Inspection on 25/01/07 for Bannatyne Lodge Care Home

This inspection was carried out on 25th January 2007.

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

Bannatyne Lodge Care Home 20/07/10

Bannatyne Lodge Care Home 04/02/09

Bannatyne Lodge Care Home 02/12/05

Bannatyne Lodge Care Home 15/07/05

Bannatyne Lodge Care Home 17/12/04

Bannatyne Lodge Care Home 10/06/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Bannatyne Lodge Care Home Manor Way Peterlee Durham SR8 5SB Lead Inspector John Trainor Unannounced Inspection 10:00 25 & 29 January 2007 th th 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 Bannatyne Lodge Care Home DS0000000689.V326046.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. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bannatyne Lodge Care Home Address Manor Way Peterlee Durham SR8 5SB 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) 0191 5869511 0191 5871741 www.fshc.co.uk Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Donna Marie Remmer Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50), Physical disability (8) of places Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Physical disability up to a maximum of 8 persons with a physical disability, (aged 55 and over) may be accommodated commensurate with the home’s Statement of Purpose. Named Individual: The home may accommodate a named individual, as set out in a letter to the registered person dated 22 September 2005, which establishes the basis on which the individual’s needs will be met by the home. Where necessary the home’s Statement of Purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else, other than the named individual, who falls outside the registered category. 2nd December 2005 Date of last inspection Brief Description of the Service: Bannatyne Lodge is a care home with nursing for older people. It has some beds registered for people who are physically disabled over the age of 55 years. It has 50 single bedrooms, each equipped with an en suite toilet and wash hand basin. Older people with or without nursing needs may be admitted, depending upon their assessed needs. The home is well situated close to the centre of town. It is accessible by people with mobility problems and there are pleasant garden and patio areas for residents to enjoy. The home is well equipped and there are a number of attractive lounges throughout the building. Fees at the time of inspection were £364.50 to 576.00. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection involved the home providing information to the Commission for Social Care Inspection. This included feedback from relatives and people who live in the home. There was then a site visit which was unannounced and lasted 9 hours. During this visit records were inspected including care plans and health and safety records. Care practices were observed. People were spoken to including residents, staff and management. There was a tour of the building. What the service does well: What has improved since the last inspection? What they could do better: People did not have enough detailed information to make a fully informed choice before they moved in. Improvement was needed to information on fees and how they were structured. Some people did not have copies of contracts or terms and conditions. People should be told it is cheaper for them to have their care contracted by social services even if they have to pay social services the full amount back. The home needed to confirm in writing they could meet people’s needs, before they moved in. Choice was sometimes limited. One relative said, “I don’t think it’s fair people should have to have their doors Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 Page 6 closed, or be expected to pay £100 for something to keep it open. What about those who can’t afford it?” Fire safety practices needed improvement, as doors were being wedged open, which would pose a risk in the event of fire in the home. The home responded to requirement by the Commission to improve quickly and, on the second day of inspection, necessary action was already underway to remedy matters to ensure safety in the future. More trained first aiders were needed in the home. 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. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 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 Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, and 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People had their needs assessed before making a decision to move into the home but did not have enough detailed information to make a fully informed choice before they moved in. EVIDENCE: All files inspected had a pre admission assessment so people could be assured their needs had been assessed by the home before a decision to move in was made. Regulation requires written confirmation from the home, after assessment is completed, that the home could meet peoples needs. There was no evidence this was happening. People could visit before they made a decision. The last inspection report was available in the office upon request and the service user guide referred people to the office if they wished to see it. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 Page 9 Some people did not have contracts on file (2 of 3 case tracked. This was the same as the number of people who told us before the site visit that they had not received a contract.) The company had a statement of terms and conditions and a form for acceptance of terms and conditions. There were some areas of concern in these documents. One was the breakdown of fees in the acceptance document. These were not clear. They did not specify the amount payable by the local authority. They did not include a detailed statement of assessed nursing contribution and who this was payable by. All nursing files inspected did have a record, from the PCT to the service user, informing them of their assessed nursing contribution, so it was clear people did get this information. This was not facilitated by the company as required by regulation. Also in the terms and conditions there was a statement saying the home could charge people for “extraordinary” nursing care not covered by the PCT free nursing contribution. This was a vague and unclear statement, extraordinary was not defined. The company could increase the amount of money required for assessed nursing care and charge this to the resident. There was no outline for the process to determine this or what appeals process is in place. This needed to be clarified. People