Inspection on 29/06/07 for Bolters Corner

This inspection was carried out on 29th June 2007.

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

Bolters Corner 11/10/05

Bolters Corner 26/05/05

Bolters Corner 06/01/05

Bolters Corner 23/06/04

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

CARE HOMES FOR OLDER PEOPLE Bolters Corner Bolters Lane Banstead Surrey SM7 2AB Lead Inspector Vera Bulbeck Unannounced Inspection 29th June 2007 10:30 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 DS0000013302.V342137.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. DS0000013302.V342137.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bolters Corner Address Bolters Lane Banstead Surrey SM7 2AB 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) 01737 361409 01737 370856 Mrs Eleni Panayi Mr Pangratios Panayi Care Home 28 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (28) of places DS0000013302.V342137.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Up to 2 beds may be used for Respite Care Up to 15 Patients may be treated on a Day Care basis from 0800 to 2000 hours Total Number of beds not to exceed 28 To include one named Service User under 65 years with Dementia. Date of last inspection 11th October 2005 Brief Description of the Service: Bolters Corner is a large detached property situated close to Banstead local shops. The accommodation in the home is situated on three floors the ground and first floor is accessible by a passenger lift. The third floor accommodates the staff that lives in the home. The home is registered for 28 service users and 15-Day Care Placements. The Day Care facilities are situated in the conservatory at the back of the home, with a separate access as well as the garden. The service users also use these facilities for activities. The grounds of the home are nicely laid out and user friendly for the service users. The service users can access the garden freely and the grounds and gardens are spacious and well maintained. The home was found to be homely and well presented. There is an on going, upgrading of bedrooms and refurbishment programme in operation with substantial improvements to the home. Ample car parking is available at the side of the premises. The fees for the home are from £550.00 to £750.00 per week. DS0000013302.V342137.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit formed part of the key inspection process and took place over six hours commencing at 10.30 am and ending at 16.30pm. Mrs V Bulbeck, Regulation Inspector carried out the visit. A full tour of the premises was undertaken. Four care plans were sampled and the care observed for the four individuals. The inspector spoke with a number of service users to obtain feedback. Two relatives/visitors the inspector was able to speak too, and several members of staff were spoken to during the visit. A number of records were observed. The registered manager Mr P Panayi was on duty. There were twenty-eight service users living in the home on the day of the site visit and there were no vacancies, the home has a waiting list. Several bedrooms have been changed or in the process of being changed to include en-suite facilities. CCTV has been installed in the car park of the home following a number of thefts, mainly flower plant pot holders. The inspector would like to thank the service users and staff for their cooperation and hospitality during the inspection. The service users living in the home wish to be called residents, therefore service users will be referred to as residents throughout the report. What the service does well: Resident’s views are continually sought to improve the service the home provides. Regular meetings are held with some residents and relatives to ensure the home is meeting the needs of the residents. The majority of the residents are unable to hold a conversation however; several residents were able to make comments. Residents were well dressed and some stated they enjoyed their lunch on the day of the site visit. Lunch is served in the main dining area and some who need feeding have lunch in the lounge. The tables were nicely laid the food was plentiful and appeared appetising and nourishing. The inspector spoke with a number of staff on duty on the day of inspection; staff commented they feel supported by the registered manager. Staff also commented they work well together and the team is stable, with very few changes in the team. DS0000013302.V342137.R01.S.doc Version 5.2 Page 6 The home was homely and welcoming. Some residents had some items of furniture in their bedrooms, which they had brought into the home with them 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. DS0000013302.V342137.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 DS0000013302.V342137.