Inspection on 09/06/05 for Bidna House

This inspection was carried out on 9th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bidna House 15/01/10

Bidna House 17/11/08

Bidna House 09/10/07

Bidna House 20/11/06

Bidna House 18/09/05

Bidna House 28/10/04

Bidna House 15/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Honeybourne House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Bidna House Bidna Lane Appledore Bideford EX39 1NU Lead Inspector Andrew Towse Unannounced 09 June 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 3 SERVICE INFORMATION Name of service Bidna House Address Bidna Lane Appledore Bideford EX39 1NU 01237 470714 01237 425842 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 Barbara Haywood Mr Simon Haywood Care Home 12 Category(ies) of LD Learning disability (12) registration, with number MD Mental Disorder (12) of places Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Age range 18 to 60 years of age Date of last inspection 28 October 2004 Brief Description of the Service: Bidna House is a detached older style property standing in its own grounds and is reached via an unadopted lane. It is registered to accommodate 12 people who have either learning disabilities or mental health problems. All but two service users are accommodated in single occupancy bedrooms. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of 7.5 hours. The information contained in this report was obtained through discussion with the registered manager, proprietor, staff and service users and complemented by examination of records, including care plans, information supplied by the manager prior to the inspection, and comment cards completed by residents. 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. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 4 Although the home has a well-written admissions procedure which involves ascertaining the aspirations and needs of prospective service users, inadequately maintained records meant that it could not be shown that this procedure is always followed. EVIDENCE: The home has a new admissions policy which was introduced in May 2005. This includes an initial assessment over the phone at the time of referral, followed by a home visit. Examination of files of recently admitted service users showed that they had made visits to Bidna House as part of their admission programme, with the manager of Bidna House also visiting the prospective service user’s place of residence. These visits, together with discussions with the service users and those involved with their previous care and family members enabled Bidna House to draw up an assessment of the service users’ needs, which included their individual aspirations. However, at the time of the inspection, assessments carried out for one of the service users could not be located, although the registered manager stated that one had been completed at the time of the admission. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 8 The home recognises the need to include the service users’ aspirations and involve them in the admissions process. The newly introduced admissions policy refers to plans ‘being drawn up using information gained during admission assessment and during consultation meetings with service user, their family, friends, professionals or any other person the service user may request to have an input.’ The home also received a care plan drawn up by the Social Services department during the admissions process. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7,9, 10 Whilst the review of policies and procedures and the change in care plans is good practice, the lack of a care plan for a recently admitted service user should be addressed. EVIDENCE: Of the two most recently admitted service users, one had a care plan; however the other, although having a care plan supplied by the Social Services Department, had yet to have one drawn up by the home although the service user had been there for over five weeks. This is because the home is introducing a new system of care planning. Examination of another service user’s file showed that a relative had been involved in compiling the care plan. Minutes of Residents’ Meetings showed that service users are consulted over choices regarding activities, venues for outings as well as discussions regarding their involvement in the day to day domestic tasks within the home. The home has a robust confidentiality policy which discusses the legal and moral responsibility to maintain confidentiality and requires that records are Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 10 kept in a locked cupboard, which on the day of the inspection they were observed to be. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14, 15 Although the rationalising of day care has reduced day time activities for service users, there is still involvement in activities within the community and strong links with families and relatives have been maintained. EVIDENCE: Due to rationalising of day care by social services few service users receive day care. Service users attend clubs such as the Gateway and Breakaway clubs and on Friday they enjoy games of skittles and a lunch at a public house in Barnstaple. Another service user regularly uses the library. One service user attends North Devon College and another decided to withdraw from the course she was attending. One service user assists the gardener in maintaining the garden of the home, but had previously attended college for several years. On the day of the inspection another service user was going shopping on her own. One service user spoke about a pair of shoes he had chosen whilst out shopping in Barnstaple. Another service user appeared withdrawn but was being encouraged by a member of staff to assist with doing her laundry. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 12 Towards the end of the inspection there was a barbecue being held in the garden. Residents were seen assisting in preparations for this. There has been recent contact with the local church with the local vicar visiting the home. Other service users go horse riding and swimming. In addition to this there are in-house activities and the home has its own transport. Minutes of Resident’s Meetings showed that activities were discussed. The service users have an annual holiday. This year it was at Seaton. Minutes of Residents’ Meetings showed that this was a destination discussed with residents. With the exception of spending money and transport the holiday is funded by the home. Meal times were seen to be leisurely and on the day of the inspection most residents chose to eat outside, although two ate indoors as this was their preference. Service users spoken to said that they enjoyed their meals. Resident are encouraged to maintain regular contact with family and friends. One service user goes home to the family every week, another sees her mother monthly, another has an aunt and uncle who visit fortnightly and another sees her mother monthly. Bidna House has a policy in respect of relationships. One resident has been involved in a long-term relationship with another resident in another home of which he spoke about positively. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 Service users receive appropriate support from relevant specialists and from the staff group to manage their physical and emotional health needs. EVIDENCE: Examination of one file showed that one service user preferred to be assisted bathing by someone of the same gender. This had been arranged. The home has a medication administering and storage procedure which was last reviewed in May 2004. Whilst no resident is fully self-medicating, one is given one tablet daily to take at a prescribed time. This resident’s file contained a risk assessment regarding the safety of the resident to carry out this task. The home has regular contact with specialists. A CPN who administers medication to two service users visits fortnightly. A physiotherapist advises on the needs of another resident, whilst another receives input from a clinical psychologist. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 Whilst the home is developing its complaints procedure and the majority of staff have attended courses regarding the protection of vulnerable adults, it is necessary that all staff receive this training and knowledge if service users are to be adequately safeguarded. EVIDENCE: A new complaints procedure was implemented on 9.5.05, however the obsolete procedure was still being displayed on the notice board. The new procedure includes a form for complainants to complete. There was also a pictorial complaints procedure displayed, which was more service user friendly, although the registered manager said that he was still thinking about how to make the complaints procedure more service user friendly. The procedures need changing in order that they make explicit the right of the complainant to contact the CSCI at any time during the complaint process. The registered manager has completed training for trainers relating to the Protection of Vulnerable Adults (POVA). This enables him to offer in-house staff training on the protection of vulnerable adults. He has done this using the ‘No Secrets’ training video. Five staff have completed Vulnerable Adults Training offered by Devon Social services, however the Director of Care has yet to do this training as has one member of staff who was scheduled to attend a course which was then cancelled. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 29, 30 Bidna House is an older style property which is being refurbished in accordance with its schedule of maintenance and which currently meets the needs of those who reside there. EVIDENCE: Bidna House is an older style property. Since the last inspection the large communal lounge has been recarpetted and redecorated. One service user’s bedroom had a lino floor; this was his choice. Two service users share a room. When asked, they confirmed that they had been friends for a considerable time and enjoyed being in a shared room. The home has a written maintenance plan for the year 2004-2005. Much of the work listed has been carried out; including the requirement to replace specified existing glass with safety glass. The home has two separate lounges, which house a pool table and television respectively, allowing service users a choice of where to sit. Externally there is a very accessible and well-maintained garden area with a patio with tables and chairs to the rear of the property. Service users were seen to use the patio to have meals and at the end of the day were having a barbecue in the garden. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 16 Only one service user needs specialist equipment to maintain his independence. This has been arranged and the home has worked consistently to ensure this service user maintains his mobility. This person has a bedroom and nearby bathing room suitable to his needs. Bedrooms were seen to have been personalised. A tour of the premises confirmed that the home had an appropriate level of hygiene and cleanliness. The home has a policy which states that service users ‘should have access to private, lockable rooms and will issue keys to bedrooms as standard unless the service user is assessed as at risk or specifically requests not to.’ Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34, 36, 32 Staff receive training appropriate to meet the needs of service users and comply with that required under the National Minimum Standards, which is complemented by regular supervision. EVIDENCE: Rotas showed that there are always two staff on duty, with three on in the morning. Currently around 25 of staff have NVQ 2, however, with the exception of one, all the remaining members of staff should be completing their NVQ 2 or 3 by the end of 2005. This means that by the end of the year this home should have a qualified staff complement above the minimum suggested by the National Minimum Standards. The home has a written recruitment policy. Examination of staff files showed that it is adhered to. Staff files now all have evidence of CRB clearance and contained references. Staff receive supervision from the team leader who did a two-day supervision training course in June 2003. In addition to 1:1 formal supervision the home also does group supervision. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 18 Staff have attended various training courses over the previous twelve months. This has included Moving and Handling, First Aid at Work, Medication Administration training, training in epilepsy, writing of reports and physical restraint training. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The health and wellbeing of service users is safeguarded as the home maintains good records of matters relating to the health and safety and complies with recommendations made in respect of these. EVIDENCE: Records showed that the home had a valid NICEIC certificate confirming the safety of electrical installations within the home. Portable electrical appliances had been tested. Safety glass had been installed in all windows as specified by HSE. The surface temperature of radiators was kept at 45 degrees to ensure the safety of service users. An inspection by the Environmental Officer of the kitchen in October 2004 found it to be satisfactory, and requiring no action. Fire precautions were seen to be appropriate with training available as required. Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x 3 3 Standard No 11 12 13 14 15 16 17 x x 3 3 3 x x Standard No 31 32 33 34 35 36 Score x 3 x 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bidna House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 21 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 23 Regulation 13 (6) Timescale for action The registered person shall make 30.9.05 arrangements by training staff or by any other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. The registered person shall after 31.8.05 consultation with the service user prepare a written plan as to how the service users needs in respect of his health and welfare are to be met. Requirement 2. 6 15 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 Good Practice Recommendations Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 22 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Bidna House D54 D06 S22084 Bidna House stage 4.doc V222833 090605 Version 1.30 Page 23 - 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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