CARE HOMES FOR OLDER PEOPLE
Bluebell House 408 Boothferry Road Hessle Hull East Riding Of Yorks HU13 0JL Lead Inspector
Ms Wilma Crawford Unannounced Inspection 27th February 2007 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 Bluebell House DS0000019650.V329654.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. Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Bluebell House Address 408 Boothferry Road Hessle Hull East Riding Of Yorks HU13 0JL 01482 649234 F/P01482 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.V329654.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 17th January 2006 Brief Description of the Service: Bluebell House is a care home offering residential care for up to 26 older people some who may 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 residents’ private accommodation in 18 single and 4 shared bedrooms to the ground or first floor. There are no en suite facilities or passenger lift. A stair lift is available for people who may need assistance to their first floor accommodation. Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over eight hours including preparation time. Three residents, two relatives, and three staff were spoken with during the inspection. The manager was available throughout. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. The premises were looked at and the records of three residents and two staff were inspected. The comments and views of people spoken with are included within this report. A Pre Inspection Questionnaire asking for information about home was sent out before this visit and information from this was included as part of the inspection process of this service. Comments from replies to questionnaires that were sent out to relatives and professionals are also included in the report. The fee charged is £375 per week. The comments and views of people spoken with are included within this report. What the service does well:
Bluebell House offers a home where the preferences and wishes of each person are taken into account and respected. Residents are encouraged to make choices and they said they feel valued as individuals. The home provides good quality care to the residents living there in a friendly, homely environment The residents were very complimentary about the way the staff care for them and one person said ‘The staff are first class’. A relative described the home as ‘It’s the best care home I have ever seen and I did visit a lot before making the decision that this was the best place for my mum to be.’ ‘I can’t fault it’ ‘Mum is supported in a dignified manner.’ ‘I am always fully consulted about all aspects of Mum’s care.’ ‘There is always plenty going on and we are welcome to join in.’ The home is very well organised and managed, with trained staff that are well supported and have a good knowledge of residents’ needs. The home has a strong key worker system in place and residents spoken to were able to identify their named key worker. 80 of the current staff team have achieved NVQ level 2 or above. The home has its own assessor and staff are given time to work towards their awards.
Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 Page 6 No requirements were made as a result of this visit. 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. Bluebell House DS0000019650.V329654.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 Bluebell House DS0000019650.V329654.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 &6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personalised needs assessment means that people’s diverse needs are identified and planned for before they move to the home. EVIDENCE: Evidence seen at this inspection in residents’ files and care plans showed that the home does not admit residents without a care assessment being undertaken. Discussion with residents and relatives also confirmed that this happened. Comments included ‘I looked at a lot of care homes with my relative, this is the only one that they said ‘It’s nice here isn’t it? We had the opportunity to visit several times before making the decision to move in.’ Bluebell House DS0000019650.V329654.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, &10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans offer the staff good information on which to base their daily care, and the residents health needs, privacy and dignity are met The policies and procedures in place ensure the safe handling and administration of medication for the people who use the service. EVIDENCE: The resident’s care plans seen showed that they are developed from the initial needs assessment carried out by the home. Reviews of the plans are monthly to ensure that they are still current and any new issues have been addressed. Risk assessments are available, including a falls risk assessment. These show how each person has had risks assessed that are relevant to them. There is evidence that all residents have access to relevant health care professionals. Care plans evidence that health care professionals visit the home and that residents when required visit the hospital. Two visitors commented that they are happy with the care provided and confirmed that their relatives see the GP, district nurse and other professionals as required. Residents said that they were consulted about their care and were aware of their care plans. Relatives confirmed that they were also consulted about their relatives’ care.
Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 Page 10 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, &15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities within the home and community mean that service users have a range of opportunities to participate in stimulating and motivating activities. Relatives and friends of residents are made welcome as are visiting health care professionals. Meals and meal times, are relaxed and an enjoyable experience for service users. EVIDENCE: Residents said that the food at this home is varied and well prepared. Residents have a choice of where they can take their meals, the dining room, the conservatory, or tray service. One relative commented ‘ my mum has been well supported with her diet and the recommendations made by the dietician have been closely followed and implemented by the home. They have made her home made soups and catered for her every need.’ The homes pre-assessment forms were seen and included residents’ dietary needs and listed their likes and dislikes. Staff spoken with, were aware of individuals’ personal likes and dislikes. Observations made by the inspector were that adequate numbers of staff are available at mealtimes to help residents. Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 Page 11 Three residents seen during this inspection commented that their visitors are always made welcome in the home and refreshments are made available. Two visitors confirmed that they are made welcome at the home. One visitor said that ‘ The staff always inform me of any changes in my relative.’ A resident confirmed that she could take her visitors to her bedroom. The homes signing in book was seen and showed that visitors attend this home in numbers at various times of the day. Residents and relatives are also consulted through the home’s Quality assurance process. One resident stated ‘ I feel fully consulted about all aspects of my care and the day to day running of the home.’ The home undertakes a variety of activities for the stimulation of residents and a record of these is maintained. This includes day trips, meals out, visits to pantomimes and old time music hall shows, Easter and summer fairs, entertainers, coffee mornings, karaoke, keep fit, poetry and quizzes. Residents are all registered on the electoral role. A Monitored Dosage System of medication is used in the home and only staff that have received appropriate training are able to administer this. Medication is suitably stored and administered. Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are listened to and their views taken into account. Policies and procedures ensure residents are protected from abuse. EVIDENCE: Residents and their relatives are made aware of the complaints procedure on admission to the home. The home takes all complaints seriously. There have been a number of complaints and niggles have been made in the last year all of which have been dealt with appropriately and within the agreed timescale. Two residents spoken with confirmed that they felt safe in the home. One resident stated, ‘ I have never had any cause to make a complaint, but if I did I’m sure that Joan or the staff would take action. They would definitely sort it out.’ She also said that she would feel confident about approaching staff with a complaint. Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a comfortable, pleasant and safe environment, with both private and communal space being suitable for their needs. EVIDENCE: The home presents as a homely environment. A planned programme of maintenance is in place. The home was found to be in a good state of repair with resident’s rooms personalised with photographs and other memorabilia. Residents commented that they were happy with their rooms. They also said that as rooms become vacant they are asked if they would like to move to another room. Since the last inspection further bedrooms have been completely redecorated as they have become vacant. The home was found to be clean and odour free. There are two cleaning staff available within the home.
Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are well trained and supported ensuring that residents’ personal and safety needs are met at all times. EVIDENCE: The home provides an induction training for all newly appointed carers. The home records all training undertaken by care staff and a training plan is in place for 2007.The home also carries out appropriate checks for all new workers before they commence work at this home. 80 of the staff team have achieved NVQ level 2 or 3. A further two staff are working towards NVQ level 2 and 3. An assessor is available for staff in the home and they are given time to work towards this award. The duty rota showed that a minimum of six and maximum of seven staff numbers were available to meet the needs of residents during the day and two staff during the night in this home. Staff said that the numbers of staff on duty at the busiest times are able to accommodate the numbers of residents. One visitor said ‘The care staff are cheerful and friendly and there seems to be a lot of staff when I visit.’ The staff have completed the Protection of Vulnerable Adults, Fire training, moving and Handling, administration of medicines, Health & Safety and First Aid in the workplace training in the last year Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in an open and inclusive manner with residents being consulted on their care and their health and safety needs being met. EVIDENCE: The manager is competent through her experience and qualifications to run the home. She has extensive years experience of working with older people and has achieved NVQ level 4, she has also completed the Registered Managers Award. Staff said they are well supported and they are confident to approach the manager with concerns or ideas. The home has a quality assurance system, conducting regular surveys to monitor quality. The results of this have been very positive. However, the
Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 Page 16 manager stated that should any action be identified from these, an action plan would be developed and implemented. Staff are regularly supervised both formally and during every day observation. Annual appraisals also take place. Assessments are documented in relation to health and safety issues that may arise from the environment of the home. Maintenance records are also kept. Records within the home are stored securely. Residents said they were aware that they can see them if they wish. Relatives and residents commented; ‘Joan is excellent, she is always there and available to talk.’ There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm, fire drills and emergency lighting checks have been undertaken. Certificates were available showing that the shaft lift and bath hoists had been serviced six monthly. Electrical equipment had also been serviced. Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 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 3 X X 3 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 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 Page 18 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. 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. 1. Refer to Standard OP19 Good Practice Recommendations The registered person should replace the carpet in the main hallway, which is showing signs of wear, before it becomes a trip hazard. Bluebell House DS0000019650.V329654.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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
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