were not informed if they independently chose to use the home they would be charged a higher rate per week. If they sought the support of a social worker to contract through social services arrangements, they would be charged the same, lower fee as the local authority, regardless of their income. The contract did not outline how fees were calculated, specify the bedroom to be used, outline the rights and obligations of the customer or care home or who would be liable for a breach of contract. One outcome of this inspection required the home to secure devices to enable them to wedge open doors safely. Though the company responded promptly, the charge for making these basic health and safety improvements was passed on to the service user or their relative, to the cost of £100. This information about additional costs for accommodation was not included in statement of purpose or service user guide. Nor would it be covered in the statement of terms and conditions as an increase in fees resulting from a “material change in the companies operating costs which was not reasonably foreseen at the time of the annual review.” It is reasonable to expect the company to know these basic fire safety measures, as an operating cost, before people move into the home, so unreasonable to pass on the cost after people have made the decision to move in. The home did not provide intermediate care. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs were met in a planned way, assessing potential risks. Care was delivered with regard to dignity and respect. EVIDENCE: All files inspected had care plans. These included comprehensive assessment of need and plans to ensure people were looked after in a consistent way. Plans were signed to confirm agreement by service users. There were records of access to the doctor and district nurse as well as specialist secondary health care services. Care plans were reviewed monthly and the manager completed a rolling audit on a 3 monthly basis. There was an activities co-ordinator who provided group activities but also worked on a one to one basis with people. She found out the things they liked and disliked and attempted to give people activities they would enjoy. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 Page 11 Staff were seen to treat people with dignity and respect. They were patient and understanding. Medication was stored safely and most records of administration were good. There were some gaps in recording where it was not clear if people had got their medication. The manager could identify which staff members were responsible for this and was to deal with it through individual supervision, having previously reminded the whole staff team of the importance of accurate recording for medication. Care plans were good though improvement could be made by recording specific individual preference, (e.g. detailing which products people liked to use for personal care). Recording the detail of individual activity plans would also improve plans and ensure continuity of care. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s lifestyle met their expectation in most areas though choice was sometimes limited. EVIDENCE: Activities were provided by a co-ordinator, who tailored both group and individual sessions to people’s preference. One staff member said of the activities co-ordinator, “brilliant with them, you can see the residents come out of themselves.” Visitors could come when they wished and gave glowing references of the service provided by the home, though some were unhappy with additional charges for the fire safety devices to doors. These charges did inhibit some peoples choice. Food was said to be good by everyone who responded. One person said, “the food’s marvellous I used to get too much on my plate but I told them and now they just give me what I can eat and that’s ok.” And went on to say, “ I asked cook for brown bread and jam and got it.” This showed people could have a choice and did get their preferences respected. Another said, “the foods Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 Page 13 canny.” Some of the choices on the set menus were not real choices and this needed revision. Fish or fish pie, savoury mince or chilli, steak or steak pie did not give real choice. Kitchen staff confirmed fresh vegetables were used and ordered as needed, bread and milk was delivered every day. Suppliers were said to be good and they had what they needed. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People had their concerns and complaints listened to, dealt with and were protected from potential abuse. EVIDENCE: Complaints records were inspected and the home kept accurate records of complaints and concerns. Relatives also fedback that action was taken when complaints are made. Staffing had been increased since the last inspection. There was an adult abuse policy. Staff were trained in adult protection using a booklet which once completed could be retained as a permanent reference. Staff were recruited safely, all files inspected had Criminal Records Bureau checks. Staff could identify actions to take in the event of abuse when interviewed during the inspection. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People lived in a clean, and comfortable home though fire safety practices needed improvement. EVIDENCE: The home was clean tidy and well decorated. People said their rooms were comfortable and communal areas were comfortable and well maintained. One person said, “I’ve never been in such a lovely place in my life.” The central heating system did not work effectively leaving problems with some radiators. The dining room radiators were not working properly. Additional heating had been brought in as an interim measure and the estates supervisor was aware of the problem and was taking steps to identify a solution. People said they were warm enough and the home was warm on the day of inspection. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 Page 16 Communal bathroom and toilet areas would benefit from having paper towels and liquid soap to improve infection control. There was a laundry and sluicing facilities with sluice disinfector in working order. Many doors in the home were being routinely wedged open. This contravened fire safety legislation and if there was a fire would place people at risk. Doors must not be wedged open unless by devices approved by the fire officer for this purpose which will close in the event of a fire. Wedges were removed during inspection to ensure safety and the home was required to ensure safety was maintained. Immediate action was taken by the company and on the second day of inspection devices were already being fitted to doors. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff were skilled and deployed in sufficient number to meet people’s needs. EVIDENCE: Staffing numbers had increased since the last inspection. There were now 1 nurse and seven carers on duty during the day and 1 nurse and four carers on duty at night to cover both floors. The manager and staff felt these numbers were enough to meet people’s needs. Feeback from relatives and service users was positive that people were being well looked after. There had been an increase in the number of staff qualified to NVQ level 2 or above though the home still did not meet the 50 required level. Some staff members were in the process of doing this training. Staff were recruited safely with Criminal Records Bureau checks. Staff files did not contain a comprehensive employment history, application forms had been left blank and no record of checking this had been recorded at interview. Staff were receiving training. More people needed first aid training. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was being managed in the interests of the people who lived there. EVIDENCE: On the site visit the manager was found to be approachable and confident. Most health and safety matters had been addressed. Electrical hard Wiring and Gas safety certificates were current. The passenger lift was being serviced. The manager audited care plans on a rolling programme, audited medication and audited falls. COSHH assessments were in place. Water temperatures and legionella records and procedures were being checked and maintained. PAT testing was being completed annually. Service user monies were being maintained with an auditable system. Accident and incident Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 Page 19 records were inspected and being well maintained. Supervision of staff was taking place 2 monthly. There was a fire risk assessment. Safety checks were being conducted on fire alarms, emergency lighting and fire fighting equipment. Fire drills were held. All of these meant the home was being kept safe for the people who lived there. Residents and relatives knew the manager by name. Staff said the manager was approachable, “fair and thorough. She likes jobs done properly.” And that the home was, “run nicely.” The manager did not complete any Quality Assurance checks with regard to relatives or service user questionnaires/feedback. The company was developing a quality assurance programme which would be implemented. The manager was in the process of completing her Registered Manager Award. Doors were being routinely wedged open (see environment section of this report). The provider had not been completing visits and reports to the home as required by regulation. A new manager had taken over responsibility for this recently and had made an initial visit to the home. These visits must be completed monthly and must be recorded. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 Page 20 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 2 1 3 x X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 Page 21 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 OP1 Regulation 5(1(bd)), 6 Requirement The registered provider must revise the service user guide to make explicit any difference in fee between people paying for their own care and people whose care is funded, in whole or in part, by a person other than the service user. And shall notify the Commission for Social Care Inspection and service users of the revision when completed. The registered provider must provide people with a contract or statement of terms and conditions. They must also review and revise contracts and terms and conditions to make sure they are fair and give sufficient detail about peoples’ rights. Particular attention should be given to those matters raised in the relevant evidence section of this report. (Choice of Home) The registered provider must confirm in writing that it is able to meet the health and welfare needs of a person, following assessment and before they move into the home. DS0000000689.V326046.R01.S.doc Timescale for action 31/03/07 2 OP2 5 30/04/07 3 OP2 14(1(d)) 31/03/07 Bannatyne Lodge Care Home Version 5.2 Page 22 4 OP9 5 OP19 13(2), 17(1(a)) schedule 3 (k) 23(4)) 6 OP33 26 7 OP38 18(1(a)) The registered persons must ensure staff adhere to procedures for recording administration of medication. Doors were wedged open and it was apparent this was a routine occurrence. Wedges were moved during the inspection to ensure safety. It is required that doors must not be wedged open unless with devices approved by the fire officer for this purpose. Reports of visits made under Regulation 26 must be completed each month and a copy forwarded to the Darlington office of the Commission for Social Care Inspection. A copy must also be maintained in the home. (Previous requirement not met by 31/03/05 and 01/09/05.) More staff must be trained in first aid to ensure a qualified first aider on duty at all times. 25/01/07 25/01/07 31/03/07 30/04/07 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 Refer to Standard OP7 Good Practice Recommendations Care plans were good though improvement could be made by recording specific individual preference, (e.g. detailing which products people liked to use). Recording the detail of individual activity plans would also improve plans and ensure continuity of care. People should be able to choose to have their doors open when they wish to remain in their rooms and have this facilitated safely regardless of their income or ability to pay. Menus should be revised to ensure there is a real choice for people each day. A minimum of 50 of care staff should be qualified to DS0000000689.V326046.R01.S.doc Version 5.2 Page 23 2 OP14 3 4 OP15 OP28 Bannatyne Lodge Care Home 5 6 OP31 OP33 NVQ level 2 or above in care during 2006. The manager should complete the Registered Manager’s Award. The views of service users about the quality of the services and facilities provided at the home should be sought, and the results published as part of quality assurance. Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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. Extracts may not be used or reproduced without the express permission of CSCI Bannatyne Lodge Care Home DS0000000689.V326046.R01.S.doc Version 5.2 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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