Inspection on 28/02/07 for Bilton Court

This inspection was carried out on 28th February 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.

Other inspections for this house

Bilton Court 11/03/09

Bilton Court 25/02/08

Bilton Court 20/09/06

Bilton Court 17/10/05

Bilton Court 04/11/04

Bilton Court 19/05/04

Bilton Court 23/01/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Bilton Court Windermere Drive Queensway Wellingborough Northants NN8 3FR Lead Inspector Tobias Payne Key Unannounced Inspection 28th February 2007 08:15 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 Bilton Court DS0000012708.V331158.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. Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bilton Court Address Windermere Drive Queensway Wellingborough Northants NN8 3FR 01933 401613 01933 401615 kerry.morgan@anchor.org.uk sharon.blackwell@anchor.org Anchor Trust 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) Position Vacant Care Home 48 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (48), of places Physical disability over 65 years of age (24) Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The total number of service users must not exceed 48 in Bilton Court No service users with a physical disability over the age of 65 PD(E) may be admitted to Bilton Court when there are already 24 service users accommodated within the home No one falling within category DE(E) may be admitted into Bilton Court where there are 10 persons of category DE(E) already accommodated within this home. 20th September 2006 Date of last inspection Brief Description of the Service: Bilton Court is a care home providing personal care and accommodation to forty eight older people twenty four who may have a physical disability and ten who may have a dementia related illness. On the day of the inspection there were 47 people living in the home. The home is operated by Anchor Homes, which is part of Anchor Trust. It is situated on a residential estate on the outskirts of Wellingborough with public transport to and from the town centre. The home is purpose built. The home has single bedroom accommodation with en-suite facilities consisting of shower, toilet and washbasin for all residents on two floors. A passenger lift provides access to the first floor. There are four separate units within the home each unit having a communal lounge/dining room. There are pleasant grounds surrounding the home, which are accessible to all the people living in the home. Information about the home can be obtained from Anchor Homes in the form of a Service Users Guide and a Statement of Purpose. The fee on the day of the inspection ranged from £420 to £450 a week. Extras were hairdressing which ranged from £7 to £23, chiropody £12 and personal newspapers and magazines. . Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This second unannounced key inspection started at 8.15 am. It was undertaken using a review of all the information available to the inspector regarding our service history about Bilton Court. It took place over 6 hours. The inspector spoke to 9 residents 6 staff and the acting manager. The main method was called “case tracking”. This involved selecting 2 residents and tracking the care they received. This was done through the checking of records, discussion with them, the care staff and observation of how care was delivered. What the service does well: What has improved since the last inspection? Staffing levels have improved since the last inspection. Formal supervision of staff has been introduced to support and develop the staff. New care plans have been introduced and a number of senior members of staff have received training. One bedroom had been decorated with the involvement and consultation with the residents living in room about the colour schemes they wanted in the room. Activities have been reviewed to allow more involvement of the people living in the home. Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Bilton Court DS0000012708.V331158.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 Bilton Court DS0000012708.V331158.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): Standards 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are assessed by a competent person before coming into the home. People receive detailed information to be able make a decision to come to the home or not. However this information is not up to date. EVIDENCE: There was a detailed statement of purpose and service user’s guide available but they had not been amended to include new details about the categories of people who could be admitted to the home. The acting manager however agreed to address this. There was a clear and detailed admission procedure. Each person was assessed by a competent person with resident/relative involvement. The home did not provide intermediate care. Bilton Court DS0000012708.V331158.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): Standards 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care records had improved since the last inspection but there was inconsistency and little evidence to show residents had been involved in identifying their needs. Medication records had improved since the last inspection and were being safely administered by staff who knew what they were doing. EVIDENCE: Since the last inspection a new Anchor Housing care plan package had been introduced since December 2006 and all information from the old system was being transferred across. The acting manager agreed with the inspector that this was not consistent and explained that only recently had certain staff received training centrally which would be cascaded throughout the home. There was however an improvement seen in the care planning since the last key inspection. The new records included a profile with photograph (not yet introduced), personal details, life history, pre-admission assessment, medication agreement, personal emergency evacuation plan, action plan regarding risks, Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 10 care plan, mobility plan, care plan and evaluation sheet, weight chart, night check record, alert sheet, support and daily care assessment and where required additional information. The 2 tracked resident’s care records were examined. Most of the information