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Inspection on 06/09/07 for Bide A While

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

This inspection was carried out on 6th September 2007.

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

There was a warm and friendly atmosphere in the home and the people who use the service were clearly very comfortable and relaxed with the staff. The day centre is opened five days a week and takes place in the large lounge area of the home. A resident said "It is quite enjoyable," having other people come into their home during the day because it provided an opportunity to meet with others and take part in the varied activities. The premises are very clean with flowers and ornaments around which create a pleasant domestic environment.

What has improved since the last inspection?

The requirements made after the previous inspection have been met. There are soap dispensers and paper towels adjacent to all washing facilities as part of the infection control procedures. The care plans and many other records have been redesigned and are in formats which ensure that information is in detail and readily available.

What the care home could do better:

The service is registered to provide care for people with dementia. At present, the training is a basic two-hour training module. Arrangements are in place for every member of staff to have in depth, accredited dementia care training, which is relevant to the roles they have. This training should be treated as a priority so that if a person with dementia moves into the home, he or she will be supported by staff with the essential skills to provide a high standard of care, support and meaningful activities, appropriate for people with dementia.The service user guide and the individual service contract is well set out and easy to read, without jargon being used but the information does not make it sufficiently clear that on five days a week, residents share their semi open plan communal areas with people attending the day centre.

