CARE HOMES FOR OLDER PEOPLE
Bickerley Green Kingsbury Lane Ringwood BH24 3EL Lead Inspector
Tracey Box Unannounced 25.08.05 10:00am 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. Bickerley Green H54 S37284 Bickerley Green V244784 250805.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Bickerley Green Address Kingsbury Lane, Ringwood, BH24 3EL 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) 01425 473312 Hampshire County Council D Kearton CRH 42 Category(ies) of OP- 42; DE(E) - 42; LD(E) - 42; LD- 2 registration, with number of places Bickerley Green H54 S37284 Bickerley Green V244784 250805.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Two identified service users may be accommodated in the category LD. 2. Two identified service users may be accommodated in the category LD(E). Date of last inspection 11.02.05 Brief Description of the Service: Bickerly Green is a Local Authority care home located in a quiet cul-de-sac close to Ringwood Town centre. The home is registered to provide up to forty two older people who may have dementia and learning disabilities. The home is a large detached purpose built establishment , comprising of single bedrooms, a large dining room, seating area just beside the main enterence, lounges and television room. The registered provider is Hampshire County Council and the registered manager is Ms Doris (Dorrie) Kearton. Bickerly Green is undergoing major renovation and the number if residents has reduced from forty two to twenty four until the work is complete. Bickerley Green H54 S37284 Bickerley Green V244784 250805.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours. The people living at Bickerly Green prefer to be referred to as residents, therefore will be referred to as this throughout the report. At the time of the inspection 23 residents lived at the home (One resident was in hospital). The manager showed the inspector the layout within and surrounding the home. Major building work is being completed to the side of the home, fortunately this has caused little disruption to people living, working and visiting Bickerly Green. One resident said “ for all the work that’s being done, it hasn’t bothered me, and my bedroom overlooks the work site.” The majority of the environment within and surrounding appeared clean and comfortable, however the inspector witnessed an offensive odour in a communal area and in one bedroom, the inspector was assured the cause was being investigated. The inspector witnessed good interacting between residents and staff. Records were seen and the inspector asked residents and staff for their views and experiences of living and working at Bickerly Green. What the service does well:
Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. Two staff told the inspector “I receive more than adequate training to enable me to carry out my role” “I am encouraged to do training, I really enjoy doing it, and working here”. The manager says there is great demand for the respite care service the home provides. The manager ensures residents are kept up dated of the current building work to the home, and consults and informs residents of future plans to renovate the existing Bickerly Green home. The inspector received comment cards from one resident and seven relatives/visitors. One resident stated “I like it here very much” All other comment cards stated on their satisfaction with the care and support the residents receive. One card read “I am more than satisfied with the care given to my relative. The staff are kind, efficient and patient. The care at Bickerly Green is excellent”. Bickerley Green H54 S37284 Bickerley Green V244784 250805.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bickerley Green H54 S37284 Bickerley Green V244784 250805.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 Bickerley Green H54 S37284 Bickerley Green V244784 250805.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) These standards were not assessed on this occasion EVIDENCE: These standards were not assessed on this occasion Bickerley Green H54 S37284 Bickerley Green V244784 250805.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) 10 Practices demonstrated that residents felt they are treated with respect and their privacy is upheld. EVIDENCE: One comment care read “Staff are tolerant of the individual needs of residents”. One visitor said “I can speak with my relative in private if I want to, today I wanted to chat with other residents as well.” The inspector saw staff knock bedroom doors and wait for a response before entering someone’s bedroom. Residents were referred to by their chosen manor, one resident conformed she prefers to be called by her Christian name. Residents rights and responsibilities are included in there ‘service user guide’ Staff receive training as part of induction, and the topic is discussed at supervision meetings and staff meetings. Staff receive a handbook which explains the meaning of privacy, dignity and respect, staff also have copies of the General Social Care Council Codes Of Practice. One resident said staff treat them with respect and dignity when helping them.
