up to date. The plan indicated that the resident could move about independently although during the visit he was using a wheelchair. Elsewhere in the care plan it had been noted that this resident was unsteady on his feet and needed the assistance of two staff to transfer to a wheelchair from a seat in the lounge. Inspectors noted that a district nurse had recorded that one resident did not sleep well and wandered in and out of other residents rooms. There is nothing in the care plan about this; the plan states that the resident “has no problems with sleeping”. The nurse noted that the same person had sore heels and used Propad mattress, there was nothing in the care plan about this. One pre admission assessment that was looked at acknowledged that the resident was fairly independent, had a network of friends and was moving from another area to take up residence at the home. The resident was clear that he wanted to maintain his freedom to continue to socialise outside Bankfield. The records indicated that he had been told that he would be supported to do so and would be assisted to maintain his independence. There was no care plan in place to show how this would be achieved. Since moving to the home the resident had been out unescorted, no risk assessment had been conducted about his safety outside the home and no one had checked on his knowledge of the local area. No account had been of the possibility that additional staff may be required on duty so that the assessment could take place, nor of how he would be provided with the support he had been led to expect. Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 13 The system for reviewing the care plans needs to be improved. Some had not been reviewed regularly and on one plan a member of staff had written, “care plan relevant” at the end of each element of the plan. There was nothing to indicate that the care plan had been genuinely evaluated. Daily records are often repetitive and are not always informative, there were several entries where “good day, no problem” had been recorded. The records provide the evidence of the care and support that the staff provide, they should reflect what is in the care plan. Detailed daily records will help the manager to audit the care that is being provided and ensure that staff are following the guidelines in the care plans. Five relatives returned comment cards giving their views on the quality of the service being provided. Three were satisfied with the service provided; two were not and felt there was room for improvement. The majority felt that they were kept informed of important matters and were consulted about care issues. Relatives who were not satisfied shared similar concerns, they talked about sometimes finding residents unshaved, not having their hair brushed and looking undignified. The major concern raised by relatives was about poor communication amongst staff, they felt that information was not always being passed on and this affected the care provided. The manager has recently reviewed the medication system and there are plans to introduce a new monitored dose system in the coming weeks. The medication policy and procedure needs to be updated to reflect these changes. Medication storage and records were checked and were generally satisfactory. The thermometer on the medication fridge was showing a reading in the “red zone”, the fridge needs to be defrosted. Staff must book in all “non blistered” medication and use a brought forward system so that a balance of all medication held at any one time can be calculated. This was discussed in the feedback at the end of the visit. Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 14 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): 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is very little stimulating activity on offer and little evidence that residents have been genuinely consulted about how they want to spend their time. Residents maintain contact with friends and family who are able to come to the home to visit them; there is limited scope for people to go out with staff. The menus offer plenty of choice and residents enjoy the meals provided. EVIDENCE: Evidence indicates that residents get up and go to bed when they choose to, these routines are not determined by the number of staff on duty or by their list of jobs for the day. They said they could have whatever they want for breakfast, at whatever time they choose to get up. Most people sit in one of the lounges during the day. Some people alternate this with time spent in their rooms watching TV or reading. These residents who are more independent and can determine what they want to do, are in the minority. Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 15 Residents said there was very little on offer in the way of organised activities. They said a singer sometimes visited the home, which they enjoyed. They said there would probably be more going on in the run up to Christmas. During the course of the visit the TV was on in the lounge, no one was watching it; one person said “its background noise”. Residents said they don’t really watch the TV, they said it gets switched on by staff out of habit. Earlier in the year a visitor to the home raised an issue about replacing the music system that was broken, in order that residents could listen to music of their choice. Staff said there is now the facility to play music. It is not clear whether residents are offered this option, as a matter of routine. What happens each day seems to depend on the staff on duty; there was little evidence of anything specifically tailored to meet the needs of individuals. Inspectors saw some activity records in the care plans. The record sheets listed a whole range of activities, staff are required to sign and date the records indicating which activity had taken place. There was nothing on the records to indicate whether a resident had particularly wanted to participate, whether they were engaged in the activity or whether they enjoyed their involvement. The home needs to consult with residents and improve performance in this area. If residents go out it is invariably with the support of family and friends. There is little evidence of people going out with staff support, other than to hospital appointments. At the time of this visit, no arrangements had been made to support one resident who specifically asked for support to maintain links with his contacts in who live just