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 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident is only admitted to the home following a needs assessment to ensure that the home can meet the resident’s identified needs. The home does not offer intermediate care. EVIDENCE: A number of residents have been admitted to the home, since the last inspection. It was noted that the proprietor or the matron had undertaken pre assessments. These documents were found to be well documented, the resident, relative or care manager is involved where possible and signs the document to ensure the home is able to meet the residents needs, prior to admission to the home. The home has provided a service users guide to all residents and relatives on admission to the home. This was not checked on this visit, management of the DS0000013302.V342137.R01.S.doc Version 5.2 Page 9 home stated that the statement of purpose and the service users guide is reviewed on a regular basis to include any changes, and an up to date copy is provided to all relatives. Some residents are also provided with a copy particuarly, if a resident is able to be involved with the care provided. The home does not admit residents requiring intermediate care, as the facilities required for the care needed are not available in the home. The home is registered for two residents requiring respite care, however, due to the popular demand of beds the home has reduced the number for the present time and in the future will review the situation again. DS0000013302.V342137.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care and healthcare support and assistance is planned and was clearly documented in care plans by the staff. Resident’s healthcare needs are maintained with a good working relationship with the healthcare professionals involved who visit the home on a regular basis, they provide, assistance support and guidance. EVIDENCE: Four residents care plans were sampled and there was evidence that resident’s health, personal and social care needs had been identified and assessed. Care notes are well documented and detailed. A copy of the care plan is kept in the manager’s office to enable staff to use as a working tool. A number of risk assessments have been updated for all residents living in the home. Medication records were found to be well documented and a list of staff signatures was recorded on the file, only trained staff is able to administer medication. There was a photograph of the resident on the MAR sheet. The DS0000013302.V342137.R01.S.doc Version 5.2 Page 11 matron is maintaining a weekly check on the administration of medication to ensure there are no errors. Storage facilities were appropriate. There are no residents who are to self medicate. Lockable facilities are available in all the bedrooms for residents to store the medication or valuables if necessary. Appropriate records are maintained of the drugs provided to the residents and the nurse in charge undertakes regular checks to ensure the medication is being administered as directed. The inspector observed that staff are respectful and knock on bedroom doors before entering. Observation by the inspector was residents and staff has a good rapport. The inspector would advise the management of the home to seek the services of an advocate for residents who do not have any family of friends who visit the home. DS0000013302.V342137.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported and encouraged to maintain contact with family and friends. Meals are well balanced and varied with individual choices and preferences as well as special dietary needs catered for. EVIDENCE: The Majority of residents have contact with family and friends and the inspector had the opportunity to speak with two relatives who were visiting the home on the day of the site visit. Those spoken to confirmed they are very happy with the home and one person stated, “She could not have chosen a better home for her relative to live in” Discussion with the families at the time of the inspection confirmed that some visit on a regular daily basis. It was also noted in the visitor’s book that there is a daily record of visitors to the home. Those residents who do not have family or friends an advocate needs to be involved. A number of residents are subject to Power of Attorney. DS0000013302.V342137.R01.S.doc Version 5.2 Page 13 There is a planned activity programme, which is undertaken in the day centre, residents are encouraged to attend. The home has its own transport, and there have been three visits to Nonesuch Manor. Five residents are able to go as well as any relative. Residents have tea and cake or ice cream when they go out. Some residents are able to go out with their relatives, to garden centre’s, out for lunch and shopping trips. The meals served in the home were nutritional in content and well balanced. The chef is involved with the menu planning, and seeks some of the resident’s views. The menu of the day is discussed with the residents on a daily basis and residents are given a choice. One resident informed the inspector that he did not eat meat and he was given an alternative. He was very clear with what he was having for lunch; he informed the inspector that it was fish and chips day. The chef was on duty at the time of visiting the kitchen and was able to demonstrate the procedures and the operation of staff working in the kitchen. Cakes are baked every day for afternoon tea. A number of residents require feeding and the inspector observed some staff feeding the resident’s; this can be a long process as some residents eat slowly. However, the lunchtime procedure went very smoothly and the majority of residents who require feeding were fed appropriately, not rushed or hurried. DS0000013302.V342137.