CARE HOMES FOR OLDER PEOPLE
Bingley Wingfield Oakridge Court Off Priesthorpe Road Bingley BD16 4ED Lead Inspector
Mary Bentley Unannounced 18 May 2005 9.30am
th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Bingley Wingfield Address Oakridge Court, Off Priesthorpe Road, Bingley BD16 4ED 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) 01274 567161 01274 566809 Dr A T Ghoneim Mrs Jennifer May Oetgen Care Home with Nursing 48 Category(ies) of Old age (48) registration, with number of places Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: That the home can admit up to a maximum of two people between the ages of 60 and 65 Date of last inspection 12/01/05 Brief Description of the Service: Bingley Wingfield is registered to provide personal and nursing care for a maximum of 48 service users. The home offers care to male and female service users over the age of 65 years, however the home can admit up to a maximum of two people between the ages of 60 and 65. The original Victorian building has been extended to incorporate a wing of single en-suite accommodation. The home offers both single and shared accommodation, en-suite facilities are provided in twenty-five of the single rooms. The home is situated near Bingley and is on a local bus route. The area has many shops and local amenities. The home has a relatively small but well maintained garden area and car parking is provided at the front of the building. The home has a second entrance via a ramp for wheelchair access. Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection year runs from April to March and within that twelve-month period, the CSCI is required to undertake a minimum of two inspections of all regulated care homes. This was the first inspection of this home for the 2005/2006 inspection year. The inspection was unannounced and carried out by one inspector who spent six hours in the home. The home was last inspected in January 2005 and the main purpose of this inspection was to focus on the experiences of people living in the home. Since the last inspection the CSCI has received one complaint about this service, the complaint was investigated by the provider and the CSCI has been informed of the actions that are planned to address the issues raised by the complaint. The methods used in this inspection included discussions with eight of the 40 residents, one relative, staff and management, examination of care records, indirect observation of care practices and a partial tour of the home. The manager was not present in the home at the time of the inspection therefore the requirements from the last inspection were not discussed however there was evidence that the home is making progress towards achieving compliance. Comment cards were left at the home for distribution to residents, relatives and other professionals involved with the home, these cards provide an opportunity for people to share their views of the service with the CSCI. Comments received in this way will be shared with the provider without revealing the identity of the respondents. What the service does well:
Several residents made positive comments about the activities co-ordinator and stated how much they enjoy the social and recreational activities provided which include crafts, games and entertainment. One resident said how much she enjoyed baking, something she had not done for several years before coming to the home. A selection of cards made by residents is offered for sale in the home and the money raised is used to fund social events. The home respects the wishes of residents who prefer to spend their time in their own rooms pursuing their own interests rather than engaging in communal activities. The majority of residents were aware of how to raise any concerns they might have and one relative commented that concerns she had raised had been dealt with positively and to her satisfaction. Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 6 The home provides a clean and comfortable environment for residents and visitors are welcomed at any time. 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. Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The needs of prospective residents are assessed prior to admission however the well being of residents is not safeguarded as the initial plans of care do not address all the needs identified during the pre-admission assessment process. EVIDENCE: Comprehensive pre-admission assessments had been carried out for residents recently admitted to the home. One resident recently admitted to the home had specific needs in respect of nutrition and a recent bereavement which were identified during the pre-admission assessment but not adequately addressed in the initial care plans. The residents spoken with had come from a variety of places, including other care homes, hospitals and their own homes. They all said that their relatives had chosen the home for them and for the most part they were satisfied that their needs were being met. A requirement has been made relating to this standard. Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 10 Overall the health and personal care needs of residents are met, despite the care plans not providing detailed information on all their assessed needs. Residents are not consulted about how their individual care needs will be addressed. EVIDENCE: The standard of record keeping in the care records continues to improve and the records are set out in a format that is clear and easy to follow. The appropriate risk assessments are carried out to address issues such as nutrition, pressure sores and falls and care plans are in place to address identified risks. A number of the care plans to address specific risks did not contain sufficient detailed information such as the type of pressure relieving equipment in use. The emotional needs of some residents were not adequately addressed in the care plans seen. Residents have access to a range to NHS services via their General Practitioners. Sight tests are arranged in the home and private chiropody is provided for an additional charge. Overall, residents appeared well cared for and were satisfied that their personal and health care needs were being met however there was no evidence that residents are involved in the care planning process. Residents
Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 10 were not aware of who their key workers were. Staff always knocked on bedroom doors before entering but did not always wait for an answer before entering. Requirements and recommendations relating to these standards have been carried forward from the last inspection. Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Residents are encouraged and supported in pursuing their personal interests and hobbies by means of flexible daily routines and an activities programme that aims to reflect their preferences and capabilities. Residents are supported in maintaining contact with family, friends and the local community in accordance with their wishes. EVIDENCE: The activities programme is prominently displayed in the entrance hall, residents spoken with said there was a good range of activities to choose from including baking, bingo, card making and musical entertainment. The dining room on the lower ground floor is now mainly used as an activities room, a range of games and craft materials are available and there is a permanent “jumble sale” the proceeds of which are used to fund social activities. Some residents prefer to spend their time in their own rooms pursing their own interests and they are enabled to do this, residents can have their meals served in their rooms if that is their preference. It was positive to note that in the absence of the activities co-ordinator, who was on holiday with a resident, that care staff were continuing to provide recreational activities, one member of staff was observed sitting with a resident discussing family photographs and a number of residents were preparing to take part in a baking session in the afternoon. Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 12 Visitors were observed to come and go throughout the day and residents confirmed that they could receive visitors in private. A number of residents went out with visitors and staff seen to be hospitable. Overall residents were satisfied with the food, they confirmed that choices are offered and that their individual dietary needs and preferences are catered for. One resident said she had been involved in a meeting with other residents and staff to discuss the summer menu, another resident said she would like to see a more varied choice of vegetables offered. The bedrooms seen were very personalised with items of furniture, personal photographs and memorabilia; many residents have their own televisions and telephones. One resident said her room had recently been decorated and she had been involved in choosing the colour scheme. Recommendations relating to these standards have been carried forward from the last inspection. Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The rights of residents and/or their representatives to express any concerns they may have are supported by the fact that the complaints procedure is easily accessible within the home. EVIDENCE: Every bedroom has a copy of the service users guide, which includes the complaints procedure. The CSCI have received one complaint about this service since the last inspection, the owner carried out a thorough investigation of all the issues raised and is working towards addressing these. Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 25 The home provides a clean and comfortable environment however residents are at risk from scalding due to high water temperatures. EVIDENCE: The hot water in one of the first floor bedrooms was very hot to the touch, in one of the top floor bathrooms the water temperature was recorded at 46 degrees C, to reduce the risk of scalding hot water, in outlets accessible to residents, should be provided at close to 43 degrees C. A requirement has been made relating to this standard. Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The staffing levels for evenings and nights are not sufficient to ensure that the needs of residents are met in a timely manner and in accordance with their individual preferences. EVIDENCE: Residents spoke favourably about the staff however several commented that they regularly have to wait for staff assistance in the evenings and at night and one resident commented that staff often seem very rushed at these times. The numbers and skill mix on the day shift are appropriate to the needs of service users with 2 nurses, 2 senior care assistants and 6 care assistants on duty, giving a staff to resident ratio of 1:4. The shift finishing times are staggered between 2.00pm and 3.30pm and between 3.30pm and 9.00pm there is one nurse and 5 care assistants on duty, giving a ratio of 1:8. There is one nurse and 3 care assistants on the night shift (9.00pm to 8.00am) giving a ratio of 1:10. Housekeeping, laundry and catering staff are provided in addition to nursing and care staff. A requirement has been made in relation to this standard. Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) standards were not inspected on this visit. These EVIDENCE: Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2
COMPLAINTS AND PROTECTION x x x x x x 2 x STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x x Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 18 Yes 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 3&7 Regulation 15 Requirement Each service user must have a detailed plan of care setting out how all their assessed needs will be met. The plans must be updated to reflect the changing needs of service users. The care plans must provide evidence of service users involvement in the care planning and review process. Previous timescales of 17/12/04 and 31/03/05 not met. Care plans relating to the management of pressure area care should provide specific information e.g. the type of pressure relief equipment in use. Previous timescale of 31/03/05 not met. The registered pesons must make appropriate arrangements for the safe management of medications. Previous timescale was 31/03/05, this requirement has been carried forward.
Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 19 Timescale for action 31 August 2005. 2. 8 17(1)(a) Schedule 3 - 3(m) 31 August 2005 3. 9 13(2) 31 August 2005 4. 21 !3(4) The entrance to the sluice room, identified during the last inspection must be altered to reduce the risk of accidents. Previous timescale was 31/03/05, this requirement has been carried forward. The temperature of hot water in outlets accessible to service users must be maintained at 43 degrees C. There must be sufficient numbers of appropriately trained staff on duty, to meet the needs of service users, at all times. 31 August 2005 5. 25 13(4) 13 July 2005 13 July 2005 6. 27 18 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. 2. Refer to Standard 2 8 Good Practice Recommendations The information provided to service users at the time of admission should specify the room to be occupied. Clear procedures should be established with regard to the arrangements to be made for the reporting of accidents/incidents and this should include consultation with service users. The Tissue Viability Nurse should be consulted regarding the management of wound care. A risk assessment should be undertaken for all service users who wish to self-medicate and this should include consultation with General Practitioners. In order to safeguard the privacy of service users staff should wait for a reply before entering their bedrooms unless there is a documented agreement to the contrary or reason to believe that the resident is in danger. Training should be provided for the activities co-ordinator to assist her in developing her role. Additional dining tables should be provided. The temperature of hot food should be checked at the point of service. The home should maintain an up to date list of service
J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 20 3. 4. 9 10 5. 6. 12 15 Bingley Wingfield 7. 8. 9. 10. 21 24 29 35 users food likes and dislikes. Consideration should be given to the provision of additional bathing facilities on the top floor. A review of the furnishings and fittings in all bedrooms should be undertaken to ensure that rooms are equipped to the specification of this standard. All staff should be provided with a statement of terms and conditions of employment. All cash transactions should be witnessed by two people. The home should clarify with the insurance company the amount of cash that can be held on the premises. Bingley Wingfield J52 J03 S29135 Bingley Wingfield V225293 180505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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