Inspection on 01/05/07 for Bings Hall

This inspection was carried out on 1st May 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

Bings Hall 14/04/08

Bings Hall 25/07/06

Bings Hall 23/11/05

Bings Hall 02/06/05

Bings Hall 01/12/04

Bings Hall 03/08/04

Bings Hall 08/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Bings Hall Chelmsford Road Felsted Dunmow Essex CM6 3EP Lead Inspector Jane Greaves Key Unannounced Inspection 1st May 2007 10:00 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 Bings Hall DS0000030469.V338858.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. Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bings Hall Address Chelmsford Road Felsted Dunmow Essex CM6 3EP 01371 820544 01708 501804 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) Family First Residential Care Homes Limited Manager post vacant Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, only falling within the category of old age (not to exceed 16 persons) 25th July 2006 Date of last inspection Brief Description of the Service: Bing’s Hall is a detached two-storey property located in the charming Essex village of Felsted. Residents’ private accommodation consists of 13 single bedrooms and two double rooms, all of which have en-suite facilities. The home is owned by Family First Residential Care Homes Limited and is registered for 17 Older People over the age of 65 years. The village of Felsted has shops, public houses and a restaurant. The nearest larger towns are Chelmsford and Great Dunmow. A copy of the most recent inspection report by the Commission for Social Care Inspection was displayed in the entrance hall of the home. The fees charged for this residential care home ranged from £575 to £625 per week. Items not covered by this fee were hairdressing (£5 - £10) chiropody (£10) newspapers and personal items. Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection visit took place on 1st May 2007. There were a number of visitors to the home on this day who were happy to report to the inspector how happy they were with the care and support provided for their relatives living at Bings Hall. The inspection process included discussion with the residents, visitors, the manager and the staff team. A sample of staff and residents’ records and important paperwork was looked at together with direct and indirect observation. This report has been written using evidence gathered prior to and during the inspection. 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. The summary of this inspection report can be made available in other formats on request. Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 6 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 Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 7 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 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People moving into Bings Hall could be confident that the home would not admit them without being able to demonstrate that the service could meet their needs. EVIDENCE: All prospective residents were assessed by the home prior to admission, and information on the person’s needs was recorded. The manager showed a good awareness of the needs that the home is able to meet, and clearly took this into account when considering prospective admissions. A new resident was spoken to and confirmed that they had had opportunity to visit the home before they moved in, felt that meeting the manager and visiting the home had helped them to be confidant that this was the right home for them, and that they had settled in quickly and were happy with the way their needs were now being met. A visiting family member spoken with Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 8 expressed great satisfaction at the way the home had handled the admission and subsequent care of their relative. Bings Hall does not offer intermediate care. Bings Hall DS0000030469.V338858.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. Residents health and personal care needs were met by a staff team that showed a caring approach, treating them with sensitivity, dignity and respect. EVIDENCE: A care plan for a recent admission to the home was sampled as part of this inspection process. The care plan contained good detail painting a ‘pen picture’ of the person and providing good detail of the care and support required to maintain their quality of life as much as possible. Residents spoken with reported that staff gave them the level of support and assistance they required and provided care in an appropriate way. Staff members were observed to treat residents respectfully, and to assist them in a discrete and dignified manner. Relatives consulted as part of the inspection process were all very positive about the personal and healthcare support provided by the home, with one stating that their relative’s health had improved considerably since moving into Bings Hall. Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 10 Files also contained a range of additional assessments covering continence, nutrition, mobility and moving and handling, and pressure areas, as well as risk assessments relevant to some individual needs. A discussion took place with the manager around the risk management framework being used to encourage and support the residents to become involved in more activity around the home and in the community. Records showed appropriate referrals being made to health professionals and the manager reported that the home was well supported by local district nursing services. Medication administration records (MAR) were viewed and were well maintained. The breakfast medication procedures were observed, residents came down to breakfast when they were ready to and were offered their medication before, with their food or after they had eaten. This was a very individualised procedure. Bings Hall DS0000030469.V338858.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): 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. People living at Bings Hall were able to live their lives according to their personal and individual preferences. EVIDENCE: Residents and staff reported that routines in the home were flexible and individuals’ choices were accommodated. One person said that they felt the best thing about the home for them was “you can please yourself, you can always put forward a suggestion” another described the home as ‘like one big family’. Where able, residents were encouraged to exercise control and choice over their lives through personalising their rooms, maintaining previous contacts outside of the home and being supported to voice opinions. Information relating to advocacy services was available in the hallway at Bings Hall, accessible to residents, family and visitors. Over several inspections it has been noted that there is a consistently high level of interaction between staff and service users at Bings Hall. One resident Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 12 reported, “I do like the carers, they are so full of fun and helpful – lovely people”. The home had an activities programme that included pastimes as sing-alongs, walks, chats, cards, sitting in the garden, exercise sessions, nail painting, listening to music and having people from Church to visit to sing hymns and chat. Bings Hall used to employ a dedicated activities co-ordinator however this is no longer the case and it was reported that staff did not always have the time to provide appropriate activities and to spend time investigating and researching different options to provide stimulation for the residents. A discussion was held with the manager around the provision of more varied activities that could be offered for the residents and how the risk management framework could support people wishing to undertake activities as opposed to limiting choices. One resident had expressed a wish to go swimming, the manager reported that a risk assessment was to be undertaken and that staff were happy to accompany the resident. Visitors were welcome at any time, and the relatives spoken to all found staff friendly and supportive, and felt that they were encouraged to ‘feel at home’. Staff