CARE HOMES FOR OLDER PEOPLE Bide A While 14 Brick Kiln Road Old Town Stevenage Hertfordshire SG1 2NH Lead Inspector Patricia Rogan Key Unannounced Inspection 6th September 2007 14:00 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.V350547.R01.S.doc Version 5.2 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.V350547.R01.S.doc Version 5.2 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.V350547.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th March 2007 Brief Description of the Service: Bide A While is registered to provide care and support for up to three service users over the age of 65 years. This large, two storey detached house is situated in a quiet cul-de-sac close to the Old Town of Stevenage. There is a spacious lounge/dining/activity area which looks out onto the garden and patio. On weekdays, this area is shared with day centre visitors. Residents also have their own, smaller lounge / dining room, if they prefer this. A large domestic kitchen is at the front of the house. A stair lift enables service users to have access to the bedrooms on the first floor. 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 garden is well maintained with a patio, seating and shaded areas. Fees range from £650 to £750 and are set out in the Service User Guide, which can be obtained from the manager and is available for all prospective residents. Fees for additional services such as hairdressing and chiropody are listed in the individual service contract. Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of all the key standards of the National Minimum Standards took place during one afternoon. This was a positive inspection and time was spent speaking with the people who use the service and with members of staff on duty. The support provided for the two residents was observed while the two residents were sitting in the lounge with people attending the day centre. When the day centre was closed for the day, the residents sat in their smaller lounge speaking with the inspector about what it is like for them living in Bide A While. Files were inspected, including care plans, staff records and the training schedule. What the service does well: What has improved since the last inspection? What they could do better: The service is registered to provide care for people with dementia. At present, the training is a basic two-hour training module. Arrangements are in place for every member of staff to have in depth, accredited dementia care training, which is relevant to the roles they have. This training should be treated as a priority so that if a person with dementia moves into the home, he or she will be supported by staff with the essential skills to provide a high standard of care, support and meaningful activities, appropriate for people with dementia. Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 Page 6 The service user guide and the individual service contract is well set out and easy to read, without jargon being used but the information does not make it sufficiently clear that on five days a week, residents share their semi open plan communal areas with people attending the day centre. 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. The summary of this inspection report can be made available in other formats on request. Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 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.V350547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. (Standard 6 is not applicable to this service.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and their family or representative are given full information about the home and are involved in the assessment prior to moving into the home. EVIDENCE: The residents were assessed prior to moving into the home and records show that they were involved in the decision to stay in the home on a trial basis. The assessment format has been improved to include more information about health, physical and social care needs. This ensures that prospective residents and their families know that all aspects of care and support are being considered before a placement is offered. Prospective residents are invited to visit the home and meet the residents and staff and this helps to give an overview of how the home is being run. Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are individualised and include all relevant information, which is amended as needs change. Access to health and social care professionals is readily available. People who use the service are treated with respect. EVIDENCE: The people who use the service said they were very happy living in the home and both agreed that they were very well looked after. Care plans have been revised to ensure that the individual needs of the resident are recorded. Staff were heard speaking kindly and they respected the wishes of each resident and did not impose their own view of how care should be given. The residents health care is provided by the local General Practitioner service. Residents have access to nursing and social care services and also to chiropody, optical and dental treatment whenever this is needed. Medication administration is well managed and safely stored. It is only administered by staff that are trained to do so. Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people who use this service have a high level of satisfaction with their lifestyle. Staff training which included general knowledge about what school and working life may have been like for most residents would provide many relevant topics of interest for all residents and encourage individual and more meaningful activities. Contact with family, friends and the local community is actively encouraged. The views of the people who use the service are listened to and acted upon. Meals are well balanced and freshly prepared and served in pleasant surroundings. EVIDENCE: On weekdays, the residents spend daytime with the people who attend the day centre, which is held in the large communal lounge/ dining room. Both residents said they did not mind doing this and enjoyed the varied activities. A smaller lounge with settees is available although the activities in the day centre can be heard during the day and this might be confusing to a person with dementia. This does not cause any difficulty whatsoever with the residents at the time of the inspection. Residents spend their evenings in the Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 Page 11 smaller lounge watching television and chatting or pursuing hobbies such as reading and knitting. Friends and families are encouraged to visit and often, the person on duty will take the residents shopping or to visit friends. In warmer weather, the residents sit out in the well-tended garden. The meals are seasonal and reflect the tastes of each resident. Meals are served in the communal dining room when the day centre visitors are present and at other times, in the smaller lounge. If the resident prefers to have breakfast in bed, this will be provided. Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are given the opportunity and support to express any concern or complaint and their legal rights are protected. All staff are trained to recognise poor practice and understand their responsibility to protect residents from any form of abuse. EVIDENCE: When speaking with the people who use this service, it was evident that they felt that if they had a concern or complaint, they would be taken seriously and steps would be taken to address the problem. Visits from families and friends and other professionals involved with this service are encouraged and this provides additional avenues for the service users to express any concerns they have. There is also an advocacy service available. Service Users have access to the wider community and are supported if they wish to vote in the local and general elections. Staff have had training to recognise all forms of abuse and have signed the whistle-blowing policy and understand their duty to report anything untoward. Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises and grounds are maintained to a good standard to ensure the safety of the people who use the service. The home is domestic in appearance and is kept clean and hygienic. EVIDENCE: Since the previous inspection, all areas of the home are regularly audited to ensure that repairs are carried out in a timely manner. A person qualified to do so checks equipment and appliances. Staff carrying out domestic cleaning have training in the safe use of chemicals. The home was clean and hygienic and furnished with comfortable domestic furniture and ornaments and flowers are displayed throughout the home. Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment and vetting procedures are robust. In depth, accredited dementia care training is needed to ensure that if a person with dementia moves into this home, the staff have the necessary expertise and specialist communication skills to provide person centred care and meaningful activities. EVIDENCE: The people who use this service expressed satisfaction with the care and support they receive and the care staff were described as being just wonderful. There were sufficient staff on duty to support the people who live in the home and the people in the day centre, with whom the residents chose to spend their daytime. The staff files have been further improved since the previous inspection and a checklist and a thorough vetting procedure is in place. This home is registered to accommodate up to three people with dementia and at present, there are no residents with dementia. However, staff training in dementia has been just two hours. The registered manager and all staff must have the specialist accredited dementia care training which is relevant to their roles, thus ensuring that people with dementia have a high standard of person centred care and are enabled to take part in individual, meaningful activities. Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. On a day-to-day basis, the day centre manager runs this service extremely well and there are regular visits by the registered manager. Safeguards are in place to protect the service users from financial exploitation. Records, policies and procedures are relevant to this service and are up to date. EVIDENCE: The day centre manager carries out most of the duties involved in running this home. This includes arranging staff training, establishing new format care plans and other records, carrying out formal staff supervision, ensuring equipment and medication comply with legal requirements. She is competent and knowledgeable and was described as friendly and approachable by staff who work in the home. The registered manager lives locally and frequently Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 Page 16 visits the home to meet with the manager, staff and people who use the service. A social care professional described the registered manager and the unregistered manager as two very competent people who have the welfare of the residents at heart. Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 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 x x 3 x x n/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 Page 18 Are there any outstanding requirements from the last inspection? no 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 OP14 Regulation 12(2)(3) Requirement All staff must have accredited, in depth dementia care training do that they have the with the specialist skills to communicate effectively with those residents who have dementia and find it difficult to express their needs or explain how they feel. Timescale for action 01/12/07 2 OP27 18(1)(c) All staff must have accredited, in depth dementia care training do that they have the with the specialist skills to communicate effectively with those residents who have dementia and find it difficult to express their needs or explain how they feel. 01/12/07 Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 Page 19 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 OP12 Good Practice Recommendations Staff training which included general knowledge about what school and working life may have been like for most residents and what main historical events occurred during the residents lifetimes would provide many relevant topics of interest for all residents, in particular for those residents who need help to recall past events. Bide A While DS0000019292.V350547.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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