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a simple, clear and accessible complaints procedure, which includes timescales for the process. All staff spoken to confirm they are aware and were knowledgeable regarding protecting residents from harm or abuse. EVIDENCE: There have been no recorded complaints in the home for some considerable time. The procedure for dealing with complaints was available and any complaints would be dealt with within the 28-day time scale. The registered manager was very clear on the procedure for managing any complaints and the outcome of the complaint, for example letters and the closure of the complaint. The Commission for Social Care Inspection (CSCI) has not received any complaints on the home. All residents are provided with a copy of the complaints procedure, which is available in the resident’s terms and conditions, all new residents are given a copy on arrival in the home. A copy is also provided to all relatives. The homes policies and procedures for the protection of vulnerable adults and a whistle blowing policy were in place and the majority of staff has received the protection of vulnerable adults training. However, there are some new staff that have not had the training and need to attend a training session. DS0000013302.V342137.R01.S.doc Version 5.2 Page 15 The majority of staff on duty confirmed they had undertaken this training and were aware of the procedures. The home has an up to date copy of Surrey Multi Agency procedures. The majority of residents would be unable to vote, those residents who are able to vote the management registers them for a postal vote. DS0000013302.V342137.R01.S.doc Version 5.2 Page 16 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 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements in the home are continuous in order to ensure a safe and wellmaintained environment for residents. The home was observed to be clean and hygiene. EVIDENCE: The environment is homely and welcoming the majority of bedrooms were nicely decorated and furniture was of a good standard, rooms were personalised with some items brought into the home from the resident’s own home, or purchased by the residents to suit their new surroundings, for example; new televisions. Bedrooms are decorated when a new resident moves into the home. The registered manager, who ensures all areas in the home are meeting the standards, undertakes the maintenance in the home. He also ensures all the bedrooms and communal areas are decorated whenever the bedrooms are empty and when communal areas are in need. DS0000013302.V342137.R01.S.doc Version 5.2 Page 17 The laundry facilities are situated in an outside the main house area. The domestic person and care staff undertakes the laundry duties. A new washing machine, which pumps oxygen into it, has recently been fitted. There is quite a considerable amount of rubbish outside the laundry area, which needs to be cleared. Some areas in the home need to be attended to, for example, the radiator in the bathroom is rusty and the flooring needs replacing. A toilet on the ground floor needs up grading. The registered manager explained the bathroom and toilet are to be completely re decorated within three months. The sluice room and bathrooms need a rubber glove dispenser. The front door has a cracked pane of glass, which needs replacing. The registered manager informed the inspector he already knows about these issues and is in the process of dealing with it. All bed rails are currently covered with foam liners, this need to be replaced with appropriate covers to ensure residents are protected from getting limbs stuck. Hand rails are provided in all areas of the home except the long corridor, the inspector would advise the management of the home to fit hand rails to enable residents to walk with the aid, and as a precaution of residents falling. The registered manager explained that residents do not walk around upstairs unaided. However, it is possible that residents can get out of bed and fall during the night. The registered manager stated he would fit a handrail. It was noted that a divan bed needs to be changed in one of the resident’s bedrooms; the bed is not suitable for the resident or the staff who provide personal care. The registered manager stated he has purchased a number of new beds and has one already in stock; therefore the bed will be changed immediately. A new bath has been fitted on the ground floor, which has the overhead hoist rail. The hose for washing hair for example needs replacing as it is worn and the control appliance needs replacing, which, was found to be taped up with red tape. The inspector advised management of the home to switch off the electricity from the mains to ensure the health and safety of all the residents and staff, until a new control appliance is fitted. The garden at the back of the house is of a good size; it is well maintained and nicely laid out. Access to the garden is via a ramp from a small conservatory or the day centre. DS0000013302.V342137.R01.S.doc Version 5.2 Page 18 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of the staff meets resident’s needs. The home has a comprehensive staff recruitment programme which, incorporates all areas needed to ensure, as far as reasonably possible, that residents are in safe hands at all times. However, there is a need to up date staff training. EVIDENCE: The staffing arrangements in the home include four care staff, and