continued to support the people who lived at Bings Hall to go out into the local community. All residents spoken with were positive about the meals provided, and confirmed that a choice of food was available. One person said, “On the whole the food is pretty good – you can’t please everyone though!” The cook had a good knowledge of individuals’ preferences and individual needs. The main meal on the day of the inspection was well balanced, was appetising, and was eaten well by residents; nutrition records showed a good range of meals being provided. At lunchtime staff assisted service users in an appropriate and respectful way, and the dining experience was pleasant. Previous inspection reports have identified that the kitchen at Bings Hall was looking tired and in need of refurbishment and it has been repeatedly reported that this was due to be done. The proprietor reported that a new domestic kitchen had been purchased however it had since been decided that a professional catering kitchen would be a more suitable option. The cooker is to be replaced immediately and the proprietor reported that she is currently investigating the purchase of a ‘catering kitchen’ in consultation with the cook. Bings Hall DS0000030469.V338858.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): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home operated appropriate practices and procedures to protect vulnerable adults. EVIDENCE: The CSCI has not received any complaints about the service over the last year. The home’s complaints folder contained evidence of three complaints since the previous inspection visit; these had been clearly documented with a record of the appropriate actions taken. Residents and their families spoken to had no complaints about the home, and felt safe and confident living in the home. There were many cards and letters praising the kindness afforded to residents and their families by the staff and management team at Bings Hall. There were some gaps evident in the training provision/refresher training for the safeguarding of vulnerable adults, the manager was aware of this and the appropriate courses had been arranged. Staff recruitment files for people employed since the previous inspection visit contained evidence to confirm that all checks necessary had been made to protect the safety and well being of the people living at the home. Bings Hall DS0000030469.V338858.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): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Bings Hall is a well maintained and attractive home that meets the needs of the people who live there EVIDENCE: On the day of the inspection communal areas were clean, tidy and free from any unpleasant odours. A relative spoken to stated that they visited regularly, and always found the home to be clean and odour-free. The inspection took place on a sunny spring day, one resident chose to take lunch in the garden and five others joined after lunch to take in some fresh air. There is a pleasant courtyard garden area however there are shallow steps leading from the home, it has been previously reported that ramps were to be fitted to enable residents to access this area independently without staff supervision however this was still at the planning stage. Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 15 Laundry and sluice facilities met the needs of the home, were located away from areas where food was prepared or eaten, and contained hand wash facilities. The washing machine included a sluice wash programme. Bings Hall DS0000030469.V338858.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): 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. Staff members are recruited appropriately, suitably skilled and employed in numbers sufficient to protect the health, safety and welfare of the people living at the home. EVIDENCE: Discussion with staff and residents and sampling the staff rota confirmed that staffing levels were well maintained and were appropriate to the needs of people living at the home. The loss of the home’s dedicated activities coordinator has had an impact and the manager recognises that the care staff do not always have the capacity to spend time allocated as care shifts to devising meaningful and stimulating activity choices for residents. Two staff members were currently working towards the NVQ 2 in care; once these have been achieved the home will have 100 staff trained to this level or above. This is to be commended. The file of one new staff member was inspected, and showed that all the appropriate checks had been obtained before the person started work. The previous inspection had identified that some staff members had started to work at the home without all the relevant checks being completed. The manager reported that she had forgotten to put this situation right after the inspection as requested however evidence was available to confirm that these checks had since been applied for. Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 17 Staff training records were sampled and it was observed that the majority of the training required to meet the National Minimum Standards was due to be refreshed during the summer months. The manager was able to confirm that some of the courses had been arranged. Bings Hall DS0000030469.V338858.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): 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. The manager demonstrates clear leadership within the home, and promotes an open, positive and supportive atmosphere. EVIDENCE: Residents and relatives spoke highly of the internal management of the home, and felt there was good communication. The manager demonstrated a good awareness of the needs of older people, and a positive approach to promoting independence and fulfilment for the people living in the home. The manager had very recently submitted an application for registration to the Commission for Social Care Inspection. The home had clear lines of accountability including with external management. The registered provider undertook regular checks at the home and prepared reports accordingly, these were available for scrutiny at the home. Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 19 The manager reported that the home’s annual quality assurance survey had been commenced in April 2007. A summary had not yet been however the survey responses were available; all responses from people who live at the home, family members and visitors to the home were very positive and praised the services the home provided. The home does not manage the financial affairs of any residents, but does look after small amounts of money on their behalf. Procedures for managing money were safe and efficient: the home maintained clear individual records, and receipts for all expenditure. The home had a clear health and safety policy statement, and additional information and guidance on various aspects of health and safety. The home’s training summary record showed that the majority of staff had current moving and handling and fire safety training, and that staff had attended other relevant health and safety training (e.g. COSHH, food hygiene, first aid, health and safety). Records showed that appropriate servicing and checks were carried out on facilities and equipment. The fire logbook provided evidence that regular fire alarm checks, extinguisher checks and emergency lighting checks took place. The manager reported that fire drills including total evacuation took place 6 monthly. The manager reported the intention to secure external fire training to underpin the in-house training that currently takes place. Bings Hall DS0000030469.V338858.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 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 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 3 28 4 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 Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bings Hall DS0000030469.V338858.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Bings Hall DS0000030469.V338858.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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