outside Halifax. Relatives said they were made to feel welcome when they called at the home; some qualified this statement by adding that this largely depended on who was on duty. Two relatives said the atmosphere at the home had been “flat” lately but they were looking forward to an all round improvement now that a new manager had been appointed. There is a four weekly cycle of menus, organised by the home’s two cooks. The menu for the day is usually on display in the dining room. Residents are asked what they would prefer to have from the day’s menu. Residents said they liked the food and they said there was plenty of choice available. The cooks and kitchen assistants are involved in serving the meals from a hot trolley in the dining room. The catering staff know what people like to eat and what size Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 16 of portion they prefer and they cater accordingly. Hot and cold drinks and snacks are available at all times. The cook on duty said if residents wanted anything that didn’t feature on the menu, they only had to ask and she would do her best to cater for them. Visitors are very welcome to stay for a meal if they wish, one relative who stayed for lunch said the standard of catering was good and she enjoyed her meal. Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 17 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): 16,18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and relatives know who to go to if they have a complaint about the service. They need to be reassured that complaints are taken seriously and acted upon. EVIDENCE: Since the last inspection the Commission has received three complaints about Bankfield. The complaints were about the quality of care provided and about the attitude of some members of staff. Each complaint was referred to the home’s Operations Manager for investigation and responses to the issues raised were sent to the complainants and to the Commission. The complaints were dealt with in accordance with the home’s complaints procedure and those aspects of the complaints that were upheld have resulted in changes in care practices at the home. Two complainants were not completely satisfied with the responses they received and they made further representation to the Operations Manager. These issues have now been resolved. Four out of five relatives said they were aware of the home’s complaints procedure. The procedure is on display in the home and details are in the Service Users Guide, which is given to prospective residents and their families. Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 18 One of the relatives who contacted the Commission with concerns about care practice said she had complained to the previous manager of home in the first instance. Her complaint escalated when she found that the issues she raised had not been recorded at the home. Practice at the home has improved and all concerns raised are now recorded at the home. When the home’s complaints log was examined, it was noted that the outcomes of the complaints investigated by the Operations Manager had been removed from the log. The record of complaints must include details of all complaints and details of investigation and any action taken. An incident involving two residents was recorded in the accident book. One resident had sustained a skin tear after being pushed by another resident. This was discussed with the manager and deputy at the end of the visit and it was agreed that this, and any other incident of this nature, should be reported to the area adult protection coordinator. Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 19 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): 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is pleasant and residents are comfortable in their surroundings. All parts of the home are clean and well maintained. EVIDENCE: All parts of the house are comfortably furnished and pleasantly decorated. There are 23 en suite bedrooms out of a total of 33 single rooms, and of the 2 double rooms 1 has en suite facilities. All bathrooms and toilets are close to bedrooms and the shared areas of the home. Assisted toilets and bathing facilities have been installed to ensure the safe handling of residents. Bedrooms are arranged to suit individual needs. Each one is individually decorated and there is evidence that people have lots of their own possessions Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 20 around them such as photographs, ornaments and plants. People spend varying amounts of time in their rooms depending on their preferred daily routine. All bedrooms are fully furnished although service users are informed that they can bring items of their own furniture with them when they move into the home if they wish. There is plenty of choice of sitting areas where residents can meet relatives and friends in privacy, or they can see guests in their own rooms if they wish. The domestic team maintain high standards and keep the home clean and hygienic throughout. The following observations were made during a brief tour of the building: • • • The staff room door was propped open; this is a fire door and staff smoke in this area. The sign on the door says, “Keep closed”. Some bedroom doors were propped open. If doors need to be left open they should be fitted with a mechanism that links to the fire alarm system, allowing the door to be released when the alarm is activated. It should not be necessary for reminder notices about care tasks to be pinned up in resident’s bedrooms. One notice was to remind staff to make sure a resident was helped to wash and dress each morning and to make sure she had clean clothes on. It should be sufficient to include this information in the care plan. In one of the bathrooms a notice was displayed reminding staff to weigh residents and to cut their nails. Some of the bedroom doors were not closing fully. These need to be checked. • Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 21 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): 27,28,29,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff need to be better deployed so that residents can readily call upon them if they need assistance. Staff records need to be checked to make sure they contain all the required information. EVIDENCE: According to the staff rota, the home is adequately staffed to meet the needs of residents. Five staff were on duty at the time of the visit to