CARE HOMES FOR OLDER PEOPLE
Bluebell House 408 Boothferry Road Hessle Hull East Riding Of Yorks HU13 0JL Lead Inspector
Mavis Pickard Unannounced Inspection 17th January 2006 11:00 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 Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 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. Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Bluebell House Address 408 Boothferry Road Hessle Hull East Riding Of Yorks HU13 0JL 01482 649234 01482 649234 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) Mrs Joan Todd & Mr David Todd Mrs Joan Todd & Mr David Todd Care Home 26 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (26) of places Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 13th September 2005 Brief Description of the Service: Bluebell House is a care home offering residential care for up to 26 older people who may or may not have a dementia type illness. The home is situated in a residential area of Hessle, Hull, close to the Humber suspension bridge and to local shops. The house a converted property provides resident private accommodation in 18 single and 4 shared bedrooms to the ground or first floor. There are no Ensuite facilities. There is no passenger lift. A stair lift is available for people who may need assistance to their first floor accommodation. Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was undertaken over a 4-hour period during which the deputy manager was present in the home. The home was found to be running well. Residents and staff were noted to be going about their daily routine in a comfortable and relaxed way. There were 3 care staff on duty including the deputy manager plus a cook and domestic staff this, the deputy manager said is the usual complement of staff. What the service does well: What has improved since the last inspection?
The home now records in a more systematic way that foot, oral and optical care are undertaken regularly. Medication records show no gaps and does not indicate any signing errors. Accurate records are maintained with respect to controlled medication. This report confirms that although a medication error prompted a requirement of the previous report, the manager and staff has for a considerable time ensured that 2 staff members sign for the administration of controlled medication, in an appropriate paginated hardback book.
Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 Page 6 The bath hoist has been inspected and a record of its satisfactory testing was examined. 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. Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 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 Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 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): None of these standards were inspected at this visit. EVIDENCE: Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 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 the following standard(s): 7 and 9 All residents have appropriate and detailed care plans in respect to their assessed needs. The home maintains and follows appropriate medication policies and procedures. EVIDENCE: A number of residents care files were examined that are noted to be detailed and well organised. All those examined gave evidence that care plans specific to individual need are maintained and reviewed regularly. Case files contained detailed records of care provided all are signed and dated. The deputy manager ensures that all residents and/or their representative are asked about the residents preferences with respect to the time they wish to get up in the morning. These preferences are recorded and reviewed regularly. It was discussed with the deputy manager that the residents and staff would benefit should nighttime activity be recorded in more detail than at present.
Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 Page 10 Medication records were examined where it is found that there are no signing errors or omissions. Controlled medication records show that the home has for a considerable time recorded the administration of such drugs in a paginated book that is signed by 2 staff at the time of administration. From direct observation it is clear that staff follow appropriate procedures in respect to the receipt, storage, recording and administration in the home. [In respect to Standard 10 please refer to Standard 26] Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 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 the following standard(s): 14 Residents are helped to have control over their lives. EVIDENCE: From direct observation and from the examination of care and other records it is clear that people accommodated are helped by staff to have control over their lives. People choose their meals, where to take them. People choose when to get up in the morning and what clothes to where. People choose where to sit and who to sit with in the home and from records and speaking with residents and staff, people accommodate and/or their representatives choose that the resident live at the home. Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 Page 12 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 A recent anonymous is unfounded. EVIDENCE: An anonymous complaint forwarded to the Commission from Hull Social Services was investigated during this visit. The complaint referred to an unknown resident being ‘forced’ to get up at 4am in the morning, sometimes. Records at the home were examined that evidenced that the home staff has, for some considerable time been implementing a system where residents and/or their representative are consulted about such issues and are asked to sign a record showing residents preferred time of getting up in the morning. Records are reviewed regularly and amended if preferences change. Residents spoken with said that they get up and go to bed when they wish. It is the conclusion of this investigation that the complaint is unfounded. Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 Page 13 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 Residents live in a safe, well-maintained environment that suit their needs. Not all areas of the home are clean and tidy. EVIDENCE: The home presents as a homely environment. A planned programme of maintenance is in place. Policies for the control of infection are in place and followed in practice. Laundry facilities in the home are appropriate and meet the needs of the service users. It was discussed that although the home is in general clean and there were no unpleasant odours detected, there are areas that could benefit from more frequent attention. Toilet and bathrooms inspected did not present as being wholly clean and tidy. Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 Page 14 The home does not in general provide liquid soap and disposable towels in communal toilet areas. Bathrooms visited showed that this is the place used generally for the storage of resident’s continence requisites. This practice does not promote dignity and privacy of people living in the home. It is more usual that small amounts of such items are stored in the resident’s own private room, the bulk being stored in a suitable store cupboard. [Referred from Standard10] It was noted that in one bathroom toiletries such as tooth brushes, soap, talc and hairbrushes were evident. The person in charge was confidant that these items are not used as communal toiletries and that they belonged to a former resident. If this is the case they need to be removed. Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 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 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): 29 and 30 Not all checks required for the safety of residents are up to date. Not all training recommended for staff has been implemented. EVIDENCE: The home follows laid down procedures regarding ensuring that all people employed by the home are in receipt of satisfactory Criminal Records Bureau [CRB] and Protection of Vulnerable Adults [/POVA] disclosures prior to starting work in the home. However the not all people employed had up to date disclosures. The person in charge said that she and she understands the home’s management are not aware that CRB/POVA disclosures are not ‘portable’ from one employment to another. The person in charge said that she would ensure that in the future new CRB/POVA checks are undertaken for all newly appointed staff. The management should continue to encourage and make available for staff appropriate training, in particular training in respect to Adult Protection and the recognition of abuse. Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 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 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): 37 and 38 Any previous requirements made in respect to these standards are met EVIDENCE: There are no current issues regarding these standards. Any previous requirement relating to these standards are now met. Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 2 STAFFING Standard No Score 27 X 28 X 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X 3 3 Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 Page 18 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 OP29 Regulation 19 Timescale for action The person registered must 17/01/06 ensure that CRB/POVA disclosures relating to employment in this home are received prior to employment starting. Requirement 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 OP26 Good Practice Recommendations The person registered should consider ensuring that resident’s personal items are stored in their private accommodation. The person registered should consider any implications that may arise from not providing liquid soap and disposable towels in the communal toilet/washing areas of the home. The person registered should continue to ensure that appropriate training is made available and undertaken by the home’s staff, including Adult Protection Training. 2. OP26 3. OP30 Bluebell House DS0000019650.V278496.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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