Inspection on 23/05/05 for Bosworth

This inspection was carried out on 23rd May 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bosworth 26/08/09

Bosworth 14/05/09

Bosworth 24/11/08

Bosworth 02/10/07

Bosworth 12/02/07

Bosworth 01/11/05

Bosworth 07/03/05

Bosworth 18/05/04

Bosworth 24/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Bosworth 6 Southdown Avenue Preston Weymouth DT3 6HR Lead Inspector Pat Downes Unannounced 23 May 2005 10:30 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. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Bosworth Address 6 Southdown Avenue, Preston, Weymouth, Dorset, DT3 6HR 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) 01305 833100 Mrs Christine Wells Mr Derek Edwin Luckhurst Mrs Meryl Susan Hodder Mrs Vanessa Danielle Laming CRH 22 Category(ies) of OP - 22 registration, with number of places Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: One named service user (as known to the CSCI) within the category of LD(E) may be accommodated to receive care. Date of last inspection 07 March 2005 Brief Description of the Service: Bosworth Residential Care Home is located in a quiet residential area of Preston, about 2 miles from the centre of Weymouth. The home looks out over a wildlife reserve and has fine views of the sea and Portland. The home is registered to accommodate a maximum of 22 older persons over the age of 65 years, and also currently accommodates one person who has a learning disability, by arrangement with CSCI. Bosworth offers 18 single and two double sized bedrooms, spread over two floors; as the house is set on hill, a number of 1st floor bedrooms have direct access to the garden. the home has a passenger lift which gives level access to the main area of the 1st floor, six bedrooms on this floor have access via 3 steps on the landing. On the ground floor there are communal lounges and a dining area, together with a bathroom and WC. The registered providers are Mrs Wells, Mr Luckhurst and Mrs Hodder. Mrs Wells takes the main responsibly for overseeing the management of the home. Mrs Katrina Arthur has been appointed as Registered Manager Designate; Mrs Laming is currently the registered manager and retains legal responsibility for the day-to-day running of the home although she is now working in the capacity of Head of Care, assisting Mrs Arthur. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken without prior notice and began at 10:30am. The home manager Katrina Arthur and three care staff were on duty and Mrs Arthur remained in the home throughout the inspection. Seventeen residents were being accommodated and the majority were at home and able to take part in the inspection. The morning of the inspection visit was spent speaking with residents, to seek their views on the care and support being provided to them; the relative of one resident visited during the morning and joined in this discussion. The remainder of the visit was spent with Mrs Arthur to review progress toward meeting the requirements and recommendations set out in the inspection report dated 7th March 2005. Mrs Arthur was appointed as manager of the home in October 2004; an application for her registration has now been received by the CSCI and is currently being processed. What the service does well: Residents say that the home is comfortable and has a friendly atmosphere; they feel that staff know them well and respect their wishes; examples given by residents were: “ I have all the help I need to get up and dressed at whatever time I wish.” “ I am not hurried and although I sometimes have to wait a little, when staff come they go at my pace.” “I can come and go as I please, the staff are always pleased to see me getting out and about.” Residents all said that they particularly enjoy the meals provided to them and thought that the food was very well cooked and presented. They also said that the cook knew their likes and dislikes very well and always offered an alternative meal if the menu choice was not to their liking. All residents and the visitor spoken with felt that the manager was very approachable and listened to any concerns that they had about their care: “I can tell her what I think and she makes sure that something is done about it.” “ I think that they (staff) do listen, but a suggestions box would be a good idea also.” Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 Page 6 What has improved since the last inspection? What they could do better: The manager and registered provider must ensure that appropriate and timely action is taken to address matters that affect the health and safety of residents and staff, for example, fire safety precautions to ensure safe exit from the property in the event of a fire. The manager and staff must continue the progress that has been made to improve plans of care for residents, particularly where residents have specialist needs. There is further work to be done to make sure that residents are fully consulted and involved in every aspect of their care, to whatever degree they wish. The manager should look at how those residents who are less mobile can be helped to spend time out of the home, in the local community. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 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 standard(s) 2 All residents or their representatives had been provided with updated contracts, setting out their terms and conditions of residence, thereby ensuring that they have clear information about their rights and obligations. EVIDENCE: The manager had revised and updated the home’s standard contract to include all of the details required by regulation, and provided individualised contracts to all residents and/or their representatives. The contracts seen during the visit had been signed by the resident or their representative, and discussions with residents and a visiting relative confirmed that they had had the terms and conditions explained to them by Mrs Arthur. