Inspection on 29/06/06 for Bluebell Lodge Care Home

This inspection was carried out on 29th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Bluebell Lodge Care Home 15/05/08

Bluebell Lodge Care Home 26/11/07

Bluebell Lodge Care Home 07/02/07

Bluebell Lodge Care Home 12/10/05

Bluebell Lodge Care Home 25/05/05

Bluebell Lodge Care Home 29/11/04

Bluebell Lodge Care Home 11/05/04

Bluebell Lodge Care Home 20/11/03

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

CARE HOMES FOR OLDER PEOPLE Bluebell Lodge Care Home Forest Lane Chippenham Wiltshire SN15 3QU Lead Inspector Alyson Fairweather Key Unannounced Inspection 29th June 2006 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 Bluebell Lodge Care Home DS0000040675.V300581.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 Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bluebell Lodge Care Home Address Forest Lane Chippenham Wiltshire SN15 3QU 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) 01249 443501 01249 447506 Chippenham Limited Vacant Care Home 19 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (1), Old age, of places not falling within any other category (19) Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users who may be accommodated in the home at any one time is 19. Not more than 1 service user aged 65 years and over with a mental disorder may be accommodated at any one time. Not more than 1 service user in the age range 50 - 64 years may be accommodated at any one time. This person may only occupy the accommodation referred to in the variation application dated 27 March 2004 for respite or intermediate care and for a period not exceeding 4 weeks (except by prior consultation with the Commission). This bedroom is numbered 19 and located on the first floor immediately next to the medication storage room. The room may not be used for any mental disorder placement. 16/05/06 Date of last inspection Brief Description of the Service: Bluebell Lodge is registered to care for nineteen older people. Within the nineteen places, one room is fully designated to respite care. The home is located in a residential area of Chippenham, and offers easy access to local amenities. It is situated in a quiet cul-de-sac, with ample parking to the front of the home. To the front of the house is a well-tended lawn with trees, and there is a large, secluded garden to the side and rear of the house. There are 16 single bedrooms and one twin room. Residents can choose to bring some of their own possessions with them when they move into Bluebell Lodge, and many have televisions, radios and small pieces of furniture. All contain en-suite toilet or bathing facilities and are located on both the ground and first floors. A passenger lift is available to give level access to all areas. The communal areas of the home consist of two lounges and a separate dining room. All areas are comfortable, homely and furnished to a very high standard. The home does not provide intermediate or nursing care. Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day in June, when fourteen service users were staying. Ten service users and four members of staff were spoken to, and the manager and both providers were present throughout the day. Various documents and files were examined, including care plans, health & safety procedures, risk assessments, staff training files. The pharmacy inspector examined the medication storage, policies and procedures, and her findings form part of this report. The current fees charged by Bluebell Lodge are £450 per week, although these are subject to review. The registered manager of Bluebell Lodge left her post recently, and has been replaced by Mrs Christine Jenkins, who has been a senior member of staff for some time. She has a good knowledge of working with older people and is well known by the current service users. She is supported by experienced senior staff. The providers of the service are both experienced in the care of elderly people and own other homes throughout the country. A complaint about staffing levels during the night had been received by CSCI in May, and this had led to an unannounced inspection. At that time there were seventeen residents staying, some of whom had fairly complex needs. It was agreed with the provider that there should be two waking night staff, although this is subject to review when fewer, less dependent residents are staying. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: A great deal of time and effort has gone into improving the premises. Furnishings are of a high quality and communal rooms are large and airy. Residents’ bedrooms were homely, with en-suite facilities and each contained individual personal items. The gardens were well maintained, with more work planned for the rear of the house. Staff are to be congratulated in their determination to ensure that the home is kept clean and tidy, in spite of their other duties. The recent employment of a cleaner will be a further boost to the home. Residents said they enjoyed living in Bluebell Lodge, and spoke highly of the staff and the providers, saying that they were very well looked after. One resident said that the provider, Mr Mackey, was very good to her, and another said that staff were “very kind” and helped her a lot. Staff were seen to be Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 6 very patient with one confused resident. Links between residents and their families, are supported and encouraged by staff, and they try to maintain people’s independence as much as possible. Residents said that the food is very good and one person said that it has improved a lot since the recent staff changes. Residents described variety to the meals and reported that they can have their meals on a tray in their room if they want to. Several residents