CARE HOMES FOR OLDER PEOPLE
Bankwood Care Home Duffield Bank Belper Derbyshire DE56 4BG Lead Inspector
Brian Marks Unannounced Inspection 3rd February 2006 09:15 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 Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Bankwood Care Home Address Duffield Bank Belper Derbyshire DE56 4BG 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) 01332 841373 01332 841724 bankwood@highfield-care.com Southern Cross Care Homes No 2 Limited Mrs Izeta Hamza Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 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. 19th August 2005 Date of last inspection Brief Description of the Service: The home is located in the Derbyshire countryside close to the town of Belper. The home has 40 places – 38 for older persons and 2 for physically disabled persons – all of which are in single rooms; half of these have en-suite facilities. The home 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 that 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 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 the range of needs of its residents. Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 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 documents, care files and records, time was spent looking around the building and speaking to some of the residents who were at home, and to the manager and staff. The aim of inspection activity during the current inspection year is to assess a service against the ‘key’ National Minimum Standards and these are identified at the beginning of each section of the report. The majority of these keys standards were examined at the last inspection so, for a more complete picture of this service, this report should be read in conjunction with the report dated 19th August 2005. What the service does well:
The physical standards of the home offer a spacious and comfortable living space and all residents have single room accommodation, a good number with en-suite 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 the 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 Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 Page 6 themselves are very positive about the care they receive ‘We’re very well looked after. There’s lots to do and we get 5 star treatment’. 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 DS0000058023.V279827.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: These standards were not specifically looked at this inspection, other than as part of a general examination of individual care records. It was noted that the manager had completed a programme of replacing the existing care planning and assessment documents with those that had been produced by the new proprietors. For the full assessment of the key standards see the inspection report dated 19 August 2005. Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not specifically looked at this inspection, other than as part of a general examination of individual care records. As noted above the manager had completed a programme of replacing the existing care planning and assessment documents with those that had been produced by the new proprietors. For the full assessment of the key standards see the inspection report dated 19 August 2005. Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 14 Residents at the home experience a range of activities and social events that are aimed at maintaining their independence. Family members and friends are also encouraged to join in with the life of the home and broaden the social network of the people who live there. EVIDENCE: From discussion with a group of residents and the displays on notice boards, the home offers a healthy social life for residents to enjoy and the activities coordinator is kept busy. At the time of the inspection a beauty therapist was doing manicures in the conservatory and records indicated that the hairdresser visits at least twice a week; a well-equipped room is available for her to use. The residents also talked about a short holiday that was planned for later in the year, which, if successful, will be repeated in the autumn. Good numbers of visitors are always seen at this home and those spoken to at this inspection were very positive about the home and their relationships with manager and staff ‘They have an eye for the little details of care that’s so important’. Throughout the inspection it was clear that the manager encourages the staff to treat every resident as an individual and to respect their wishes for they way they are looked after. People who live at this home make decisions about their lives for as long as they are able to and those spoken to were very positive about the respectful way staff deal with them.
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The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The home has comprehensive policies and procedures in relation to making complaints and the protection of vulnerable people, and staff are made aware of their responsibilities in these areas. EVIDENCE: The home has a comprehensive complaints policy and procedure, a copy of which is included in the Service Users Guide, which is given to residents and their representatives, and is also on display at the home. The manager reported that there had been no formal complaints made by anyone within the past 12 months. The procedure includes details about the CSCI and about how people can contact the Commission if they wish to complain further. The manager’s style is very open with residents and their families and those spoken expressed confidence that they can approach at any time and will be taken seriously. Regular meetings with residents and relatives are held throughout the year and issues are dealt with as they arise. The home has a detailed policy and procedure in relation to the protection of vulnerable adults, and this includes the local statutory procedure to be followed. Staff are given instruction at the time they join the home and through other later training. The deputy manager is now approved by Social Services as a trainer, a development that will substantially increase staff knowledge on the subject and maintain its profile within the staff group. Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The home is equipped, furnished and maintained to a good standard and offers homely and spacious facilities for residents to enjoy. EVIDENCE: A substantial tour was made of the building at this visit and it was noted that the good standard of the home’s environment had been maintained. This is assisted by the employment of a maintenance man, who makes sure that any problems are dealt with promptly. The manager described plans for a substantial investment by the new owners in upgrading the quality of decoration within bedrooms and this had commenced with increased numbers of more suitable beds and of other specialised equipment. Both the Environmental Health and Fire Officers had visited the home and their recommendations for improving safety had been followed. The home’s line manager assesses the quality of the home during regular visits. For the full assessment of the other key standard see the inspection report dated 19 August 2005.
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The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 29 The home is well staffed with people who have a good cross-section of experiences and skills. They join the home after the proper checks are made which make sure that only people who are right for the job look after the people living there. EVIDENCE: Records on staff files showed that 13 care staff had completed or were completing an NVQ qualification at a minimum of level 2, and the required target of 50 of staff should be achieved within the next few months. The manager stated that it is her aim to enhance the qualifications of all the staff and 3 have progressed to level 3 already. Staff were observed with the residents during the inspection and interactions were seen to be warm and professional. Residents described how the staff support them and how they have enjoyed their lives through the work carried out at the home. Examination of staff files indicated that a satisfactory recruitment process is followed at the home and that only the right people for the job are employed; all checks required to ensure protection of the residents are routinely made. A copy of the staff contract was noted on each file. This contained details of the terms and conditions of their employment so that they have full knowledge of their rights and responsibilities as employees of the home. For the full assessment of the other key standards see the inspection report dated 19 August 2005.
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The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 and 35 The home’s manager has continued to make a positive impact on the home and has established systems to make sure that staff deliver care to residents safely and consistently. EVIDENCE: The manager has continued to take part in much of the training taking place in the home for other staff, and she has recently commenced on a Registered Manager’s course, which is required by law. She receives good support form her new line manager, who submits regular reports of her visits, which were available for examination during the inspection. As an organisation the new owner of the home, Southern Cross, is committed to providing a quality service and employs a number of systems to make sure that standards are monitored and maintained. Apart from monthly internal quality checks carried out by the home’s manager, the organisation has completed development plans that cover a number of different areas of the
Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 Page 15 home’s operation – marketing, maintenance and staff training for example – and feedback is sought through surveys of residents and their families. A weekly briefing is published by the company for its staff which describes events and developments that are occurring through its homes, and the home itself has a regular newsletter that keeps residents informed. For the full assessment of the other key standard see the inspection report dated 19 August 2005. Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 X 28 2 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X X Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP28 Regulation 18(1) Requirement The registered person must ensure that 50 of care staff receive NVQ training to a minimum of level 2 by the due date. (Previous timescale of 31/12/05 not met). The manager must complete a training course that leads to a qualification at NVQ level 4 or its equivalent. Timescale for action 31/05/06 2. OP31 9(2) 31/12/06 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 Bankwood Care Home DS0000058023.V279827.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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