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Inspection on 23/08/05 for Bide A While

Also see our care home review for Bide A While for more information

This inspection was carried out on 23rd August 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.

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 was kept clean and offered a comfortable and homely environment. All the bedrooms have ensuite facilities. Staffing levels in the home were adequate. A wide range of day activities is provided within the home.

What has improved since the last inspection?

New permanent staff have been employed and a dedicated staff team has been developed.

What the care home could do better:

The Statement of Purpose needs to be updated to reflect the change of management structure as displayed in the front entrance. The manager must also ensure that risk assessments are carried out in relation to specific medication, fire safety and that these assessments must be signed and dated. An induction training programme for all staff must be developed. Two written satisfactory references must received prior to an offer of employment being made.

CARE HOMES FOR OLDER PEOPLE Bide A While 14 Brick Kiln Road Old Town Stevenage SG1 2NH Lead Inspector Bijayraj Ramkhelawon Unannounced 23 August 2005 10:00 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. Bide A While I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bide A While Address 14 Brick Kiln Road Old Town Stevenage SG1 2NH 01438 360493 01438 220500 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) Mrs Pamela Pickup Mr Alan Pickup Mrs Pamela Pickup Care Home 3 Category(ies) of DE(E) Dementia (over 65) - 3 registration, with number MD(E) Mental Disorder (over 65) - 3 of places OP Old Age - 3 Bide A While I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18 January 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 I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the beginning of this year when the last service user past away, the home has been providing respite care only. Recently, two service users came for respite care but on the day of the inspection had returned to their normal place of residence. Their care plans were inspected and both were well detailed and comprehensive. However, risk assessments must be carried out and these must be signed by the person undertaking these assessments. The home also caters for up to 15-day care places. Staff spoken to were very positive about their work and confirmed that they were well supported by the management team. Discussions were held with the deputy manager 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bide A While I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 6 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 Bide A While I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 7 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) 1-5 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 provider prior to an offer of placement being made. However, the ‘Statement of Purpose’ requires to be updated to reflect the recent changes in management structure. Risk assessments must be carried out for service users who smoke in the home in order to minimise and manage any risk to Fire Safety regulation. All assessments must be signed and dated by the person carrying out the assessments. EVIDENCE: A written ‘Statement of Purpose’ and a ‘Service User Guide’ is in place and both documents were available to prospective and current service users and their relatives. However, the management structure displayed at the front entrance of the home did not reflect the management structure as identified in the current Statement of Purpose. This document must be updated so that service users receive the correct information. Care plans inspected for the respite care service users indicated that one of the service user smoked and it was required that a risk assessment must be carried out in order to minimise and manage the risks. Bide A While I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 8 Each service user had a pre-admission assessment carried out but these were not signed by the person who has carried out the assessments. Bide A While I52 s19292 bide-a-while v245732 230805 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) 7-11 There was no service users staying in the home at the time of this inspection. However, two service users had recently been admitted for respite care. Both 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. Records of medicines including the receipt, storage, administration and disposal were kept in good order. However, risk assessments were not be carried out for service users who are Warfarin medication. 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. However, one of the service user was on Warfarin medication and there was no risk assessment carried out to ensure staff are aware of action if the service user had a fall or were given certain citrus fruit or drinks, which could leave the service user at risk. A policy and procedures were in place for care of the dying. Bide A While I52 s19292 bide-a-while v245732 230805 stage 4.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) 12-15 The home also provides day care services for 15 attendants 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. However, from the information gained from the care plans, one of the service users who received respite care worked on a part time basis. However, the inspector was unable to ascertain feed back from service users as they had returned to their normal place of residence at the time of the inspection. Bide A While I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 11 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 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 provider or 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 I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 12 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 & 26 The home and its surroundings offers 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 I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 13 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&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 staff do not receive an induction training to NTO specification within six weeks of appointment to the posts. Service users are not protected by a robust recruitment procedure. Satisfactory references wre not obtained prior to an offer of employment being made. EVIDENCE: A rota is maintained showing which staff were on duty during the day. There was adequate numbers of staff rostered on duty. The manager and co-owner 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, some newly appointed staff had only one reference. It was noted that staff did not receive induction training. The home is currently discussing with Hertford Regional College to devise an appropriate training programme for the staff team. Bide A While I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 14 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 & 38 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, to ensure service users safety a risk assessment should be carried out for fire safety. 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. Plicies and procedures are 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 with legislation. Records inspected were up-to-date and accurate and were held securely. Bide A While I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 15 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 I52 s19292 bide-a-while v245732 230805 stage 4.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 2 3 1 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 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 3 x x x x 3 x 2 Bide A While I52 s19292 bide-a-while v245732 230805 stage 4.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 OP 1 Regulation 6 Requirement Timescale for action 28/10/05 2. 3. 4. 5. 6. OP 3 OP3 OP 9 OP 29 OP 30 23(4)(a) 13(4)(c) 14(1)(a) 13(2) 13(4)(c) 17(2) 18 (1) (c (i) The Statement of Purpose must be updated to reflect the recent changes in management structure and a revised copy supplied to the Commission. Risk assessments must be carried out for service users who smoke in the home. All assessments carried out must be signed by the person assessing the service user. Risk assessment must be carried out for service users who are on Warfarin medication. Two satisfactory references must be received prior to an offer of employment being made. ) An induction programme must be devised and implemented for all members of staff. 28/10/05 28/10/05 21/10/05 28/10/05 04/11/05 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 OP 18 Good Practice Recommendations All staff should receive training in Adult Protection. I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 18 Bide A While 2. OP 38 A risk assessment should be carried out for all fire safety procedures. Bide A While I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City AL7 3BQ 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 Bide A While I52 s19292 bide-a-while v245732 230805 stage 4.doc Version 1.40 Page 20 - 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. 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