Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 08/11/05 for Bickleigh Down Care Home

Also see our care home review for Bickleigh Down Care Home for more information

This inspection was carried out on 8th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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 relationship between the staff and the clients and their relatives were observed to be good. The staff seemed to be, and were reported by the clients to be providing good care, good food and a clean environment. The staffs each seemed to have a clear understanding of their duties and were getting on with them without fuss, including the clients in the tasks and motivating them to be independent where they could. The home has provided all the staff with training appropriate to the role they play in the home and provide evidence of this in the training matrix and staff files. The administration of the home was well organised and records such as the Statement of Purpose and other information useful to the clients and their visitors was readily available at the main entrance.

What has improved since the last inspection?

The home, especially the mental health unit seemed to be tidy and clutter free during the inspection despite it being a busy period. The mental health unit has had some redecoration but no alterations have commenced to improve the communal space. The conservatory is now more accessible and has been decorated making it possibly a more suitable place for some clients who need a less stimulating area from time to time. There were discussions taking place during the inspection with an outside facilitator to recommence nurse training at the home.

What the care home could do better:

The elderly mentally ill unit has a large communal area that is not of an ideal design for this client group as all activities occur in this open design area. Some sensible screening would allow separation between the lounge and dining/activities area. There is some movement to address the problems with the design but no actual alterations have commenced.