prefer to have breakfast in their bedrooms, and this is accommodated by staff. What has improved since the last inspection? What they could do better: An assessment of needs is done before a resident comes to live in a home, in order to make sure that the home can offer them the service they need. There were no needs assessments on any of the service user files examined. The new manager, Mrs Jenkins, stated that she knew that there had been a number of assessments done previously, as she had done some herself. She has therefore been asked to make sure that any new resident has an assessment done, and to continue to look for the others. Each resident has their own care plan, and although some of these held good information about residents, some of them were not up to date. Some did not have risk assessments, and some did not have evidence that the home had asked for specialist advice about moving and handling using hoists and belts. The manager has been asked to make sure that these issues are addressed. Previous inspections noted that the recruitment practices within the home were poor. During this inspection it was found that this was still the case. One staff member had no enhanced CRB check, and no POVA check requested. Two staff members had given different names on their CRB check and one had received a very poor reference. These breaches of good recruitment and employment practice mean that residents are potentially at risk of abuse by staff. These serious issues were Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 7 discussed with the providers and the new manager has been told that each member of staff must have two satisfactory references, a CRB and a POVA check in place. 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 Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 8 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 Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 9 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 It was impossible to verify if service users had their needs assessed before moving into the home. Quality in this outcome area is poor. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: There were no needs assessments on any of the service user files examined. Both the new manager and the provider had looked for them, but they were no where to be found. The manager stated that she knew that there had been a number of assessments done previously, as she had done some herself. The manager has therefore been asked to ensure that assessments are completed for all new service users who are referred to the home. This should be done using a formal assessment tool which gathers information such as personal care and physical well-being; diet and weight, including dietary preferences; sight, hearing and communication; oral health; foot care; mobility and dexterity; history of falls; continence; medication usage; mental state and cognition; social interests, hobbies, religious and cultural needs; personal safety and risk; carer and family involvement and other social contacts and Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 10 relationships. The manager should continue to try to find the missing assessment information. Bluebell Lodge does not offer Intermediary Care services, and there were no service users receiving respite care. Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 11 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 Residents do not have all their health, personal and social care needs set out in care plans. Their health needs are not fully met. Resident are not fully protected by the home’s medication procedures, although these have improved a great deal. Residents feel they are treated with dignity and respect. Quality in this outcome area is poor. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: Each resident has their own care plan, and these include details of people’s needs and how they can be met. On examination of these care plans it was found that there were varying degrees of detail on file. The new manager has plans to introduce a different format, so advice was given about the level of detail which would be required to be recorded. Whilst talking to staff, it was clear that they were aware of individual’s details, and some daily records reflected this. However, one file showed that a resident with continence issues had no care plan in place to reflect this, and that the care plan had not been reviewed for some time. The manager has been asked to ensure that this is done, and that all residents care plans are reviewed on a monthly basis. This Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 12 person must also have a risk assessment on file relating to the use of a walking frame and the danger of falls. All residents are registered with a GP and there is input from other health professionals, such as dentists and opticians as required, with appointments being recorded in the care plan. Weight checks are done for residents where there is any concern The home has good links with the local mental health teams, and residents’ reviews can be held in the home when necessary. There has been poor recording of pressure care in the past, and advice has been given relating to this, as well as the importance of nutrition in pressure care. Staff reported that one resident needed to use a sling when being moved. There was no OT assessment in place which would guide staff in the correct use of this equipment, and the manager has been asked to make sure that this is done. Significant improvements had been made since the last inspection, particularly in the recording of medication. Medication Administration Records were completed and reasons for omissions given. Drug and dose changes were cross-referenced with GP instructions. All medication received