Inspection on 07/07/05 for Bathampton Manor

This inspection was carried out on 7th July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bathampton Manor 23/01/07

Bathampton Manor 06/03/06

Bathampton Manor 07/02/05

Bathampton Manor 09/07/04

Bathampton Manor 30/12/03

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Bathampton Manor Mill Lane Bathampton Bath Bath & N E Somerset, BA2 6TS Lead Inspector John Clarke Unannounced 7th 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. Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bathampton Manor Address Mill Lane Bathampton Bath Bath & N E Somerset BA2 6TS 01225 466260 01225 466260 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) BCVS Homes Mrs Marilin Evans PC Care home 21 Category(ies) of OP Old age (21) registration, with number of places Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 21 persons aged 65 years and over requiring personal care only. Date of last inspection 7-Feb-2005 Brief Description of the Service: Bathampton Manor is one of three homes owned and managed by B.C.V.S. a Bath based charity. The home is a converted older property set in extensive grounds. It is some distance from Bath the nearest facilities being in Bathampton which has pubs, church and small shop. The home offers care and accomodation for up to 21 older people over three floors with stair lift or lift access to all floors. Nine of the rooms offer en-suite facilities. There are two communal lounges and dining room with plans for a conservatory to be built during this year. The gardens and grounds are particularly attractive with level saccess and a number of seating areas. The philosphy of the home is to look after the residents in a caring and sympathetic way so that their privacy and dignity are respected and to encourage active independence where possible. A resident said of the home if you cant live in your own home its the next best thing. Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. Records seen included training records, care plans, medication records, staffing rota. A number of residents were ‘interviewed’ either individually or in a group. The manager was not present during this inspection the inspector being assisted by the deputy manager and a member of the senior care staff team. The staff were welcoming and helpful. What the service does well: What has improved since the last inspection? The home has met the requirements set from the previous inspection: these related to practice around the administering of medication and the training of staff in this area of work. The organisation has also introduced Protection of Vulnerable Adult guidance and this provides a clear procedure to all care and management staff about the actions they should take if an allegation of abuse is made. Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 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. Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 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 Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 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 The home obtains pre-admission assessments enabling them to make an informed decision as to their ability to meet the care needs of the prospective resident. EVIDENCE: Local authority assessments completed by a social worker with contribution from the individual gave information about the health and social care needs. The home also completes their own assessment and where possible visits the individual before they visit the home. If an individual has specific needs such as mental health then an assessment is obtained from the relevant specialist ie CPN, district nurse, GP. Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 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) 7,9,10 There is a clear and detailed care planning system in place to make sure that staff have the information they need to satisfactorily meet residents’ needs. The arrangements in the home to meet the residents’ medication needs are good and provide safe working practice. The working practices in the home ensure that residents are treated with respect and there are positive and appropriate relationships between residents and staff. EVIDENCE: Care plans gave full and detailed information about personal care needs, social interests and other areas of health and social care. Risk assessments about self-medication, leaving the home (for a resident who has an element of confusion) are completed and reviewed regularly. Keyworkers complete a weekly ‘diary’ which provide a picture of residents routines and events. Care plans are signed by individuals. Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 Page 10 Medication records were satisfactory, controlled drugs are witnessed by another member of staff. Arrangements for storage are safe and secure, returns are signed by pharmacist representative. Staff have completed accredited training promoting safe and good practice. Residents spoke positively about how they were treated by care staff: “I am always treated well”, when asked if treated with respect residents replied “always”, “never have cause to complain about how they (staff) speak to me”. In observing staff there was a patient approach made by staff particularly in one instance where the resident wanted to go home, asking why she was there. Staff were also observed asking residents “if they wanted ?” rather then telling. There was a choice given by staff. Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 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) 13,15 The home encourages residents to maintain their contact with the local community and family or friends so that these links are not lost because they are in a care home and continue to be an important part of their lives. The meals in the home are good offering choice, variety and where required cater for any special dietary needs. EVIDENCE: Residents spoke of regularly going out in one instance the resident said “it’s never a problem and they will always keep me a meal if they need to”, another “when my daughter comes they always make her welcome”. Residents spoke of going to local restaurant. Where able residents are encouraged and enabled to go out of the home though a risk assessment is completed. Comments in care plans confirmed that it is the right of residents to visit friends and family in the community even though they maybe at risk because of frailty or confusion. Meals are taken in a comfortable environment. When meals were served it was observed that staff offer support and were aware of particular likes and dislikes of residents. Residents were also offered choice in the meals they wanted. Residents said how the food was “always good”, “food is excellent”. Records showed a good range and choice of meals being provided at the home. Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 Page 12 Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 Page 13 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) 16,18 The home has a satisfactory complaints procedure which residents are aware of and feel able to say if they are unhappy about the care they receive and that they will be listened to and something done. The home has an Adult Protection policy and procedure and staff have received training making sure as far as possible that residents live in a safe environment. EVIDENCE: Copies of the complaints procedure forms part of resident’s information. Residents said that they were aware of the procedure. When asked residents said they would “always say” if unhappy, another “always consult you”, “I would tell someone”. Residents also said that they felt “listened to”. When asked residents said that they felt safe in the home. The Adult Protection policy sets out in a clear way the action to take if an allegation of abuse is made. Training records confirmed that all staff had received Adult Protection “Alerters” training and the manager had also done the “Investigators” training. A copy of the B&NES Multi-Agency Vulnerable Adult policy is available in the home. Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 Page 14 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 The environment in the home is of a high standard providing residents with an attractive and homely place to live. EVIDENCE: The home is well maintained with ongoing improvement in decoration. The top floor of the home was being decorated; on the previous inspection decoration of the second floor was being done. The garden is well maintained, paths and seating in good condition. Residents’ rooms are decorated to a good standard. Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 Page 15 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) 27,30 The home provides sufficient staff throughout the day and night to ensure the care of residents is provided. A low turnover of staff and not using agency staff helps to makes sure that there is consistency in the care of residents. A good level of training is provided so that staff have the necessary skills and confidence to provide care in a safe and competent way. EVIDENCE: Staffing rotas showed that there are generally 3 staff including senior care on duty in the mornings, 2 evening and 2 during the night. A duty manager is available throughout the 24-hour period. Staff said they felt there was enough staff on duty. Residents spoke of the staff as “always there to help”, “I can always call them and they will help me”. One resident said she liked the home because “the staff will do anything for you”, another “staff always helpful”. Training records showed that all staff had received the mandatory areas of training: moving and handling, fire safety. Some staff (particularly night staff) had received first aid training and food hygiene. Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 Page 16 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) These standards will be looked at on the next inspection. EVIDENCE: Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 Page 18 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 Regulation Requirement Timescale for action 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 Good Practice Recommendations Bathampton Manor D56_D05_S8147_Bathampton_V233933_070705Stage4.doc Version 1.30 Page 19 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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. 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