the home, although one person had escorted a resident to a hospital appointment. Four out of five relatives who completed comment cards were of the opinion that there were not always sufficient staff on duty. One relative said that on some occasions when they visited the home, they could not see any staff when they first entered the building, another said there were periods when staff were not in evidence in the communal areas at all. Relatives said in their opinion, too many staff took their breaks at the same time, leaving the communal areas unsupervised at times. During our visit, we noted that there were no staff in the lounge at one point for a period of 30 minutes. We witnessed a resident in the lounge shouting for staff, and had to alert a senior member of the team. She then summoned staff using the intercom system and after a short time a member of staff attended to the resident. In the surveys Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 22 residents were asked if there were staff available when they were needed. One person replied “sometimes” another said “not always”. Some of the residents at the home are confused and would not be able to use a call bell to summon help. It is important that staff are effectively deployed within the home at all times, to make sure that residents are safe. This was discussed in feedback at the end of the visit. A sample of five staff files were examined to see whether prospective employees were being appropriately checked before they started work in the home. The home has to carry out these checks to make sure that the staff are suitable to work with people who are vulnerable. In all cases Criminal Records Bureau checks had been carried out. Not all of the files contained two dated references that had been received before employment commenced. In one case a member of staff had left the home and had been re-employed without completing a new application form. These issues need to be addressed. The files contained details of training that staff had taken part in and of staff supervision. No staff contracts were in evidence. There needs to be a more systematic approach to maintaining what is held in the staff files. Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 23 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): 31,33,35,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although there are areas for improvement in performance, the management team is taking positive action to address these. Measures are in place to improve consultation with residents and their families about the service provided. EVIDENCE: There is evidence to indicate that the home has not been well managed over recent months. The standard of record keeping has deteriorated, staff morale has been low and in some areas the home has not performed to its usual good standard. Relatives have made complaints about the quality of care and some have expressed concern that the issues they raised were not taken seriously. Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 24 A new manager has been in post since mid September 2006, although she is not yet registered with the Commission, she has applied for registration. She has a number of years of experience in working with older people in a care setting. A series of meetings have been set up between relatives and management and they are talking about any areas of concern and how these can be best addressed. Questionnaires have been sent out to all relatives asking for their views on the quality of the service provided at Bankfield. It is positive to note that a team of managers who work for the company have identified the areas where the home is underperforming. They have already established an action plan showing what improvements are planned with associated timescales; this was shared with us on the visit to the home. Records were available for the servicing of equipment that is used in the home; these were all up to date. The home does not hold money for residents as a matter of routine; relatives usually administer finances. Arrangements must be made to test the fire alarms when the maintenance worker is off work. The last recorded test was on 26/10/06. Tests must be carried out weekly. Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Bankfield Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 26 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 OP2 Regulation 5 Requirement Residents must be provided with a statement of the terms and conditions of residence at the point of moving into the home. Care plans must be reviewed to make sure they a) Contain up to date information about residents needs. b) Indicate clearly the action that staff need to take to meet residents needs. Moving and handling plans must be reviewed to make sure they are up to date and relevant. The daily records must provide evidence of the care and support that staff provide. Staff must be instructed to treat residents with dignity and respect. The medication fridge must be defrosted to make sure that medication is stored at the appropriate temperature. A risk assessment must be carried out to ensure the safety of residents who go out of the home unaccompanied. DS0000057396.V320052.R01.S.doc Timescale for action 31/12/06 2 OP7 15 28/02/07 3 4 5 6 OP7 OP7 OP10 OP9 13 15 18 13 27/01/07 12/01/07 31/12/06 24/12/06 7 OP14 12 24/12/07 Bankfield Residential Home Version 5.2 Page 27 8 9 OP12 OP16 16 Schedule 4 13 10 OP18 11 12 OP19 OP27 23 18 13 OP29 19 14 OP38 23 Residents must be consulted about the sort of activities they wish to be involved in. A record must be kept of all complaints made which includes details of investigation and any action taken. All incidents of abuse must be recorded and referred to the area adult protection coordinator. Doors in the home must not be propped open unless they are linked into the fire alarm system. Staff must be available at all times in sufficient numbers to meet the assessed needs of residents. Two written references must be obtained before appointing a new member of staff; gaps in employment history must be explored. Arrangements must be made to test the fire alarms every week. 31/12/07 24/12/06 24/12/06 24/12/06 24/12/06 24/12/06 24/12/06 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 Residential Home DS0000057396.V320052.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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. 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