Inspection on 25/07/06 for Bings Hall

This inspection was carried out on 25th July 2006.

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 01/05/07

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 25th July 2006 09:30 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.V306614.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.V306614.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.V306614.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) 23rd November 2005 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.V306614.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection site visit took place on 25th July 2006; the inspector arrived at Bing’s Hall at 0800hrs on a hot and sunny summer’s day. 21 of the 38 National Minimum Standards were assessed during this inspection process. Views were gathered from the residents, visiting family members, healthcare professional visitors to the home and the staff and management team. Records were sampled and a physical tour of the building was undertaken. The inspector appreciated the wholehearted co-operation from residents and the staffing team during this inspection visit. Overall the standard of care provided for residents and Bing’s Hall was good. What the service does well: What has improved since the last inspection? Previous inspection reports had identified a shortfall in the storage facilities for controlled medications. A double mechanism metal cabinet had been secured to the wall in the manager’s office since the last inspection visit. Since the last inspection all staff members had received infection control training. Daily menu choices had been restricted to one cooked meal with salad as a daily alternative. The menu had been further developed since the previous inspection to include two daily choices of a hot meal with salad as a third option if required. Bings Hall DS0000030469.V306614.R01.S.doc Version 5.2 Page 6 The previous inspection report included a recommendation for the kitchen to be refurbished. The manager reported that the new kitchen had been purchased and was ready to be fitted. 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. Bings Hall DS0000030469.V306614.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 Bings Hall DS0000030469.V306614.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 at least once during a 12 month period. 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. No residents moved into the home without having their needs assessed and being assured that these would be met. EVIDENCE: The home’s Statement of Purpose and Service User Guide had been updated to reflect the current staffing structure at the home and provided prospective service users with a clear picture of the service they could expect to receive when they entered the home on a permanent basis. Care plans sampled at this inspection visit included those for some residents admitted to the home since the previous inspection. It was reported that the manager and the provider visited with potential residents and their families/representatives to undertake comprehensive pre admission assessments of their needs. The files sampled contained pre-admission assessments covering all areas of the residents’ personal, social, spiritual and healthcare needs including assessments of potential risks to the residents’ health, safety and well being. Bings Hall DS0000030469.V306614.R01.S.doc Version 5.2 Page 9 Evidence was available to confirm that the residents, their families/representatives, social workers and healthcare professionals were involved with the pre-admission processes and the development of the individual’s plan of care. One file sampled contained a residents’ questionnaire regarding the process of their admission into the home, this provided evidence that the resident had received adequate information to make the decision to enter the home on a permanent basis. Bing’s Hall does not admit residents solely for intermediate care. Bings Hall DS0000030469.V306614.R01.S.doc Version 5.2 Page 10 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 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 was delivered in a manner that respected their privacy, dignity and individuality. EVIDENCE: Files sampled as part of this inspection process provided evidence that the comprehensive pre admission assessment formed the basis of individuals’ care plans setting out in detail the actions needed to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the resident were met. There was evidence to confirm healthcare appointments made and attended by residents, the outcomes of these appointments were recorded with changes to the care plans made as required. Care plans were regularly reviewed to identify and reflect residents’ changing needs; evidence was available to confirm that residents, families and representatives were involved with the review process. Files sampled of some new residents did not contain their photographs however all other documents required by regulation to protect the health safety and well being of residents were present on file. Bings Hall DS0000030469.V306614.R01.S.doc Version 5.2 Page 11 Where possible care staff supported individuals’ capacity to self-care. A visiting healthcare professional reported confidence in the care provided for the residents. The manager was able to demonstrate where professional advice about the promotion of continence and tissue viability had been sought and acted upon. Previous inspection reports had made a requirement for the cupboard used to store controlled drugs to be fitted with a double locking mechanism, this site visit confirmed that this had now been done. The drug trolley was secured to the wall in the manager’s office when not in use. Records confirmed that staff responsible for the administration of medicines had attended external competency assessed training. The manager reported that pharmacy led medication audits took place. Care plans provided evidence that residents’ doctors reviewed their medication needs regularly. Medication Administration Record sheets had some gaps in recording. Discussion took place with the manager regarding the stocks of medication held at the home. Residents spoken with at this visit reported feeling they were respected and their dignity was protected. All healthcare visits took place in private and residents were able to receive visitors in the privacy of their own rooms or in a private lounge area. Staff members were observed to treat each resident as an individual and demonstrated good awareness of the manner in which each person wished to addressed and supported. Bings Hall DS0000030469.V306614.R01.S.doc Version 5.2 Page 12 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 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. Residents found their experiences of living at Bing’s Hall matched their expectations and preferences. EVIDENCE: Routines of daily living at Bing’s Hall were flexible around residents’ preferences. On the day of this inspection visit it was observed that some residents took breakfast in bed whilst others were able to breakfast in the dining room. Menus demonstrated that daily choices were available for both lunch and supper. Food stocks were ample and of good quality. The previous inspection report made a recommendation for the kitchen to be refurbished. This was still outstanding at this inspection however the manager reported that new kitchen furniture has been purchased and was waiting to be installed. Mealtime was a happy relaxed and enjoyable affair with the manager, care staff and the inspector joining the residents. Where residents required assistance to eat this was provided in a sensitive and discrete manner. All those present enjoyed their meal and chatted happily with the inspector, all residents praised the food provided. Some activities were available to residents such as bingo, reminiscence sessions, manicures, meals out and the home’s open days and social events. Bings Hall DS0000030469.V306614.R01.S.doc Version 5.2 Page 13 The manager reported awareness of the need to develop the home’s activities further and specifically to explore different avenues to encourage residents to partake in meaningful past-times. Visitors were welcomed at the home at any time and one visitor spoken with at this inspection praised the home for the care and attention provided for the residents. One resident reported that their family enjoyed the freshly baked cakes and tea they were offered when visiting the home. Residents’ private rooms were pleasantly decorated and personalised with their own belongings. Most of the people living at Bing’s Hall had friends and families to represent their interests, however it was noted that information on independent advocacy groups was available in the entrance hall. Residents handled their own financial affairs as long as they wished to and as long as they were able to do so. Residents confirmed they chose when to go to bed and to rise. Bings Hall DS0000030469.V306614.