into the home was recorded; however the date was missing from the record. Medication is now held in a locked trolley which can be used for administration rounds. The room where the medicines are stored can get very warm in the summer. The temperature should be monitored and action taken if it exceeds 25c. Residents who want to self-medicate are supported to do so and have regularly reviewed risk assessments. Medication for one resident was omitted for 10 doses due to the product being out of stock. It was in the cupboard and had been dispensed before this. An investigation must be done to find out what happened and the Commission informed of the outcome. All residents spoken with confirmed satisfaction with staff members and expressed that his or her privacy and dignity were respected at all times. Staff were observed knocking on doors and residents were spoken to with their preferred form of address. Residents confirmed that all personal care was given appropriately and staff respected residents’ wishes of wanting to spend time in their room. Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 13 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 Activities within the home appear limited, yet residents appear satisfied with this and enjoy their solitary interests. Residents are encouraged to follow their preferred routines and make their own choices. People can have as much or as little contact with family and friends as they wish, and are supported to do so by staff. Residents receive a wholesome, appealing, balanced diet. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service EVIDENCE: All residents spoken to reported that they are able to follow their preferred routines and choose how they spend their day. Residents are therefore able to get up and go to bed at preferred times and spend time in their room as required. Some residents reported that they are happy to spend all day in their room, and have solitary interests such as reading, crosswords and television. One resident with a visual impairment was watching the tennis from Wimbledon, and was pleased that staff had moved her chair near the television so she could see. Another was resting in her room prior to going out with a relative later in the day. Both spoke highly of the staff and the providers, saying that they were very well looked after. There is no formal activities Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 14 worker, although some residents reported that they wouldn’t join in organised activities because they preferred their own company. Residents can entertain family or friends either in the privacy of their own bedrooms or in the communal areas available. Staff encourage and support links between residents and their families, although the frequency of contact varies depending on individual circumstances. Some family members keep in touch with regular phone calls. One resident said she goes out for meals and to the pub regularly with her family and another uses public transport to vist her daughter. Another resident talked about how often her son came to visit. One resident drives a car, and is able to come and go as he pleases. All residents confirmed that the food is very good and one person said that it has improved since the recent staff changes. Staff take responsibility for cooking, and one staff member has a cooking qualification, with another one keen to undertake a catering course. Residents described variety to the meals and reported that they can have their meals on a tray in their room if they want to. Several residents prefer to have breakfast in their bedrooms, and this is accommodated by staff. The main meal of the day is usually in the evening, although twice a week a roast lunch is provided. Lunch on the day of the inspection was was roast chicken with vegetables and roast potatoes, as well as a sweet. Alternatives are offered for those people who may be vegetarian or those who do not feel like eating the planned meal. The home is in the process of developing a four week rolling menu, and it is planned that this will change according to winter or summer weather. Any special dietary needs are recorded in the care plan, and staff record in the daily notes if residents are not eating, so that thay can be sure to pick up if anyone is ill or has gone “off their food”. Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 15 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 Residents were sure that their complaints would be listened to, although there was no documentary evidence to support this. Lack of awareness and training in local protection procedures, and failure to meet previous requirements relating to this, means that residents are not protected from abuse. Quality in this outcome area is poor. This judgement has been made from evidence gathered both before and during the visit to the service EVIDENCE: The home has a complaints procedure and a form which would be used by any complainant, a copy of which is in the hall. The complaints procedure was said to be in every residents’ file, although it was missing from one file examined. Residents spoken to were sure that if they had a complaint they could talk to staff and that something would be done about it. However, there had been no complaints log set up, making it difficult to establish if there had been any complaints made to the home. The manager has therefore been asked to ensure that a file is set up in which both minor and major complaints can be recorded. The last complaint to the Commission for Social Care (CSCI) relating to staffing issues has been dealt with satisfactorily, although several other areas of concern were noted during that inspection. These are also in the process of being dealt with the providers and the new manager. The home did not have a