CARE HOMES FOR OLDER PEOPLE
Bodley Community Care Support Centre Wayside Crescent Whipton Exeter EX1 3LF Lead Inspector
Sue Dewis Announced 19 April 2005 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 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. Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Bodley Community Care Support Centre Address Wayside Crescent, Whipton, Exeter, Devon EX1 3LF 01392 462473 01392 461973 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Devon County Council Mrs Deborah Mary Bewes Care Home 20 Category(ies) of PD Physical Disability (20), registration, with number PD(E) Physical Disability - over 65 (20), of places SI Sensory Impairment (20), SI(E) Sensory Impairment over 65 (20) Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 25 October 2004 Brief Description of the Service: Bodley Community Care Support Centre consists of a day centre (which by law does not need to be inspected by CSCI) and the Intermediate Care unit. It is owned by Devon County Council, Social Services Department and managed by Debbie Bewes. The Intermediate Care unit is for older people who have been discharged from hospital and no longer need medical care, but need some extra time to recover and make decisions about their future. All through their stay in the unit, residents are assessed. This includes visiting their home with a member of staff and an occupational therapist to enable the staff to see what may be needed to help the person to live at home. The home is purpose built and all on one level. There are three separate units which are used as ‘stepping stones’ as residents become more able. Other health professionals are based at the unit, as are the domiciliary care services for east, south and west Exeter. Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The home only provides Intermediate Care and therefore several of the NMS (National Minimum Standards) are not appropriate to the service. For this reason the document Guidance to contractors for intermediate care services (DOH) was used to supplement the applicable NMS. The inspection took place over 8 hours on one day in April 2005, with the manager, Debbie Bewes present. Two staff and three residents were spoken with individually and four resident comment cards were received. Lunch was taken with service users. What the service does well: What has improved since the last inspection?
The home now meets the requirement to ensure that the correct medication is given to service users. Notices are now displayed to remind staff of the correct temperature at which foul laundry should be washed. Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 6 The manager has made herself aware of the fact that the electrical wiring is due for testing in June 2005. 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. Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 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 standard(s) 3, 4 and 6 Residents spend a maximum of four weeks at the home and rarely visit the home prior to admission due to the need for them to be discharged quickly. The length of the admission process varies from a couple of hours to 24 hours and involves a range of health care professionals at the hospital and in the home. The admission procedure ensures that there is a proper assessment prior to people moving into the home. Residents do not always have access to the Statement of Purpose or Service User’ Guide prior to their admission, therefore they may not have sufficient information to decide if the home will meet their needs. EVIDENCE: Residents are assessed by consultants, staff nurses and care managers while in the hospital. The need for a speedy discharge from hospital led to one resident not having enough information about the routines of the home.
Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 9 Residents who are admitted on a Friday afternoon have to wait until Monday morning for an assessment at the home. Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 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 standard(s) 7 and 10 Care planning and risk assessments provide staff with the information they require to satisfactorily meet service users’ needs safely. Personal support is offered in such a way as to promote and protect service users’ privacy, dignity and promote their independence. EVIDENCE: Residents’ plans are drawn up by the occupational therapist based at the home and clearly show how the residents identified goals will be achieved. Care staff then ensure that the resident’s day is arranged around the aims of their plan. Residents are allocated a key-worker before their arrival, who admits them and cares for them during their stay. Key-workers also attend reviews and accompany the resident on their home visit. Staff are expected to respect the privacy and dignity of residents starting on admission by asking them what they would like staff to call them, and to knock on doors and offer help discreetly. Residents said that they were always treated with respect, and staff were seen to knock on doors.
Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 and 15 Residents are provided with well-balanced and nutritious meals. Social activities are well managed. They provide daily variation and interest for residents and create opportunities for increasing independence. EVIDENCE: Residents are asked about their expectations and preferences with regard to food, and activities on admission and through quality assurance surveys. There is a well-equipped craft room within the home that service users have access to. A list is kept of all activities that have taken place through the day and who has attended them. Typical activities include exercise classes, trips out and board games. One resident felt that the home was a bit quiet, while another said that they had great fun mixing with other residents. Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 12 In order to increase local community involvement within the home, eight volunteers are being vetted. They will run a trolley shop and help with the garden. As part of the goals of care planning, residents are helped to increase their confidence to return to the community, and to come and go as they please from the shops, pubs and church. Residents are asked to choose meals for the week from a menu that provides a choice for each meal. Residents said that the food was always good and that there was plenty of it. Residents can make drinks and snacks for themselves at any time and notices are placed around the home encouraging them to do this. Lunch was taken with service users and the meal was well presented and balanced. Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 13 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 standard(s) 16 and 18 Complaints are handled objectively and residents are confident that their concerns will be listened to. Staffs’ excellent knowledge and understanding of Adult Protection issues provides a safe environment to protect residents from abuse. EVIDENCE: The home has a detailed, clear and easily understood complaints procedure. There is also a detailed complaints log, that showed how the complaints had been investigated and what the outcomes were. Residents said that they could raise any matter at any time and felt sure it would be looked into. No complaints have been received by CSCI since the last inspection. Staff have received Adult Protection training. A procedure for responding to abuse is available and staff were aware of this, and responded appropriately when questioned about it. Staff were also aware of the home’s ‘Whistleblowing’ policy and felt confident they would be listened to if they raised concerns about bad practice. Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 The home provides a comfortable, safe and enabling environment for those living in and visiting the home. EVIDENCE: The home is arranged over three separate units that residents move through as they become more able and reach the end of their stay. Each unit has its own kitchen/diner and lounge and residents are encouraged to make drinks and snacks throughout the day. Residents said that they appreciated being able to make drinks and snacks whenever they wanted to, knowing that staff were there to assist if they needed them. All rooms have ensuite facilities and are pleasantly decorated, with aids and adaptations as required, including grab rails, T.V., tea and coffee making facilities and radio/cassette players. Residents are encouraged to bring some personal items with them, though, as their stay is limited, it is not practical for residents to bring in too many.
Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 15 All areas of the home were clean and well maintained. Furniture and fittings throughout the home are of a good quality and of a domestic type. Two bathrooms have assisted baths and there are adequate communal toilets throughout the home. The laundry area is being refurbished to provide a dirty/clean flow through, helping to minimise the risk of infection. Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Staff are well trained and motivated resulting in an enthusiastic workforce that work positively with residents to increase their independence. Arrangements for staff recruitment are good, ensuring that residents are safeguarded. EVIDENCE: There are five care staff on duty in the morning, four in the afternoon and three each evening, as well as an assistant manager day and night. There are also ancillary staff, including domestics and cooks throughout the day. A multidisciplinary team, including an occupational therapist, a physiotherapist and a registered nurse are also based at the home Monday through to Friday. Residents said that staff were very kind and helpful and arrived quickly if help was needed. Three staff files contained all the necessary recruitment checks to ensure the protection of residents. One contained evidence of a detailed induction. Staff training records show that they have received training in Fall Prevention, Moving and Handling First Aid and First Aid. Staff are also undertaking NVQ training, ensuring that staff are competent to do their job. Staff confirmed that they receive regular and appropriate training that helps them to meet the needs of the residents.
Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 35 and 38 The manager provides clear leadership, guidance and direction to staff ensuring residents receive consistent high quality care. This results in practices that promote and safeguard the health, safety and welfare of the residents. EVIDENCE: The manager has many years experience of working with older people in a residential care setting. She has received regular and appropriate training throughout this time. Staff confirmed that they receive regular documented supervision and are aware of the policies and procedures for the home. Staff and residents commented that there was a warm and friendly atmosphere within the home.
Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 18 Records showed that fire drills and instruction had regularly taken place. However, staff do not sign to say they have received and understood the fire training. It is rare that the home manages residents’ money; on the occasions when it does, records show that it is handled appropriately. Radiator covers are fitted throughout the home and thermostatic valves are fitted to taps, helping to minimise the risks of burns and scalds. Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 2 x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x 3 x x 2 Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 20 NO 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 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. 2. 3. Refer to Standard 4 4 38 Good Practice Recommendations You are recommended to ensure all residents receive a copy of the service users’ guide and statement of purpose prior to entering the home You are recommended to explore ways to ensure residents do not have to wait over the weekend until they receive an assessment You are recommended to ensure that staff sign to say they have received and understood the fire training Bodley Community Care Support Centre D54 D06 S33037 BodleyHouse V212890 190405 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Suite 1, Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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