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ views were respected and listened to however recruitment policies and procedures in place to protect residents’ safety and well being were not always adhered to. EVIDENCE: There was a clear and comprehensive complaints policy and procedures in place. Records indicated the home had not received any complaints since 2003. A discussion was held with the manager regarding training staff in recognising complaints however ‘minor’ they may appear to be. Residents spoken with said they would know who to make a complaint to if they felt the need however no resident was able to say what response they should expect from the home or in what timescales. One resident reported: “I wouldn’t want to complain because, on the whole, they are really, really good here” All staff had undertaken training in the Protection of Vulnerable Adults and refresher courses were scheduled and planned for. Policies and procedures were in place to protect the safety and well being of the residents however two staff files sampled did not contain evidence that a Criminal record Bureau enhanced disclosure had been obtained. Bings Hall DS0000030469.V306614.R01.S.doc Version 5.2 Page 15 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 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. Residents lived in a clean, fresh and well-maintained environment. EVIDENCE: On the day of this visit the home appeared fresh inviting and welcoming. The inspector took an unaccompanied tour of the home and found the environment to be well maintained, clean and fresh throughout. As mentioned previously in this report the kitchen is scheduled to be refurbished and the manager reported that a first floor bathroom was to be made into a walk in shower room as this suited the preferences of the residents. A bathroom would remain on the ground floor. All staff members had attended training in the control of infection. The manager reported plans to remove the shallow steps in the garden area and replace them with gentle ramps in order that the residents could access the entire garden with more safety. Bings Hall DS0000030469.V306614.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 at least once during a 12 month period. 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. The staffing levels and skill mix at Bing’s Hall were appropriate to meet the assessed and recorded needs of the residents. Recruitment practices did not always protect the safety of the residents. EVIDENCE: Rotas provided evidence that staff were employed in appropriate numbers to reflect the numbers and needs of the residents. All new staff undertook a structured induction process. 9 of the 14 care staff had achieved NVQ level 2 in care and 2 had achieved NVQ level 3. Two further staff members were due to start the NVQ 2 qualification. The home’s recruitment policy and procedure was appropriate for the protection of the residents however this was not always followed in practice. Two staff members’ files did not contain evidence that an enhanced Criminal Bureau Records check had been obtained. All other documents required to meet regulation and to protect residents was present on staff files. Since the previous inspection the manager had further developed the home’s training and development plan and was able to demonstrate that current staff members had attended training in all the mandatory areas such as Food Hygiene, Moving and Handling and the Protection of Vulnerable Adults as well some training specific to meet the needs of the residents at Bing’s Hall. Bings Hall DS0000030469.V306614.R01.S.doc Version 5.2 Page 17 Refresher training was planned for the year and discussions were held with the manager regarding training for care staff in areas such as handling complaints and understanding the National Minimum Standards. Bings Hall DS0000030469.V306614.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 at least once during a 12 month period. 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. Residents benefited from a well managed home. Their health, safety, welfare and financial interests were safeguarded. EVIDENCE: The manager had the relevant qualifications and experience for the role however had not yet applied to be registered with the Commission for Social Care Inspection. The home had sound policies and procedures reviewed and updated by the manager in line with current thinking and practice. Evidence was available to confirm that the manager had undertaken periodic training to update skills and competence whilst managing the home. The home had clear lines of accountability including with external management. Regulation 26 visits by the registered provider were regularly undertaken however reports of Bings Hall DS0000030469.V306614.R01.S.doc Version 5.2 Page 19 these visits were not always forwarded to the Commission for Social Care Inspection. The home sought the views of the residents and their families as part of the annual development plan of the service. Where shortfalls in the service provision were identified an action plan was developed to address those issues. Discussion took place with the manager regarding obtaining views of the service provision from healthcare professionals and other stakeholders in the community. The manager was able to demonstrate that residents’ individual monies were safely maintained in individual wallets with receipts in a locked space within the office. Records required by regulation for the protection of residents and for the effective and efficient running of the home were maintained, up to date and accurate. Residents had access to their records and information held about them by the home if they so wished. The manager was able to demonstrate that the home operated under effective health and safety policies and procedures and operated safe working practices. Certificates were available to demonstrate that regular testing of electrical systems and equipment took place and a safe environment was maintained for residents’, staff and visitors’ well being. Risk assessment was carried out for all safe working practice topics and these were recorded appropriately. All staff received induction and foundation training ensuring that residents’ health safety and well being were safeguarded at all times. Bings Hall DS0000030469.V306614.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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 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.V306614.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. 1 Standard OP18 OP29 Regulation 19 (4) Schedule 2 Requirement The registered person shall not allow a person to work at the care home unless the employer has obtained in respect of that person the information and documents as specified in paragraphs 1-7 of schedule 2 of the Care Homes Regulations 2003. This specifically refers to Criminal Records Bureau disclosures. Timescale for action 31/07/06 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.V306614.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: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bings Hall DS0000030469.V306614.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. 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!