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Inspection on 10/02/09 for Bilton House

Also see our care home review for Bilton House for more information

This inspection was carried out on 10th February 2009.

CSCI found this care home to be providing an Adequate service.

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.

Inspecting for better lives Random inspection report Care homes for older people Name: Address: Bilton House 5 Bawnmore Road Bilton Rugby Warwickshire CV22 7QH one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Debby Railton Date: 1 0 0 2 2 0 0 9 Information about the care home Name of care home: Address: Bilton House 5 Bawnmore Road Bilton Rugby Warwickshire CV22 7QH 01788813147 01788811184 care.biltonhouse@btconnet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Rugby Free Church Homes For the Aged care home 33 Number of places (if applicable): Under 65 Over 65 0 33 dementia old age, not falling within any other category Conditions of registration: 33 0 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 33 Dementia (DE) 33 The maximum number of service users who can be accommodated is: 33 Age: Dementia - Code DE age 55 and above. Date of last inspection Brief description of the care home Bilton House is a residential care home with a Christian ethos and is governed by the Trustees of Bilton House charity. The aim of the charity is to provide a home for the Care Homes for Older People Page 2 of 8 Brief description of the care home care of older people within the liberal Free Church traditions, and to enable each resident to continue living as independently as possible. The home was established as a residential home for older people in 1946. Bilton House is a large building, which has been extended over a number of years and has bedrooms on two floors, which can be accessed by a lift. The property fronts directly onto Bawnmore Road and there is a large visitors car park at the rear of the home, which can be accessed via a side entrance. The home is registered to accept 33 older people 17 of which are for people with a diagnosis of dementia. There is level access to the home for wheelchair users to the front and back of the home. The Clarice Cooper wing accommodates eight residents with a diagnosis of dementia, this is referred to as the specialist dementia care wing and the main building accommodates the additional nine people with a diagnosis of dementia. Most of these residents occupy bedrooms on the ground floor. Both the frail elderly category residents and those with a dementia diagnosis freely intermingle with one another within the home. The Clarice Cooper wing has its own secure gardens and there is also a large well-maintained garden with a footpath, which residents can utilise from the main building. All rooms in the main building have ensuite showers and toilets. The rooms in the Clarice Cooper wing have ensuite toilets. There are 32 rooms in all but the home have used one of the larger bedrooms as a double hence the registration for 33. There are five communal lounges, large corridor areas, with seating, and two dining areas. At the time of the inspection visit the fees are based on dependency levels and are charged in the range £390.00 - £555.00 per week. Care Homes for Older People Page 3 of 8 What we found: The pharmacist inspection lasted three hours. Five residents medicines were looked at, together with the Medicine Administration Record (MAR) chart and care plans. One resident and two members of staff were spoken with. All feedback was given to the manager and assistant manager throughout the inspection. The medicine management had improved since the last inspection and all the requirements left regarding medication had been met. The home has a dedicated medication room with locked cabinets and a medication trolley to safely transport medication to the residents. The room temperature was sometimes too hot. The manager decided to set the radiator at a lower temperature to ensure that medicines are stored correctly. The medicine refrigerator was too cold at the time of the inspection and the temperature had fallen to 0.1C. Despite the refrigerator temperatures being read daily no action had been taken to prevent potential freezing of the medicines within. All medicines must be stored between 2C and 8C at all times to ensure their stability. All prescriptions are seen and checked before they are dispensed and a copy is taken. The copy is not used to check in the medication as it should be. The quantities of all medicines received are recorded including any balances carried over. This has enabled audits to take place. The assistant manager has installed a lengthy auditing system whereby staff count the number of tablets at the end of each day. Whilst this is very time consuming it has successfully addressed the issue of staff failing to give the medicines as prescribed. All audits undertaken during the inspection indicated that the medicines had been administered as prescribed and this was commended. Additional information had been recorded on the MAR chart, for example, any allergies the resident may have to medication, a brief description of what the medicines had been prescribed for and where emergency medication was kept on the premise. Residents are actively encouraged to self administer their own medication. They have a locked cabinet in their room to store their medicines in, and the keys kept securely. Risk assessments have now been completed to assess whether the resident understand how to take their medicines correctly. No compliance checks had been documented to confirm that the residents do safely self administer their own medication. The staff do record any carry over balances and new quantities of medicines received on the new 28 day MAR chart but fail to recognize if the resident does not take their medicines as prescribed or inform the doctor accordingly. All controlled drug balances were correct and the MAR chart entries matched those in the Controlled drug register, indicating again, good practice. The care plans recorded the clinical condition of the residents, all external healthcare professional visits and the outcome of the visits. A further KEY inspection report will be available to read in March 2009 and should be read in conjunction with this report. Care Homes for Older People Page 4 of 8 What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 8 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 8 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 It is advised that action is taken if the temperatures in the medication room and medication refrigerator fall outside the recognized limits to safely store medication It is advised that the photocopies of the prescriptions are used to check the MAR chart and medication received into the home. It is advised that regular compliance checks are undertaken and documented for all service users who self administer their own medication and the doctor is informed if these indicate that the service user does not take the medication as prescribed. 2 9 3 9 Care Homes for Older People Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 8 of 8 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!