Inspection on 21/12/05 for Boarbank Hall Nursing Home

This inspection was carried out on 21st December 2005.

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

Boarbank Hall Nursing Home 11/05/07

Boarbank Hall Nursing Home 21/09/05

Boarbank Hall Nursing Home 14/01/05

Boarbank Hall Nursing Home 07/07/04

Boarbank Hall Nursing Home 13/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Boarbank Hall Nursing Home Allithwaite Grange Over Sands Cumbria LA11 7NH Lead Inspector Marian Whittam Unannounced Inspection 21st December 2005 12:00 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 Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 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. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Boarbank Hall Nursing Home Address Allithwaite Grange Over Sands Cumbria LA11 7NH 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) 015395 32288 015395 35386 The Canonesses of Saint Augustine Sister Eileen Anne Pollard Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27), Physical disability (4), Terminally ill (4) of places Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2005 Brief Description of the Service: Boarbank Hall Nursing Home is managed and run by the Augustinian Sisters and provides long term and respite care for up to 27 residents including terminal care and convalescent nursing care. Boarbank is located at the edge the village of Allithwaite, facing south and overlooking Humphrey Head and Morecambe Bay. The home is a short distance from the village of Allithwaite and its amenities, such as the public house, bus routes into Grange and the local post office/shop. Alongside the nursing home is the Sister’s own religious community, a guest house and a Chapel. Relatives and carers can stay in the community’s guesthouse and use their amenities. Accommodation in the home is on two floors and there are two passenger lifts and the home has a fully equipped physiotherapy suite on site. The home has large gardens with a terraced area, that is accessible to wheelchair users and has a children’s play area in the grounds. The home also has its own kitchen gardens and grows some of its own vegetables for use in the home. There is car parking space at the rear and side of the home. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on 21st December 2005.The inspector looked around the home, talking with residents in their own bedrooms, speaking to the nursing staff and the senior nurse on duty and also looking at care plans. Policies and procedures and records were also looked at. What the service does well: Residents spoken to liked the staff team and spoke well of them and said they felt that “staff will spend time with you and listen to you” and “have a chat”, were “so very caring” and “there are always plenty of staff around to help”. The home provides a comfortable, well furnished, well maintained and homely atmosphere for residents and visitors. Residents commented on how peaceful and calm the home is and that they were never rushed or pushed into doing anything. More than one resident commented on the “happy atmosphere” and the cheerfulness of the staff. The home took care to maintain a high nurse/carer to resident ratio so that standards of care remained high and staff can spend time with residents. One resident said that they felt that the staff were now their friends as well as carers and “nothing was too much trouble for them”. Residents and the local community are very involved in the life of the home with residents deciding on the activities and trips out. There are many activities organised over the Christmas period that included the local community and families. The home takes care to make sure that resident’s particular religious needs are catered for including multi denominational services. Residents emphasised the high standard of food on offer and attention paid to meeting individual choice and preferences. There were positive comments about the quality of the food and the variety available for residents. The home promoted a supportive culture evident in the support given to staff in their work or when dealing with terminal care and those with family commitments. Staff working in the home said they felt they had the time and resources to give a high standard of care to the residents and so had a high level of job satisfaction. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 Page 6 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. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 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 Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 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 4 A detailed assessment and care planning system is in place that includes information from other agencies. Staff have the information and skills they need to meet resident’s needs when they come in. EVIDENCE: All residents have an individual care plan and their needs have been assessed in detail before and following admission. The home manager or senior staff do an individual assessment of needs. Information is gathered from the prospective resident, family and other professionals and agencies involved in their care. Where appropriate other care agencies and professionals including the local palliative care team are involved in advising and making assessments of the individual needs to be met. A system is in place so respite residents are assessed with regard to the current workload of staff and the level of existing resident dependency. This is good practice as it prevents the existing good nurse/ carer to resident ratio being affected. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 Page 9 The home, although run by a community of Catholic Sisters, has residents from different faiths and care plans show that different social, cultural and religious needs are assessed and planned for. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 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 Staff have the information they need to meet resident’s health, personal and social care needs and promote and protect their personal dignity. The health needs of residents are being met with evidence of good multi disciplinary working and resident involvement in their care. Medication systems and handling are satisfactory however risk assessment for self medication needs improvement. EVIDENCE: All residents have an individual plan of care that sets out their assessed health, personal and social care needs and their personal care preferences. Reviews and evaluations of care are done frequently and changes identified at evaluation are incorporated into care plans and needs assessments. The plans were working documents with up to date information and are clear and resident focused. One resident said, “ Its wonderful here, the staff are so caring, they don’t just do as you ask they anticipate what you need”. Another said, “it is such a peaceful place and staff are so patient with me”. There was evidence of prompt referral to health care and services and working well with other agencies and the actions taken following their involvement. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 Page 11 Residents spoken with said their privacy was respected and felt their dignity upheld and their preferences followed. One resident said that “ I have my bell and there is always someone about when I want help”. They added that “they give you privacy, no one ever pushes themselves forward”. Observation during the inspection suggested that resident’s dignity was being maintained when receiving care and being assisted and independence and choice were being promoted. Staff were observed handling potentially difficult situations calmly and spending time with residents talking with them and reassuring them. Medication practices and handling are good and residents who wished to be supported to self medicate. However residents who have chosen to self medicate must do so within a risk management framework and have a more detailed assessment to be able to safely self- administer. