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Inspection on 05/07/05 for Bassingham Care Centre

Also see our care home review for Bassingham Care Centre for more information

This inspection was carried out on 5th July 2005.

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

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

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 has a committed manager and staff who provide care to residents in an attentive and gentle fashion. Many of the staff have worked in the home for a number of years and are very knowledgeable about their residents` needs. The cook has worked in the home for a number of years, and on each inspection has been complimented on the quality of food she offers to residents.

What has improved since the last inspection?

The manager and training officer have prepared a training programme.

What the care home could do better:

Areas of the environment need to be improved and the home has been requested to provide and action plan. Staffing levels have been reduced and need to be urgently reviewed to ensure that both residents and staff are safe. Overseas staff working in the home must be able to communicate effectively in English with residents in order to understand their needs, and ensure their safety.

CARE HOMES FOR OLDER PEOPLE Bassingham Care Home The Old Rectory 2 Lincoln Road Bassingham Lincs Lead Inspector Jean Cope and Roger Harrison Unannounced 5 July 2005 09.30 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. Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bassingham Care Home Address The Old Rectory 2 Lincoln Road Bassingham Lincolnshire LN5 9EY 01522 788215 01522 788509 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) Cornward Ltd Mrs H Boothright Care Home 61 Category(ies) of Old Age (OP) - 61 registration, with number Physical Disabilty (PD) - 1 of places Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The Service User in the category of Physical Disability (PD) is on a named basis only and is aged 62 years and over. Date of last inspection 12.02.05 Brief Description of the Service: Bassingham Care Home for Older People is situated in its own grounds in a village location, which has a church, shops and public house. Accommodation is provided in two areas. The main house was a former rectory and has been adapted and extended to provide accommodation for residents on two floors. The first floor is accessed by a shaft lift. Rooms are shared or single and some have en-suite facilities. The main building houses the laundry and kitchen, which provides a service to both units.The second area is of bungalow style units, which provide accommodation for up to two Service Users in each bungalow. The bungalows are self-contained, with a kitchenette, and bathroom, bedroom and sitting room. The bungalows have patio doors on to the garden. A large communal room is available for residents for leisure and social activities.The home has a large garden and is laid to lawn and flowerbeds. In the summer seating areas are provided. There is ample parking both to the front and side of the building. The home is registered to provide care and accommodation for people over 65 years, offering nursing and personal care for 61 Service Users. The home is privately owned and managed, and is one of four homes which are operated as a group. Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors undertook this unannounced inspection with the assistance of the manager of the home, Mrs. Boothright, over a five hour period. The inspectors toured the building, talked with residents in the home and spoke with the manager and three members of staff. On the day of the inspection, there were 32 residents living in the home. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care that they receive through the checking of their records, discussion with them, the care staff and observation of care practices. What the service does well: What has improved since the last inspection? The manager and training officer have prepared a training programme. Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 6 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. Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 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 Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 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) 1,2 and 5 Written information is provided for new residents and their families about the home to enable them to make a choice, however, residents staying in the home for a short period are given nothing in writing to confirm how much they are paying and what they are paying for. EVIDENCE: The home has a statement of purpose and a service users’ guide, which is available for new residents and their families to look at. The manager said that she and a colleague are currently reviewing these documents. A welcome pack is placed in each resident’s bedroom prior to them moving into the home. The manager prefers to visit new residents in their own homes or in hospital prior to them moving into the home, however, if this is not possible, she requests written information from social services staff. One resident explained how her relatives had looked around the home before she moved in and has chosen a room for her. Terms and conditions are issued to residents who become permanent, but not to residents who are just coming for a short stay. Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10. The health care needs of residents are taken seriously. Staff administering medication need to be more attentive in completing medicine charts to show whether tablets have been given. Poor practice is potentially putting residents at risk. EVIDENCE: Each resident has a plan of care, which in some cases, has partially been written by the resident themselves. Care plans in the bungalow areas were inspected and had been reviewed on a regular basis. One resident was seen to have an appropriate pressure relieving mattress and there was evidence that she was been turned regularly. The manager has a particular interest in the management and prevention of pressure relief and said that the resident’s pressure area was ‘tremendously improved’. Residents have access to their doctors’ and hospital treatment when necessary. Medication records were looked at, and there were five gaps which had no signature against them, making it unclear as to whether the resident had received their medication or not. A prescribed medicinal cream was found in Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 10 one bathroom, which belonged to a resident who was no longer living in the home. Staff were seen knocking on doors prior to them entering and there were privacy screens in double rooms. Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 There is little in the way of organised activities in the home to fill residents’ time during the day. Food in the home is of a good quality, offers choice and is well cooked. EVIDENCE: One member of staff organises activities one a week, which could be bingo or games. It is however, acknowledged that many of the residents living in the home are ill and very dependent and do not want to participate in activities. One resident said that the ‘food was very good in the home’; comments such as this have been received on previous inspections. Residents families and friends are made welcome when they visit the home and they are offered refreshments. Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 12 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 outcomes were not inspected on this occasion. Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 13 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) 19, 21, 22, 23 and 26 Although the home is comfortable there are areas in the home that need to be improved to provide a better environment for residents living in the home. EVIDENCE: The home is comfortable and odour free throughout, however the carpets and curtains in the dining room needed attention and there were areas in the home where the paintwork was damaged. Ivy was seen to be growing through the secondary glazing on one of the windows on the stair well. Three of the overseas staff working in the home are accommodated in one of the bungalows, registered as part of the care home. Two bathrooms were being used to store equipment, which was not being used. There are on going problems with the call bell/bleep system, which means that sometimes residents’ calls for assistance are not registered. It is acknowledged that the engineers have been out to check the system. Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 14 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, 29 and 30 Staffing levels and the recruitment procedure need to be urgently reviewed to ensure that residents’ needs are being met and that they are not being put at risk. EVIDENCE: Residents said that the staff were, ‘good kind staff’ and that they were ‘happy here’. One member of staff is allocated to work alone in the bungalows where she is responsible for fourteen residents, five of them requiring nursing care with high dependency needs. However, she works as part of the whole staff team and can call for support when necessary. Staff and a resident commented that there are a lot of overseas staff who are not able to understand the social needs of residents. One staff member said she felt she was not able to meet residents’ needs, saying, ‘I feel I have never done enough and I am not able to give the care I’d like to give’. The manager has also expressed her concerns to the proprietor in relation to staffing levels in the home. A training programme has been developed, with a staff member saying that there was ‘lots of training on offer’. One member of staff had been employed in the home without an up to date CRB check and had brought one from another home. This was brought to the attention of the administrator who was unclear whether the proprietor had employed her as permanent member of staff. Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 15 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 manager must be given sufficient time to manage the home and supervise staff to ensure the home is run in the best interest of residents. Overseas staff must have a command of English so that they are able to speak with residents and understand their needs and be able to call for assistance in an emergency situation. EVIDENCE: The home has an experienced nurse manager who has worked at the home for many years. The manager is often working as a member of the shift with little time given to manage the home and to supervise staff appropriately. Fire equipment in the home had been serviced in March 2005 and the home has an up to date fire assessment with fire training being provided for all staff in the near future. Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 16 One member of staff was unable to explain what to do in the event of a fire. This was discussed with the manager, who felt this was because she did not have sufficient use of English, rather than not knowing what to do. Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 17 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 3 3 x x 3 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 2 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 2 3 2 2 3 x x x STAFFING Standard No Score 27 2 28 x 29 2 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 2 x 2 Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 18 no 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. 2. Standard 2 9 Regulation 5(1)(b) 13(2) Requirement Timescale for action 30.09.05 3. 12 16(2) The home’s terms and conditions must be given to all residents moving into the home. Medication record sheets must Immediate be signed and reasons offered if a medication has not been given. Medications for named persons must not be used for other residents in the home and must be disposed of appropriately The Registered Person must 30.09.05 consult with Service Users about their social interests and enable them to engage in them.Some service users’ interests had been recorded, but there was no evidence that the home had offered opportunities for social activities. The manager has improved the activities available but agrees more activities should be available. The home must be kept in a good state of repair and provide a homely and comfortable environment.Some carpets are worn and faded and some areas inside and outside the home need attention. The registered person must send an action plan 31.10.05 4. 5. 9 23(2) Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 19 6. 7. 21 22 13(4) 13(4) 8. 27 18(1)(a) 9. 10. 11. 12. 29 31 36 38 19 and Schedule 2 13(4) c 18(2) 13(4) of how this requirement will be met. Bathrooms must be cleared of unused items of equipment. Residents must be able to feel sure that the call bell system will work when they call for assistance Staffing levels must be urgently reviewed to ensure that there are enough staff on duty to meet residents needs and ensure the safety of staff. All staff must be recruited safely and have a CRB check The manager must be given enough time to manage the home. All staff must be supervised appropriately All staff in the home must be able to commnicate sufficiently well to be able to deal with a crisis and be able to explain the procedure in the event of a fire. Immediate 30.09.05 Immediate Immediate Immediate 30.09.05 Immediate 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 19 Good Practice Recommendations The main path from the home is gravel based making if difficult for staff to push food trolleys over etc. and for wheelchairs users, or those service users who have reduced mobility. One area has an incline which on the day of the inspection was very slippy.The registered provider must undertake a risk assessment of this area. All staff must be supervised appropriately 2. 36 Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unity House, The Point Weaver Road Lincoln LN6 3QN 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 Bassingham Care Home C53 C04 S2504 Bassingham Care Home V236738 Stage 4.doc Version 1.40 Page 21 - 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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