CARE HOMES FOR OLDER PEOPLE Bickleigh Down Care Centre Woolwell Road Woolwell Plymouth Devon PL6 7JW Lead Inspector Doug Endean Unannounced Inspection 8th November 2005 12.00 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 Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 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. Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bickleigh Down Care Centre Address Woolwell Road Woolwell Plymouth Devon PL6 7JW 01752 695555 01752 696406 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) Four Seasons (DFK) Limited Care Home 64 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (32), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (32), Old age, not falling within any other category (15), Physical disability (4), Physical disability over 65 years of age (40), Terminally ill over 65 years of age (4) Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The establishment may admit, from time to time, up to 6 service users between 50 and 65 years of age A maximum of two service users only, in the age group of 50 to 65 years of age, can be accommodated in each of the three units at any time An identified ground floor lounge will be used as a dedicated communal space for the 50 to 65 year old service users on their request 10th May 2005 Date of last inspection Brief Description of the Service: Bickleigh Down is a 64 bedded, purpose built, care home with nursing, and is part of a large national Independent Health Care organisation. It is in the suburb of Woolwell just a few miles from the city of Plymouth and close to the Dartmoor National Park. The home is divided into three units laid out on two floors, one 8 bedded residential care unit for the elderly on the ground floor, a 24 bedded unit providing nursing care to the elderly mentally ill, including Alzheimer’s and Dementia suffers that is also on the ground floor, and a general nursing unit that has 30 beds on the first floor. There are a range of disabled bathrooms and toilets in the building and the establishment has also a number of different types of hoists available to meet the assessed needs of the clients. The organisation chooses to provide all single room accommodation at this time although 4 rooms can be used as doubles. Sharing a room would only occur following the agreement of both clients involved. There is a shaft lift between each floor and a range of communal spaces in each unit used for lounge and dining for dining purposes. The gardens areas have been tended to and now provide safe attractive outdoor spaces. Close to the home is a small shopping complex with a hairdresser, general store and a medical centre. A superstore is just one mile away and can be reached by bus. An experienced Registered Nurse manages the home and there is always a registered nurse on duty in each of the nursing units 24 hours a day. The Acting Manager has an application form for the position of Registered Manager being processed by the Commission for Social Care Inspection at this time. Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report should be read along side of the previous report in order to establish the homes performance against the National Minimum Standards during this inspection year. This unannounced inspection commenced at 12.00 hrs on the 8th November 2005. The Acting Manager was on annual leave so Suzanne Marsh, the manager of the general nursing unit, assisted the inspector during the process. The inspector looked at how the home has addressed the requirement raised at the last inspection, spent time with the homes maintenance man looking at his records of maintenance, toured the home and spoke to 4 clients and one relative about their experience of care in the home. The inspection did not include looking at clients records, policies and procedures, etc, that were found to be satisfactory at the last inspection and also on subsequent visits to the home prior to this unannounced inspection. The inspection lasted two hours on this occasion. What the service does well: What has improved since the last inspection? The home, especially the mental health unit seemed to be tidy and clutter free during the inspection despite it being a busy period. The mental health unit has had some redecoration but no alterations have commenced to improve the communal space. The conservatory is now more accessible and has been decorated making it possibly a more suitable place for some clients who need a less stimulating area from time to time. There were discussions taking place during the inspection with an outside facilitator to recommence nurse training at the home. Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 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. Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 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 Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 2. Standard 6 does not apply. There is a good level of information available to anyone coming to the home that will inform them about the services that will be provided and how care is to be managed. This is supported by professionally prepared contracts with clear terms and conditions of residency. EVIDENCE: There is a comprehensive Statement of Purpose available for all the clients or visitors that does provide a good level of information about what clients can expect to receive as a service should they choose to move into the home. A copy was at the entrance to the home along side the visitor’s signing in book and other professionally prepared information for the clients and their relatives. Leaflets were held in a unit on the wall above the signing in book that gave information about the home and subjects such as Residence and family care plans, advice on diabetes and also pressure care. There was also Adult Protection information on display for anyone to read. The inspector saw a copy of the contract of care / terms and conditions of residency, which was in the possession of the client. Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 Page 9 Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 10 There seemed to be a mutual respect between the staff and the clients that made the atmosphere in the home comfortable rather than functional. EVIDENCE: The inspector spoke to 4 clients who are resident at the home and one relative. All were satisfied with the care that is provided and the way the care is delivered, the staff being respectful towards them and sensitive to their needs. The inspector observed interactions between the staff in each unit and several clients. The staff addressed the clients in a manner that was acceptable to them and conversed in a way that included them in the task and in general conversation. One client saw her legal representative during the inspection in the privacy of her own room, which was her explicit wish. Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 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 the following standard(s): 14 The staff encourages autonomy and choice among the clients and provide the environment for this to occur. EVIDENCE: This section was fully reported upon during the last inspection. However, the inspector did experience one client clearly exercising personal autonomy and choice in that she had arrange for a meeting in her room with her legal representative and this took place during the time the inspector was in the home. Many of the bedrooms in the home had been personalised to one degree or another by the clients. Those spoken to were happy that they had made their room, their own room. Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 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 the following standard(s): 16 & 17 The home does inform clients how to make a complaint or raise a concern and supports them in having their legal rights met and protected. EVIDENCE: The complaints procedure was seen on display in the main entrance and also in the Statement of Purpose that was read during the inspection. The clients spoken to were aware that they could raise complaints and concerns following the procedure. The clients are supported by the staff so that they can fulfil their desire to have their legal rights met and protected. As stated one client was visited by her legal representative during the inspection. Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 21, 23 & 25 The accommodation in the home is clean, comfortable and well maintained and meets with the clients approval. The large communal space in the mental health unit is not of a suitable design for this client group. EVIDENCE: The inspector spent some time looking at the maintenance records with the homes maintenance man. They were clear, detailed and informative showing that on a daily basis the safety of the home is checked. There are daily, weekly and monthly checks that include the smoke alarms, fire alarm break glass and other fire equipment as well as hot water temperature tests. All the fire arrangements such as training and drills were up to date and the maintenance man has recently completed a “Fire Warden” training day that was arranged by the company. The inspector was shown to the boiler house and shown the system that provides hot water, delivered at a safe temperature around the home (with thermostatic valves seen in bathrooms), and with back up boilers to overcome problems should one break down. The tour of the home provided evidence also that it was well maintained. Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 Page 14 The garden areas that are accessible to the clients are level and have sensible surfaces that can be used by wheel chair users. The lawns are also now well maintained. The front entrance of the home is easily accessed from the car park that is on the level to it. There is a key coded entrance for security. All the communal areas are well lit and reasonably decorated however the communal space in the mental health unit is not of a suitable design for this client group and plans are being drawn up to improve this situation. The furniture in the communal areas and clients rooms were satisfactory and comfortable. Each bedroom has an en-suite toilet and WC. Some en-suites do have their own domestic style baths. There is a range of facilities for bathing throughout the home including shower rooms and large bathrooms with disabled bathing facilities. The clients bedrooms are of adequate size and shape for there needs to be met. Some rooms are doubles but they are only used as singles. The rooms have telephone and television points and a number of clients did have their own telephone lines installed. There are nurse call systems in both the bedrooms and the en-suites. Most of the clients have personalised their rooms to their own satisfaction. All the rooms had windows of a size and height that allowed a view through them from a seated position. The heating is provided by a low surface temperature radiator that is temperature adjustable in the room. Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 28. There are sufficient numbers trained nurses and care staff to meet the diverse needs of the clients resident at the home. The mental health unit does need the leadership of a nurse with skills in caring for the elderly whose primary diagnosis is dementia. EVIDENCE: There are suitable numbers of staff on duty who are qualified and experienced to meet the needs of the clients each shift. However the mental health unit presently lacks a nurse manager with the experience to manage the unit long term. Advertising for a suitable candidate to this post is taking place. At the time of the inspection there was a total of 36 care staff employed at the home of which 8 held a NVQ at level 2 or above. The training matrix provided the inspector with information that the staff have all had training in manual handling, fire, Protection of Vulnerable Adults, etc. Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 The Acting Manager and her unit manager are managing the home appropriately. EVIDENCE: The home does have a Manager who has the qualifications and experience in managing a nursing home as the “Registered Manager”. The Commission for Social Care Inspection is presently processing her application for the position of Registered Manager in this home. Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 X X X N/A 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 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 3 2 3 X 3 X 3 X STAFFING Standard No Score 27 2 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X X Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 Page 18 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 OP31 Regulation 8(1)(a)(b) (i) Timescale for action The registered provider shall 01/01/06 appoint as individual to manage the care home where there is no registered manager in respect of the care home and the registered provider is an organisation or partnership. (The Commission for Social Care Inspection has an application that is being processed) The Registered Person shall 01/02/06 ensure that at all times suitably qualified, competent and experienced persons are working at the care home. A suitably qualified and experienced nurse is needed to manage the mental health unit. Requirement 2 OP27 18(1) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 Page 19 1 OP20 2 OP28 The communal space in the mental health unit should be of a design that is appropriate to meet the specific needs of this client group and professional advice on the design should be obtained during the planning process. The home has just 22 of the care staff that have a NVQ at level 2 or above and should aim to increase this to at least 50 . Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Bickleigh Down Care Centre DS0000003574.V265415.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!