Bickerley Green H54 S37284 Bickerley Green V244784 250805.doc Version 1.40 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 standard(s) 12,13 Residents feel the home matches their expectations and preferences, their social, cultural, religious and recreational needs are met. Contact with family/friends/representatives and local community is encouraged as the individual wishes EVIDENCE: The inspector asked some of the residents what sort of activities they enjoy participating in, all explained how much they enjoy spending time perusing their own interests/hobbies, which included reading, watching television, and spending time with their visitors. Some residents enjoy music therapy, entertainment and shows provided by arts and heritage group, the home arrange a coffee morning once a month, family and friends are invited. A record of visitors to the home was seen, which showed family visits, the inspector talked to one visitor who expressed their happiness with the care and support their relative receives, they also stated that they are welcome at the home at any time, they usually avoid meal times, however have ate with their relative in the past. The home have a group of people known as ‘The friends of Bickerly Green’ who fundraise for the home, so far they have raised enough money to buy a large projective screen, and enabled the home to path a patio area.
Bickerley Green H54 S37284 Bickerley Green V244784 250805.doc Version 1.40 Page 11 Staff receive training on Dementia, one member of staff said the training helped them to understand peoples behaviour better, it made her more aware of why some people seem forgetful at times, and how she can help the resident. Transport to enable residents to attend appointments is supplied by family members. staff encourage residents to participate in activities if they want to. Bickerley Green H54 S37284 Bickerley Green V244784 250805.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) 16 The home has a satisfactory complaints procedure in place with evidence that residents feel that their views are listened to and acted upon. EVIDENCE: The inspector asked four residents if they had made a complaint in the past, all replied “No, I haven’t felt the need to.” The inspector asked if they felt able to should the need arise, all responded “I am aware of what to do, and I feel the home would do it’s best to improve things should I need to complain.” The inspector witnessed the homes complaints procedure, which gives clear guidelines of process. A copy of the complaints procedure can be found in the homes policy file. The inspector looked at the complaints log which recorded details of three complaints in the last year, all were dealt with satisfactorily. The inspector recommended that the pages of the log are numbered consecutively to show a true record of complaints received. Relative/visitors comment cards indicated that five out of seven who responded were aware of the procedure, and were confident the home would take appropriate action should a complaint be made. Bickerley Green H54 S37284 Bickerley Green V244784 250805.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) 26 The majority of the home was clean, pleasant and hygienic, however an offensive odour was present. EVIDENCE: The inspector witnessed an offensive odour in the entrance hall to the home and to one bedroom, the inspector required the cause be investigated and eliminated. The inspector witnessed good food hygiene practices within the kitchen and staff using protective clothing whilst cleaning. Staff were aware if the homes infection control procedures, and had received training recently. Bickerley Green H54 S37284 Bickerley Green V244784 250805.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) 29 The arrangements for the recruitment, induction and training of staff are good, staff clearly demonstrate their understanding of their role and responsibility EVIDENCE: The manager explained the recruitment process and showed the inspector the homes written procedure. Three staff files were sampled, individual files showed evidence of CRB clearance and checks against the POVA list. All other recruitment checks had been completed. The manager explained the procedure for the induction of new staff, the inspector saw a written record of training received. Bickerley Green H54 S37284 Bickerley Green V244784 250805.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) These standards were not assessed on this occasion EVIDENCE: These standards were not assessed on this occasion Bickerley Green H54 S37284 Bickerley Green V244784 250805.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x
COMPLAINTS AND PROTECTION x x x x x x x 2 STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x x Bickerley Green H54 S37284 Bickerley Green V244784 250805.doc Version 1.40 Page 17 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. Standard 26 Regulation 16, 2 (k) Requirement The care home is kept free from offensive odours. The manager must supply the Commission with an action plan. Timescale for action 25/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 16 Good Practice Recommendations It is recommended that the pages of the complaints log are numbered consecutively to show a true record of complaints received. Bickerley Green H54 S37284 Bickerley Green V244784 250805.doc Version 1.40 Page 18 Commission for Social Care Inspection 4TH Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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