Inspection on 19/08/05 for Bankwood Care Home ( Ashbourne Senior Living)

This inspection was carried out on 19th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Bankwood Care Home ( Ashbourne... 05/07/06

Bankwood Care Home ( Ashbourne... 03/02/06

Bankwood Care Home ( Ashbourne... 10/03/05

Bankwood Care Home ( Ashbourne... 20/10/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Bankwood Care Home Duffield Bank Belper Derbyshire DE56 4BG Lead Inspector Brian Marks Unannounced 19 August 2005 9.30am 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. Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bankwood Care Home Address Duffield Bank Belper Derbyshire DE56 4BG 01332 841373 01332 841724 bankwood@highfield-care.com Southern Cross Care Homes No 2 Limited 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) Mrs Izeta Hamza CRH N - Care home with nursing 40 Category(ies) of 40 places - OP Old Age registration, with number 1 place - 0 years - 45 years of places Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. That included in the numbers are provision for two people with physical disabilities aged 50 years and over. 2. One-off variation for named individual (SB). 3. One-off variation for named individual (MG) with LD. Date of last inspection 10 March 2005 Brief Description of the Service: The home is located in the Derbyshire countryside close to the town of Belper. The home has 40 places, all of which are in single rooms; half of these have en-suite fcailities. The home is registered for providing care for 38 older persons and 2 physically disabled persons, with a one –off variation for another physically disabled person. It consists of an older building with a larger extension, which has been built into the embankment. The lounge and dining rooms are situated in the older part of the home, and include a conservatory which is used every day by residents and is a popular meeting place. The size and shape of the bedrooms are varied and dependent on the location within the home. The home employs an activities coordinator and most residents participate in its lively social life and entertainment programme. The home has the support of local GP practices and the activities of the nurse group at the home are supported by a range of outside health and social care professionals. The home is well equipped to meet that range of needs of its residents. Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit that took place at the home over a morning. Additionally, time was spent in preparation for the visit, looking at previous reports and other documents. At the home, apart from examining the home’s documents, care files and records, time was spent looking around the building and speaking to staff, visitors and residents in various parts of the building. Staff were also observed throughout the visit, looking after and dealing with residents and visitors, whilst a group of residents took part in the morning’s activity in the conservatory. The manager was present throughout the inspection visit. What the service does well: The physical standards of the home offer spacious and comfortable living space and all residents have single room accommodation, a good number with ensuite facilities. With a good arrangement of the public rooms, there are a variety of areas for residents to use during the day, by themselves or in company. This includes patio and garden areas that are enjoyed by residents during the summer months. Staffing levels at the home have been set above the minimum standard for this type of home and although the staff group is large, successful recruitment, using guidelines developed centrally by the parent company, has produced a team with a variety of skills, knowledge and experience. Standards of induction of new staff to the home are good and staff are able to quickly get to know the individual needs of the people who live at the home and what is expected of them. The work of the staff group is guided by good quality documentation particularly the personal care plans. These are based on wide-ranging assessments, and cover a variety of needs and individual types of service user, some of whom have complex physical and emotional health problems. The care plans ensure that staff properly understand the individuals who live at the home, and work consistently and safely, using up-to-date information. Staff are very committed to their work at the home and they receive a good standard of training and development that helps them do their jobs better. Relationships between staff and residents are good and the residents themselves are very positive about the care they receive ‘We’re very well looked after – it’s like a 5 star hotel here’. Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 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 Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 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 and 6 People do not come to live at the home without their needs being assessed and the services they need from the home being identified. This makes sure that they get the right care as soon as they move in. EVIDENCE: Either just before, or at the time, someone is admitted to the home the manager or other senior staff carry out an assessment of what care they will need from the home, and whether the home is able to meet their needs. From all the files looked at, this is carried out to a good standard and a number of formal assessments are carried out as well: pressure areas, moving and handling, nutrition, continence and dependency. These all help the completion of a detailed care plan (see next section) that indicates how staff would provide help consistently and safely on a day-to-day basis. This is written in an easy-to-follow style that ensures all areas of care needed by each individual are described, including health and personal care needs. The staff spoken to commented how the documentation was easy to use, particularly when they started to work at the home for the first time. Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 9 The home does not provide an intermediate care service so Standard 6 does not apply Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 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, 9 and 10 The care of all residents, including health care, was planned and given in a way that respected individuality and privacy. EVIDENCE: The records of 3 residents were closely examined and the residents themselves were asked about how they were cared for and about life at the home. The design of the care plan was the one in operation throughout all the company’s homes, and had recently been changed by the new owners of the home. The plan was drawn up using information from the assessments prior to admission, observations made by staff after admission, and from consultation with the residents and their relatives. The care plans included a comprehensive description about how staff care for individuals divided into a number of important areas to reflect personal and health needs. Additionally, some of the assessments referred to previously identified areas of risk affecting the residents’ lives, and these created a practical guide for staff to care for residents consistently and safely. All the care plans examined were evaluated monthly by the home’s staff, and revised where necessary; general reviews of care were held with families and outside professionals on a less regular basis but at least every six months. This made sure that all the people involved Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 11 were given accurate information about how care was being given and progress that was being made. All the residents spoken to reported that staff worked well for them and that ‘care is done with sensitivity and always in my bedroom with the door closed’. Staff described how they were given guidance at the start of their employment on how care was to be given properly and how they always observed a resident’s privacy and treated them with respect. This included the giving of both personal and nursing care, and a number of written protocols are in place to guide staff in the right ways of working. Good contact with local health care services was indicated in the records and one of the residents spoken to was going out to an outpatients appointment at a local hospital that morning. The records examined indicated that none of the residents looked after their own medicines and this was managed by the home on their behalf. This area had been a cause for concern earlier in the year and a particular problem reported by the home’s manager had resulted in an additional inspection visit. The issues raised have been satisfactorily dealt with and additional training and instruction had been given to the home’s nurses as a result. Generally the storage, handling, administration and disposal of medications were satisfactory although a number of issues have prompted recommendations for quality practice. These were related to equipment in use within the clinic room and recording practice around one specific medication that will make sure the systems are completely safe. Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 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) 15 The catering service of the home meets the needs of its residents, with a menu that offers variety and choice. EVIDENCE: A visit was made to the kitchen and dining room, and discussions were held with the cooks and the manager about the home’s catering. This indicated that a choice of food was available at the main meals and that the individual preferences of the residents are identified and responded to. The kitchen assistant speaks with all of the residents at breakfast time to get their choices for the day’s meals and, for those who can’t respond to this, the care staff make sure that their likes and dislikes are passed on to the kitchen staff, who keep an up-to-date record available in the kitchen. Because of the size of the home and the choice of the residents, meals are served at regular times, although breakfast continues to be available for much of the morning if required. This was observed during a visit to the dining room, which is arranged to make dining a comfortable and enjoyable experience. A cooked breakfast is available every day, as is an option for a cooked afternoon tea on alternate days. The menu is extensive and varies around an 8-week cycle to avoid too much repetition. Special diets are catered for and people suffering from diabetes, those requiring softened meals and vegetarians are all catered for. Because catering staff are responsible for serving the meals, the care staff are available to offer assistance in the dining room where needed and lunch Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 13 was observed to be an unhurried experience, confirmed by the residents themselves. Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 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) EVIDENCE: These standards were not specifically looked at at this inspection. Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 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) 20 and 26 The home is clean, hygienic and offers good standards of comfort to residents in the garden and communal areas, and this had led to high levels of satisfaction. EVIDENCE: The home has a number of communal spaces and all were visited during the inspection. The conservatory is particularly popular with residents and was the place where the main organised leisure activity takes place. There are also quiet areas where the residents said they could sit privately with visitors and a comfortable dining area, referred to above. Decoration and furnishing standards are good in these areas and redecoration regularly takes place. Residents also reported that the patio area in front of the house has been used regularly during the summer ‘there’s such a lovely view across the valley sitting out there’. The home has a large laundry, situated at the back of the building and a laundry assistant on duty every day, so that this job is specifically attended to. A good system for managing personal laundry and bed linen was described by Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 16 the assistant on duty and clothing is usually returned on the same day to residents unless there are special requirements, such as delicate fabrics. Residents themselves spoke positively about the laundry service of the home and had no complaints or concerns, and they were all well dressed in appropriate clothing. The home was very clean and tidy, and free from odours at the time of this inspection, and the manager described the system that operated with the domestic staff that kept it that way. Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 17 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 and 30 The home employs good numbers of staff at all times and they are provided with training so that they work safely and with professionalism. EVIDENCE: Examination of the rota for care and nursing staff at the home indicated satisfactory levels of staff on duty during the day and at night, and this was borne out by observations of staff and from talking to them during the visit. Whilst the working day can sometimes be very busy staff did not feel that it was unacceptably so and usually allowed for time to them to spend individually with residents and be unhurried in their work. There were also sufficient domestic and kitchen staff on duty to make sure that the home was properly clean and the catering well managed. Examination of the staff training records and discussion with staff indicated that a lot of training and development opportunities were made available to them throughout the past year, and care staff have had regular ‘top-ups’ of the core health and safety training. The manager and deputy were particularly keen to emphasise their commitment to training, and have managed to obtain a number of different sources of training activity that are inexpensive and can be held in-house. The care staff spoken to were also very positive about the training they had received and described an atmosphere amongst the staff group where this activity can flourish and grow. A relatively new member of staff also described how she had started work at the home and how this had involved an extended period of ‘shadowing’ an experienced member of staff, Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 18 until she felt confident to work on her own. This had helped her to work safely and confidently and to get to know the residents better. Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 19 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) 31, 36 and 38 The home’s new manager has made a positive impact on the home and has maintained orderly processes to make sure that staff deliver care to residents safely and consistently. EVIDENCE: The manager has registered with the CSCI since the last inspection and has continued to take part in much of the training taking place in the home for other staff, although she has not commenced on a Registered Manager’s course, which is required by law. She receives good support form her line manager, who remains the same in spite of the recent change of ownership of the home. She submits regular reports of her visits to the home to CSCI. Examination of records and discussion with staff indicated that staff are well supported by the senior staff to do their jobs properly and to sort out difficulties as they arise. All care staff meet with a manager in a private meeting at least every two months, as required by the law, and all staff have Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 20 had their work appraised yearly, so that any areas of weakness are identified and cleared up and areas of good practice given proper recognition. Staff said that day-to-day support from the home’s management is always available if they have any problems ‘the office door is always open and the manager helps us get things done’. Records indicated that all equipment at the home is regularly serviced and staff are encouraged to work safely through training and the general management approach at the home ‘safety is a constant feature all of the time’. In particular staff receive regular sessions on fire safety and drills, and equipment checks and testing are properly carried out – the fire alarm had its weekly test during the visit. All aspects of life at the home have been the subject to a formal risk assessment and this extends to the kitchen area, where this activity is carried out by the cook who has been fully trained in the subject. Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 21 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x 3 x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 x x x x 3 x 3 Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 22 Yes 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 28 Regulation 18(1) Requirement The registered person must ensure that 50 of care staff receive NVQ training to a minimum of level 2 by 31.12.05. (Made at last inspection but deadline not yet passed). The manager must register on a training course that leads to a qualification at NVQ level 4 or its equivalent. Timescale for action 31.12.05 2. 31 9(2) 31.06.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 9 9 Good Practice Recommendations If the registered perosn is treating the medication Temazepam as a controlled drug, all aspects of practice in this area should be followed. The temperatures of the refrigerator in the clinic room should be recorded as maximum and minimum values and the equipment used to carry this out should be periodically calibrated. The equipment used for blood testing of people with diabetes should be supplied for individual residents. Risk assessmenst carried out in the kitchen area should be produced in writing and the recommendations acted upon. C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 23 3. 4. 9 38 Bankwood Care Home Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby DE1 3QT 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 Bankwood Care Home C52-C02 S58023 Bankwood V245569 190805 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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