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 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 and 15 There are a variety of organised activities in the home that also involve the local community and frequent outings that take into account resident’s preferences and capabilities. Dietary needs and individual preferences for residents are well catered for with a balanced and varied selection of nutritious food on offer. EVIDENCE: The home provides a range of group and social activities, trips in the home’s minibus and entertainments, recorded in the social diary. Resident’s hobbies and interests are recorded and individual abilities and capabilities are given consideration in planning and carrying out the activities. One resident spoke about the Christmas activities and the quizzes they have and the children and groups from the village that come into the home. Residents told the inspectors that they could chose to take part or not as they preferred. The home makes good provision for the religious and cultural preferences of residents, including multi denominational services that involve the local community. This was evident for one resident with Quaker beliefs where prayer meetings were accommodated and for Anglican services for another resident. Residents said that they could come and go as they please, take their meals where they preferred and see who they wanted. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 Page 13 All of the residents spoken with thought the quality and variety of the food provided was “excellent” and one said that “ you could ask for the most exotic dish and they would get it for you”. Resident’s comments emphasised that they have a choice of food at all meals. All agreed there was a choice of food each day and that there was plenty of it. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 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 and18 There are up to date adult protection procedures in place in line with multi agency good practice to safeguard residents and ensure staff know what to do to protect residents. EVIDENCE: The home had a clear complaint procedure made available throughout the home. There is a complaints logging system to record any complaints received, the investigation and the actions taken. The home has not received any complaints. Residents spoken with felt confident that any complaints or issues they raised would be dealt with quickly. The residents spoken with said that they had never had reason to complain. One resident said that staff “are so attentive” and felt they would “sort any problems out” and “would talk to them” about anything that bothered them. There were up to date procedures in place to protect vulnerable adults and for whistle blowing that reflect current multi agency guidance. Training is scheduled to take place in the New Year to update staff on adult protection. The home had procedures in place for dealing with verbal and physical aggression, restraint and appropriate codes of nursing practice. The home’s administrator keeps the records of financial transactions securely. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 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, 24, 25 and 26 The decoration and furnishing in the home is of a high standard with evidence of regular maintenance and ongoing decoration and improvement. The home provides a clean, comfortable and homely environment for residents to live in and has the equipment they need to promote mobility and independence. EVIDENCE: The home is well maintained and has a good standard of decoration and furnishing throughout that provides a clean, tidy and homely environment for residents. The lounge and dining areas are comfortable and well furnished and can be used for a variety of occasions. Outside the large gardens are attractive, well kept and have seating for residents. There are extensive views over Morecambe Bay and the surrounding countryside. Several residents commented on how much they enjoyed and appreciated the views. One resident said, “The surroundings are just perfect and its so peaceful here”. Residents said that they used the garden a lot in the summer months, and enjoyed them. There is a play area for visiting children that residents can see from their bedrooms. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 Page 16 Resident’s bedrooms seen by the inspector had a high standard of decoration, and appropriate furnishings and aids. Many of the bedrooms have en suite toilets. Many residents had brought some of their own possessions in and this made their bedrooms more personal and homely for them. There is a range of equipment, nursing beds, two passenger lifts and adaptations in the home to help residents make the most of their independence and to get about the home. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 Page 17 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 The numbers and skill mix of nursing and care staff on the rotas, and on duty during the visit, were at a high level to meet residents personal, health and social needs. Staff are well supported resulting in an enthusiastic, well trained team that works positively with residents to improve their quality of life. EVIDENCE: The home had a stable staff group providing continuity for residents and good levels of nursing and care staff on duty to provide adequate nursing and personal care and individual support during the day and night. Staff spoken with enjoyed their work and morale was good. There are a high percentage of carers with NVQ level 2 qualifications and the home has an annual training plan. Training opportunities are available for nursing staff to meet their professional requirements for continuous professional development. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 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, 32, 33 and 38 The manager and senior staff provide clear leadership and support in the home and this is communicated to residents and staff. Residents are consulted and involved in the life of the home with effective quality monitoring systems and reviews in place to promote resident’s interests. Procedures, systems and practices are in place that promote resident’s financial interests, safety and well being. EVIDENCE: Residents spoken to said their views and opinions were asked for and acted upon to affect the way the service is run and felt they were “listened to”. They confirmed they saw the manager most days and felt happy to raise issues with her. Residents confirmed that they were involved in the life of the home, that staff supported them in maintaining their personal interests and recreational Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 Page 19 activities. Residents spoken with commented more than once that staff and management were always available and listened to what they had to say. The registered manager promotes an open and supportive working environment which staff and residents confirm. Staff in the home have regular staff meetings and have good access to training and said that it was a good working environment. Staff said that the manager and senior staff are approachable, helpful and support staff with family responsibilities in their working practices. Records looked at that are required by regulation are up to date and in good order. Records of maintenance indicated that the home had systems, training and practices to promote resident health and safety. There was evidence that appropriate testing and cleaning was being carried out and that the home did Legionella and water testing. Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 3 3 STAFFING Standard No Score 27 4 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X X X X 3 Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 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 OP9 Regulation 13 (4) Requirement Residents who wish to take responsibility for their own medication must do so within a risk management framework. Timescale for action 28/02/05 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 Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Boarbank Hall Nursing Home DS0000006136.V271054.R01.S.doc Version 5.0 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. 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