copy of the Wiltshire & Swindon Vulnerable Adults procedures, although a copy of the “No Secrets” booklet was in the office. A Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 16 “Whistle Blowing” procedure is also available for all staff. Some risk assessments are in place, although not for all residents’ needs. The bell-call system now has the room number or name of each resident recorded on it, so that staff can tell who is calling for them, although this was not always the case. At a previous inspection there were several residents not identified on the system, and the bell was seen to be switched off by staff and not responded to. The providers are investigating the purchase of a new system which can only be turned off at the source of the call. The manager and providers reported that staff have not had training in Wiltshire County Council’s Protection of Vulnerable Adults. This training helps raise awareness of the types and risks of abuse towards older people, and is given at various locations throughout Wiltshire. The need for this had been identified at two previous inspections, and the manager had been asked to ensure that this training took place. Information was given to the new manager about how it might be possible to access such training, and the requirement has again been made, and must be actioned. Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 17 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 The care which staff take to maintain the home means that residents live in a homely, comfortable, safe environment, which is clean and hygienic. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service EVIDENCE: Bluebell Lodge is a very comfortably furnished home with large airy rooms. Residents’ bedrooms were homely and each contained individual personal items. A great deal of work has been done by the provider in fitting radiator covers in the home, with only a few left to do. Risk assessments are in place for those which are waiting to be fitted. There is a large, secluded garden to the side and rear of the house, with ample parking to the front of the home. There is a large fishpond in the garden, surrounded by a low wall. Whilst this adds greatly to the attractiveness of the grounds, it would potentially be possible for someone to accidentally fall in, so the manager has been asked to draw up a risk assessment showing how she will minimise this risk. Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 18 Staff are to be congratulated in their determination to ensure that the home is kept clean and tidy, although a cleaner has now been recruited. The home was clean and hygienic, with policies and procedures in place for the maintenance of the building. Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 19 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 Staffing levels are being maintained as agreed with CSCI. Staff training takes place, although induction training needs to be evidenced. Several staff have achieved their NVQ at Levels 2 and 3. Serious shortfalls within the recruitment procedures, despite being identified at previous inspections, place residents’ at risk of poor care practice and abuse. Quality in this outcome area is poor. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: Bluebell Lodge continues to have three members of care staff on duty during the morning period and this reduces to two for the afternoon and evening shift. There are two waking night staff when the needs or numbers of the resident group dictate, but one waking and one sleeping night staff members at other times. This is in agreement with the CSCI, although the arrangement is subject to change at any time. Care staff are responsible for cleaning tasks, although a cleaner has recently been recruited. Care staff also take responsibility for cooking, and one staff member has a cooking qualification, with another one keen to undertake a catering course. All feedback regarding staff was positive with many comments such as ‘they’re really helpful and kind’ and ‘they work hard.’ The employment of a full time cook would, however, free up care staff to spend time with the Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 20 residents, and it is recommended that consideration is given to employing someone to solely do the cooking. Previous inspections noted that the recruitment procedure within the home was poor and needed greater attention to ensure protection. During this inspection, two staff files examined showed that this was still the case. One staff member had a CRB check on file. However, this had been done in a different name than the one on the application form. There had been no enhanced CRB check, and no POVA check requested. Another staff file showed that the person had CRB and POVA checks, but had not given no middle name, as mentioned as in application form. The same person had obtained two references, one of which was extremely negative about the applicant’s capabilities. Neither the provider nor the new manager were aware of this, or what action the previous manager had taken. These serious issues were discussed with the providers and the new manager has been told that each member of staff must have two satisfactory references, a CRB and a POVA check in place. Three staff have done NVQ Level 3 and seven have done NVQ Level 2. One staff member has certificates in risk assessment, dementia care, food hygiene and health and safety. Others have done food hygiene, health and safety and fire training. All staff are also currently undertaking a detailed training course in Medication Administration, with tutors and workbooks from Swindon College. One staff file had no record of any induction training, and the manager has been asked to ensure that all new staff receive structured induction training. The provider has introduced a checklist which will highlight when pieces of training are completed as well as what work still needs to be done. Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 21 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, 35 and 38 Service users live in a home which is run and managed by a person who is yet to be registered with the CSCI. Service users’ financial interests are safeguarded, and the policies and procedures in the home try to ensure that their health, safety and welfare are promoted and protected. Quality in this outcome area is good. This judgement has been made from evidence gathered both before and during the visit to the service. EVIDENCE: The registered manager of Bluebell Lodge left her post recently, and has been replaced by Mrs Christine Jenkins, who has been a senior member of staff for some time. She has a good knowledge of working with older people and is well known by the current service users. She will be seeking registration with CSCI in due course. She is supported by experienced senior staff. The providers of Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 22 the service are both experienced in the care of elderly people and own other homes throughout the country. Few residents manage their own financial affairs. Many are subject to a Power of Attorney, and either family members or legal advocates support their finances. Full records are kept of residents’ expenses, and receipts are tallied alongside expenditure. Fees can be paid directly, by cheque or by standing order. Residents are responsible for minor expenditure such as hairdressing, chiropody, toiletries and newspapers. The home has detailed health and safety policies and procedures in place. Staff have training in basic food hygiene, and food temperatures are recorded on a regular basis. One staff member takes responsibility for fire safety procedures, and provides training for the rest of the staff. The fire bell and emergency lighting are tested regularly. Fire extinguishers are serviced annually by an outside contractor, as are portable electrical appliances. Fire drills are held on a quarterly basis, with a record kept of all resident and staff who attended. Window restrictors have been fitted where necessary, and risk assessments are in place for those which do not have them. It is recommended that the manager frequently reviews these risk assessments, as residents level of need change or new residents are admitted. The quality assurance methods used in the home will be assessed at a later inspection. Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 23 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 1 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 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 2 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 (1) Requirement The home must ensure that assessments are completed for all new service users who are referred to the home. This should be done using a formal assessment tool. The care plan for one particular resident must be updated to reflect the current personal care issues. A risk assessment for the same person must be put in place in relation to use of a walking frame and the danger of falls. All care plans must be reviewed on a monthly basis. An OT assessment must be sought in relation to the use of manual handling equipment, for example hoists and belts. Risk assessments should then be conducted for each individual using the equipment. The date of receipt of medication must be included in the record. Medication for new and respite residents must be verified before administration. DS0000040675.V300581.R01.S.doc Timescale for action 29/06/06 2 OP7 15 (1) 13/07/06 3 OP7 13 (4) (c) 13/07/06 4 5 OP7 OP8 15 (2) (b) 12 (1) (a) 13 (1) (b) 29/09/06 29/08/06 6 7 OP9 OP9 13 (2) 13 (2) 29/06/06 29/06/06 Bluebell Lodge Care Home Version 5.2 Page 25 8 OP9 37 9 OP16 22 10 OP18 18 (1) (c) (i) The CSCI must be notified of any event which adversely affects the well-being of service users. This includes the nonadministration of any prescribed medicines. A complaints log must be set up in which to record any complaints made to the home. Each resident must be given a copy of the complaints procedure. All staff must have training in Wiltshire County Council’s Vulnerable Adults procedures. 29/06/06 29/08/06 29/09/06 11 OP19 13 (4) (a) 12 OP29 19 Comment: This requirement has been identified at previous inspections. A risk assessment must be 29/07/06 drawn up regarding the pond in the garden, indicating how this is to be made safe for residents and staff. Each member of staff must have 29/07/06 two satisfactory references, a CRB and a POVA check in place. Comment: This requirement has been identified at previous inspections. All new staff must receive structured induction training in line with the Skills for Care specifications. 13 OP30 18 (1) (c) (i) 29/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations The temperature of the drug storage room should be DS0000040675.V300581.R01.S.doc Version 5.2 Page 26 Bluebell Lodge Care Home 2 3 4 OP9 OP27 OP38 monitored in warm weather and measures taken to reduce the temperature if necessary. Written additions to the medication administration record should be checked and signed by a second member of staff. Consideration should be given to employing someone to solely do the cooking in order that care staff might spend more time with residents. The risk assessments relating to the lack of window restrictor should be reviewed frequently, as residents’ level of need change or new residents are admitted. Bluebell Lodge Care Home DS0000040675.V300581.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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. 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