had been completed but staff signatures and dates of the initial record were in some instances missing. There were no resident’s signatures signifying their agreements in the records. There were 2 medication errors reported to the commission since the last inspection. None of these errors were life threatening. As a result of this the acting manager had introduced medication rounds where staff were not disturbed and so could concentrate on this important task. The inspector observed a medication round taking place during breakfast. Medication was dispensed from the trolley, checked with the resident, administered to the resident then signed. There were 7 named staff who had been assessed as competent to administer medication. Staff had been trained by Boots and also used the Boots workbook. The acting manager also monitored the medication charts and where required brought to the attention of the particular member of staff if there were any gaps or discrepancies. There were 3 people who were self medicating. There were no concerns about the medication in the home. The home has a good call system with some residents carrying their call alarm buttons on their person. During the inspection call bells were responded to in one minute. This was an improvement from the previous inspection. Staff were seen to attend to residents promptly in a calm and dignified manner. Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a lifestyle, which takes into account and suits the needs and wishes of the residents. The range of activities available has improved since the last inspection. Residents receive varied and nutritious meals served in comfortable surroundings. EVIDENCE: The home employed a part time activities person (who worked 20 hours a week). An additional activity person (15 hours a week) was to be recruited in the future in order to assist the current person. There was a notice board on each of the 4 wings with details of the weekly activity programme, which was also in the monthly newsletter. These gave details of Chiropody, Holy Communion, Songs of Praise on the first Sunday of every month, Pets as Therapy and advocacy services. A weekly taxi trip into Wellingborough has also been introduced. There was also a weekly resident’s meeting. The inspector saw breakfast and lunch served. Meals were taken in the combined lounge/dining rooms on each of the 4 wings of the home. The rooms were bright, clean and comfortable. Tables were well laid with the menu displayed on each table. A cooked breakfast was provided for those Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 12 people who required it and the food was well cooked, prepared and served from hot trolleys. Each area also had a small kitchenette with cold drink dispensers. Meals were served in an unhurried manner with staff assisting those people who needed help in a quiet and sensitive manner. None of the residents had any concern about the food. Staff in the kitchen were appropriately dressed. Residents commented, “the food is ok and “I can’t fault the food”. Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 13 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): Standards 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 were confident that any concerns would be investigated by the home in a sensitive manner. Staff were recruited correctly to ensure that residents were protected from abuse. EVIDENCE: Each person received a complaints procedure when being admitted to the home and a copy of the complaints procedure was displayed on a notice board on the ground floor. No complaints had been received by the commission and the home since the last inspection. None of the residents or staff had any concerns about the home. Two staff records were examined and showed that staff had been recruited correctly with checks by the Criminal Records Bureau (CRB). A new comprehensive induction programme had been introduced in October 2006. This was an induction to be carried out for a period of 3 days over a week. The programme included rights, elder abuse, communication, confidentiality, understanding of their role, expectations of residents and dementia. The acting manager and team leaders were to receive training on this new programme in March 2007. Records were well maintained. Recent adult protection training had been provided in February 2007. Staff confirmed this and were aware of what abuse was and what they should do if abuse was suspected. Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 14 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): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lived in clean, well maintained, comfortable and safe accommodation. EVIDENCE: Each bedroom was en-suite (shower, toilet and wash basin). There were 4 identical wings in the home. On the ground floor was Lavender and Waverley and on the first floor Mentmore and Haven. Each had an identical lounge/dining room. There were 2 shaft lifts. The inspector saw the house keeping staff vacuuming the home, which was clean, well maintained, and odour free throughout. Staff showed pride in the work they were doing and resident’s rooms were individual. The acting manager commented on a bedroom for a couple, which had been decorated using the colours they had chosen. None of the residents had any complaints about the decorative state or cleanliness of the home. They were also satisfied with the laundry service. The home also employed a maintenance person. There was a large and Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 15 accessible well laid out garden area with sitting areas. There were also sitting areas throughout the home. Resident’s doors had large signs with pictures and names to orientate residents to their rooms. There were also different colour schemes. There was an infection control policy and staff wore gloves and aprons. Residents commented, “I have settled in well, they found a room with a nice view” and “my clothes are well looked after”. Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 16 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): Standards 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The recruitment policies and practices of the home ensured that the residents are cared for safely and are protected from harm. Staff knew what they were doing by being trained to carry out the care and support for people in the home. The home has tried to address the staffing issues in the home. However there is still a problem to ensure resident’s needs are met when the home is short of staff as a result of sickness. EVIDENCE: The acting manager acknowledged that there continued to be a high turnover of staff. Two staff left recently. Anchor Housing had looked into this and during 2006 brought in an incentive scheme to reward staff for attendance. The duty rota showed that in the morning there was 1 senior and 7 care assistants. In the afternoon/evening there was 1 senior and 4/5 care assistants. At night there was 1 senior and 2 care assistants. However the levels were to be increased at night to 1 senior and 3 care assistants in the future. Staff confirmed that if all people turned up for work then they could manage the needs of the residents. Several staff commented that not all of the staff team worked as a team and this also made work harder. Residents were satisfied with the care and approach of staff but commented that staff were Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 17 often busy and there needed to be more staff. There was no evidence on the day of the inspection that the resident’s needs were not being met and staff were seen to attend to people in a prompt and professional manner. Residents commented, “the staff are very busy but cheerful and helpful” and “staff are very good but they are very busy”. Staff commented, “we need more staff particularly in the morning between 7 and 10 am” and “it is a lovely place to work”. The recruitment policies and practices of the home ensured that the residents were cared for safely and were protected from harm. Staff knew what they were doing by being trained to carry out the care and support for people in the home. The home was currently using agency staff 70 hours a week covering nights. However 2 staff had been recruited and awaiting CRB clearance. The acting manager acknowledged that she did not have a specific system for measuring dependency. She also acknowledged staffing at times was still poor if staff did not turn up for work which was a particular problem at weekends. There was a vacancy for 28 hours a week and applications received were being processed. The home also had bank staff. Where there were shortages the procedure was for additional staff to be authorised by the area manager. Training had covered since the last inspection, dementia awareness for all staff adult protection, food and hygiene and moving and handling. In addition, 9 staff had obtained qualifications in care to National Vocational Qualification standards. A further 9 staff were undertaking NVQ level 2 and level 3 NVQ. There were 24 care staff. Therefore 80 of staff had either obtained or were studying for NVQ. This had exceeded the 50 of staff who were required to obtain this training. Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 18 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): Standards 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. There was clear and professional management in the home and staff and residents had confidence in the staff and management. EVIDENCE: Since the last inspection the home has been managed by the acting manager who has worked in the home for 7 years in a variety of roles. She had been the acting manager since October 2006 when the previous manager had left her post. Staff and residents had full confidence in her approach and the home was being run in a very professional manner. Staff knew their role and there was laughter and a relaxed atmosphere throughout the home. Residents commented, “I am quite happy”, “there are things for me to do” and “I like being here”. Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 19 Resident’s monies were well maintained with electronic and paper records, receipts and resident’s signatures. There was an electronic tally and a check weekly. There were resident’s meetings every month and unit meetings with team leaders every month. Staff were now receiving formal supervision 6 times a year provided by the team leaders. Each member of staff had received and been involved in personal development discussions since October 2006. The acting manager acknowledged that there were no internal audit systems but the home received monthly monitoring visits from the area manager and copies of the reports were sent to the commission. There was a new system to be introduced in the future to obtain the views of residents but this has not yet taken place. Concerning equality and diversity, one of the residents commented that she could discuss her particular dietary/cultural needs with the chef and he also acknowledged that he met the resident and used specific spices to suit her needs. Equality and diversity issues were being met. There were health and safety policies and staff had gloves, aprons and alcohol hand rubs to prevent cross infection. The home was clean and odour free throughout. Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 20 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 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x 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 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 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 OP7 Regulation 12 Requirement The registered person must ensure that all care plans clearly identify all the needs of residents, are signed and dated and are produced wherever possible with the resident’s involvement indicated by their signature. The registered person must ensure that there are sufficient staff available at all times to meet the assessed needs of the residents. Timescale for action 28/05/07 2. OP27 18, 28/05/07 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 OP33 Good Practice Recommendations It is recommended that the manager introduce internal audits to monitor the quality of care records, medication and care practice in the home. Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. Extracts may not be used or reproduced without the express permission of CSCI Bilton Court DS0000012708.V331158.R01.S.doc Version 5.2 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. 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