CARE HOMES FOR OLDER PEOPLE
Bide A While 14 Brick Kiln Road Old Town Stevenage Hertfordshire SG1 2NH Lead Inspector
Bijayraj Ramkhelawon Unannounced Inspection 13th December 2005 10:00 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 Bide A While DS0000019292.V272731.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. Bide A While DS0000019292.V272731.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Bide A While Address 14 Brick Kiln Road Old Town Stevenage Hertfordshire SG1 2NH 01438 220500 01438 360493 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) Mrs Pamela Pickup Mr Alan Pickup Mrs Pamela Pickup Care Home 3 Category(ies) of Dementia - over 65 years of age (3), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (3), Old age, not falling within any other category (3) Bide A While DS0000019292.V272731.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 23rd August 2005 Brief Description of the Service: The home is a large two storey detached house situated in a quiet cul-de-sac close to the Old Town of Stevenage. The accommodation available to the service users consists of a large lounge/dining/activity area which looks out onto the garden and patio. There is another lounge/dining room with access to the kitchen. One bedroom is on the ground floor of the home and two of the bedrooms are on the first floor. The home has a stair lift enabling service users to have access to all areas. En-suite facilities are provided in each of the bedrooms. Two of the bedrooms have a toilet, wash hand basin and a shower and the remaining bedroom has a toilet and a wash hand basin. There are a two further toilets and an assisted bathroom. The home has a well-maintained rear garden. Bide A While DS0000019292.V272731.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The home is currently providing respite care only, although there are regular day care service users. Care plans inspected were detailed and comprehensive. However, the report required that risk assessments for smoking and all fire safety procedures must be carried out. Staff spoken to were very positive about their work and confirmed that they were well supported by the management team. Day care service users spoken to were complimentary of the staff and service provision. Discussions were held with the person in charge to whom the feed back on the findings of this inspection was given. What the service does well: 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.
Bide A While DS0000019292.V272731.R01.S.doc Version 5.0 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bide A While DS0000019292.V272731.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 Bide A While DS0000019292.V272731.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): 1.2.3.4 and 5 Adequate information was available to prospective service users and their relatives to assist them in their decision making process when chosing the home. Each service user has a detailed assessment of needs carried out by the home prior to an offer of placement being made. Risk assessment must be carried out for service users who smoke in the home in order to minimise and manage any risk to Fire Safety regulation. EVIDENCE: The home has a written ‘Statement of Purpose’ and a ‘Service User Guide’ and both documents were available to prospective and current service users and their relatives. At present there is no service user residing in the home but there have been respite care provided for some of the service users who attend the day care services. Care plans inspected for the respite care service users indicated that one of the service user smoked and it was required that a
Bide A While DS0000019292.V272731.R01.S.doc Version 5.0 Page 9 risk assessment must be carried out in order to minimise and manage the risks. Each service user had a detailed pre-admission assessment carried out. Bide A While DS0000019292.V272731.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): 7-11 There was no service user staying in the home at the time of this inspection. However, some regular service users had recently been admitted for respite care. Their care plans were inspected and found to be comprehensive, detailed and reviewed to reflect the changing needs for health, personal and their social care needs. EVIDENCE: Care plans inspected were comprehensive and had all the information required by this Standard including assessment of needs, risk assessments and how the needs of the service users were being met. Records of medicines including the receipt, storage, administration and disposal were kept in good order. A policy and procedures were in place for care of the dying. Bide A While DS0000019292.V272731.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): 12- 15 The home also provides day care services for 15 service users and promotes autonomy and choice. Visitors are welcomed and the home promotes integration with the local community in accordance with service users preferences. EVIDENCE: On the day of the inspection day care services were being provided to service users who do not reside at the care home. Some of the day service users spoken to said that the food was well presented and that the staff were caring, helpful and approachable. Bide A While DS0000019292.V272731.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 –18 The home has a complaints procedure a copy of which is available and included in the service user’s guide. Staff should be provided with training in adult protection. EVIDENCE: A copy of the complaints procedure was available to prospective and current service users. Neither the home not the CSCI had received any complaints since the last inspection. Staff spoken to said that they were aware of the complaints procedure. Staff confirmed they had not received training on adult protection as yet. The deputy manager said that the home is in discussion with Hertford Regional College to identify and provide a package of training for the staff team. Bide A While DS0000019292.V272731.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): 21,23,24 and 26 The home and its surroundings offer a pleasant, comfortable and safe environment to its service users. The home was kept clean and well maintained. EVIDENCE: The home was kept clean, pleasant and comfortable. All bedrooms have ensuite facilities. In two of the bedrooms these facilities consist of a toilet, washbasin and a shower and in the third bedroom has a toilet and washbasin. In addition to these facilities there is a toilet on the ground floor and an assisted bathroom on the first floor. The toilet on the ground floor is located close to the lounge and dining areas. The sluice area is located separately from service users’ WC and bathing facilities. Bide A While DS0000019292.V272731.R01.S.doc Version 5.0 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 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): 27-30 The skills and experience of staff is varied. There was an enthusiastic, dedicated and caring staff team who took pride in the service provision. However, it was required that all staff must receive an induction training to NTO specification within six weeks of appointment to the posts. EVIDENCE: The home maintains a rota showing which staff were on duty during the day. There was adequate numbers of staff rostered on duty. The manager and coowner reside in the home when respite care is provided to cover night duty. All staff undertake the domestic, laundry and catering duties. There was no service user residing in the home at the time of the inspection. Staff files were inspected and found to have all the required documents including the references, CRB and POVA checks. However, it was noted that there was no records of staff having received induction training. The home is currently discussing with Hertford Regional College to devise an appropriate training programme for the staff team. Bide A While DS0000019292.V272731.R01.S.doc Version 5.0 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 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): The home is well managed and is achieving its aims and objectives. The manager and staff who have direct involvement, appear to be dedicated to providing a good quality service. However, a risk assessment should be carried out for fire safety as well as regular fire alarm tests. EVIDENCE: The manager is part of the staff team and they could see her at any time with any issues or concerns they may have. Pride and dedication is taken in every aspect. All statutory records were available for inspection and maintained in accordance with legislation. However, fire alarm tests were not carried out on a regular basis. The home has policies and procedures in place to ensure that the health, safety and welfare of service users and staff are promoted and protected. All statutory records were available for inspection and maintained in accordance
Bide A While DS0000019292.V272731.R01.S.doc Version 5.0 Page 16 with legislation. Records inspected were up-to-date and accurate and were held securely. Staff spoken to were aware that service users can access their records and information held about them in accordance with the Data Protection Act 1998. These records are accessible to all staff. However, a risk assessment should be carried out to comply with current fire safety regulation. A valid insurance certificate is displayed in the reception area and this offers cover of no less than £5 million. Bide A While DS0000019292.V272731.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 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 x x 3 x 3 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 x 3 3 2 Bide A While DS0000019292.V272731.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 OP3 Regulation 23 (4) (a) 13 (4) (c) 18 (1) (c) (i) Requirement Risk assessments must be carried out for service users who smoke in the home (Outstanding from last inspection). An induction programme must be devised and implemented for all members of staff (Outstanding from last inspection) Fire Alarm tests must be carried out on a regular basis. Timescale for action 28/10/05 2. OP30 04/11/05 3 OP38 13(4)(c) 20/01/06 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. 2 Refer to Standard OP18 OP38 Good Practice Recommendations All staff should receive training in Adult Protection (Outstanding from last inspection). A risk assessment should be carried out fro all fire safety procedures (Outstanding from last inspection). Bide A While DS0000019292.V272731.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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