two qualified nurses on duty, during the morning shift and one trained nurse and four care assistants in the afternoon. The nighttime arrangements are two care assistants and a trained nurse on duty. The nurses are responsible for administering the medication as well as writing care plans and other duties as required. There are currently twenty-eight residents between the two floors and a number of residents require two or more people for providing personal care and a number of residents require feeding. There is a domestic cleaner on a daily basis Monday to Friday and two chefs working on opposite shifts. The registered manager undertakes the maintenance in the home and the proprietor keeps the garden in pristine order. DS0000013302.V342137.R01.S.doc Version 5.2 Page 19 Full recruitment procedures are being followed. All staff has been checked against the Criminal Records Bureau (CRB) and POVA checked before working in the home. Staff records were observed and found to be well documented, including contracts and terms and conditions. The majority of staff has received (POVA) protection of vulnerable adults training and further training is required on new staff and some updates are required for staff that has been employed for some time. The home has 18 of staff with NVQ Level 2 training and above, this includes fourteen staff who have completed NVQ Level 2 and above. Six members of staff are in the process of NVQ Level 2 and above. The registered manager has identified NVQ training as a priority. It was identified at the time of the visit that the registered manager and all staff need to attend various courses for example the matron and nursing staff need to keep up to date with attending to wounds and palliative care. The registered manager informed the inspector that all staff is made aware of the differences in cultures and religion. The inspector would advise the management of the home to attend equality and diversity training, and to ensure all staff receives the training. The training plan needs to be kept up to date to ensure staff training is not missed. DS0000013302.V342137.R01.S.doc Version 5.2 Page 20 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): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s, benefit from an open, positive and inclusive management style. The home has a monitoring system in place that is based on seeking the views of the residents. The health and safety of the residents is a high priority by the management and staff of the home. EVIDENCE: The registered manager is competent and qualified to manage the home, the manager has a BA/BSc honours degree in Management. Staff were complementary regarding the manager and stated they feel supported, the registered manager has an open door policy, staff also stated they are able to speak with the manager at anytime. One member of staff stated the manager is very flexible with staff and has a great understanding. DS0000013302.V342137.R01.S.doc Version 5.2 Page 21 A questionnaire (Customer Care Satisfaction) is sent to all relatives on a yearly basis. Information regarding the survey can be obtained from the registered manager. A number of records were checked and were found to be well documented and details were filed appropriately. The maintenance of the home is undertaken by the registered manager who is responsible for regular checks on the fire alarm system, and ensures the health and safety aspects of the home are meeting the required Regulations. The Environmental Health Officer visited the home on13/11/06 to undertake an inspection on the kitchen there were no requirements made and the next inspection will be 12 –18 months time. Residents finances are managed mainly by relatives, four residents have power of attorney. The management of the home finances any money for example for hairdressing and an invoice is sent to the relatives who pay for any items that are not included in the fees. At the time of completing the inspection report the inspector had not received any comment cards from residents or relatives. DS0000013302.V342137.R01.S.doc Version 5.2 Page 22 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 N/A 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 2 X X X X X X 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 X X 3 X 3 X X 3 DS0000013302.V342137.R01.S.doc Version 5.2 Page 23 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 2 Standard OP19 OP19 Regulation 23 23 Requirement Bed rails need safety covers. The broken control plug in the bathroom needs to be attended to before the bathroom can be used. Timescale for action 27/07/07 27/07/07 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 4 5 6 Refer to Standard OP19 OP19 OP19 OP30 OP30 OP38 Good Practice Recommendations Rubbish needs to be cleared from outside the laundry. Maintenance areas in the home that need attention. Handrail required on first floor corridor. Staff training needs to be kept up to date. Training plan needs to be kept up to date. Dispensers for rubber gloves required in bathrooms and sluice rooms. DS0000013302.V342137.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 © 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 DS0000013302.V342137.R01.S.doc Version 5.2 Page 25 - 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. 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