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 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, 9 & 11 Good progress had been made to ensure that individual plans of care and support for all residents provided clear information about their needs and how these were to be met. The home’s policies and procedures relating to dealing with medicines have been improved, which has reduced the risk of errors occurring; work is continuing to ensure that residents have choice and control in this area. Residents and their families have been consulted about their wishes and needs at the end of their lives or in illness, and the information has been included in their personal records; this should enable staff to respect and carry out the wishes of residents. EVIDENCE: All care plans had been reviewed and updated and there was evidence that this had been done in consultation with some of the residents, but not all; however, there were examples of very good practice, where staff had recorded the comments made by service users about their needs and amended the care plans accordingly. Further improvement to care plans is needed to ensure that all identified needs are addressed in full, particularly where there are specialist Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 Page 11 needs such as those relating to diabetes; the manager has already identified where improvements are needed and has a structured plan for involving residents more closely in drawing up and reviewing their plans of care; ways of providing evidence of how residents have been involved was also discussed. The manager has arranged for staff to have training from a diabetes specialist nurse, to ensure that they can understand and meet the needs of residents who have this condition. The manager and head of care had implemented all of the requirements and recommendations made in the previous report relating to dealing with medicines. Risk assessments in respect of residents’ ability to manage their own medication had been undertaken, but further work was needed to demonstrate who had been consulted in decisions and to ensure that welfare and rights of residents are fully protected. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 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 standard(s) 12,13 & 15 Overall, the home provides a range of social and recreational activities, which meet with the expectations and preferences of residents. Residents are actively encouraged to maintain contact with relatives and friends and to have them visit as they wish. Residents who remain independently mobile are encouraged to use local facilities within their community, but access for less independent residents to such facilities is more limited. The home has an attractive dining area and specialist seating and equipment to aid eating is provided. A cook is employed to produce the main meals and residents confirmed that the food provided was of a very good standard and very well cooked and presented. EVIDENCE: There is a monthly programme of activities, which includes ‘Extend’ chairbased exercise and various entertainers. Residents spoken with during the visit felt that the home met their expectations in all respects, and were satisfied with the range and variety of social and recreational activities on offer; comments included “I like to join in with the exercise lady, keeps me from getting too stiff.; “the staff will sit and read the newspaper with me, which I like – I would like them to have more time to just chat though.”. One Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 Page 13 resident felt that there could be more frequent entertainment brought into the home. A visitor spoken with stated that they were made welcome whenever they visited and that staff respected their relative’s privacy during visits. All residents spoken with said how good the food was at Bosworth; the home does not produce a daily menu, but residents said that they liked to anticipate what might be for lunch, and as all meals were based on their preferences, they knew it would be something that they liked. The cook spoke about how she consults with residents and demonstrated a very detailed knowledge of each person’s dietary needs and preferences. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 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 standard(s) 16 Complaints are handled quickly and effectively and both residents and their relative’s feel that the manager and staff are very approachable and listen to any concerns they may have about their care, taking appropriate action to resolve these: EVIDENCE: The home has an appropriate complaints procedure, which residents confirmed had been provided to them. Only one formal complaint had been received by the home in the last 12 months and there was clear evidence that this had been dealt with carefully and within appropriate timescales; it is also of note that the home had very clearly promoted the rights of the resident involved, resulting in an outcome that satisfied them. “I can tell her (the manager) what I think and she makes sure that something is done about it.” “ I think that they (staff) do listen, but a suggestions box would be a good idea also.” CSCI has not received or been asked to investigate any complaints about the home in the last 12 months. Although only one formal complaint had been recorded, the manager and staff had clearly recorded any minor concerns in the personal notes of residents, together with comments and how these had been resolved. The manager asked for advice on recording complaints in accordance with Data Protection. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 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 standard(s) 19 & 26 Bosworth provides an attractive and safe environment for residents, which, for the most part, meets their individual and collective needs. The building would benefit from a more systematic maintenance programme, which the manager is intending to implement. EVIDENCE: Requirements and recommendations made during the course of the last inspection had been acted upon: work was in progress to install radiator covers and additional bath seats had been purchased to provide easier access to all of the home’s baths. A rolling programme of installing locks to bedrooms doors and lockable storage was underway, together with replacement of bedroom furniture as rooms become vacant. Refurbishment of the kitchen and laundry was also being undertaken. Additional hours for cleaning had been introduced on 3 days per week. A requirement relating to handling of soiled laundry had not been met in full and the requirement for consultation with the Health Protection Unit is repeated. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 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) 30 The home has a staff training programme in place covering general and specific subjects that are relevant to meeting the needs of residents living at the home. EVIDENCE: Staff had individual records of training and development, providing evidence of their learning. In response to a recommendation made at the last inspection the manager has arranged for staff to receive awareness training from a ‘Sensory Loss’ practitioner. Although staff receive training on the Protection of Vulnerable during their induction period, there was no evidence of refresher training being provided. Staff supervision was being linked to the home’s Statement of Purpose and to the individual needs of residents. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 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) 32 & 38 The appointed manager demonstrated a clear and open approach to the management of Bosworth, and a commitment to improving standards at the home. EVIDENCE: The comments made by residents indicated that they saw Mrs Arthur as trustworthy and approachable: “ You know where you are with her, if she says that she will do something, she does it, and if she can’t, she is honest with you.” “She (Mrs Arthur) is always friendly and has time for a chat.”; “ Katrina makes sure that we are kept informed.” Mrs Arthur has introduced a successful method of seeking the views of residents and there was evidence that their views were being acted upon in the home development plan and in staff supervision records. Mrs Arthur also had plans to develop and improve consultation methods, and discussed development of the home’s ‘Action Plan’ for the next 12 months. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 Page 18 Staff also stated that they felt more included in the running of the home, particularly in care planning. All those spoken to stated that they felt well supported and informed. In relation to health and safety, Mrs Arthur had reviewed the arrangements for COSHH, to ensure that staff were following the home’s procedures. The requirement for the mortise lock to be removed from the front door had not been met and the lock was still on use on the day of the inspection; Mrs Arthur must consult with the Fire Safety Department of Dorset Fire & Rescue Service to determine the most appropriate method of securing the door without the need for a key; as an immediate safety precaution, Mrs Arthur agreed to secure the key to the door by means of a chain. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 x 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 3 x x x x x 2 Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 Page 20 yes 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 OP7 Regulation 15 Requirement Timescale for action 31/07/05 2. OP26 13(3) 3. OP38 23(4)(b) Detailed care plans for residents who have diabetes must be developed and supported by comprehensive risk assessments. The manager must consult with 31/07/05 the Health protection Unit to determine whether the infection control procedures in place in the home are satisfactory. The manager must consult with 31/07/05 the Fire Safety Department to determine the most apporpriate method of securing the main entrance door without impeding exit in the event of a fire. 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 2 Good Practice Recommendations In order to ensure that the contracts and Terms & Conditions of Residence are fair, Mrs Arthur should obtain guidance recently produced by the Office of Fair Trading and review the document against this. Risk assessments relating to the ability of residents D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 Page 21 2. Bosworth 7&9 3. 4. 5. 6. 13 16 18 30 manage their own medications should include evidence of who has been involved and consulted in the making process, and provide evidence of why a particular course of action/decision is being taken. The manager should ensure that residents who are not independently mobile have more frequent opportunities to access the local community and facilities. A loose leaf format should be adopted for recording complaints and concerns, to comply with the requirements of the Data Protection Act The manager should develop a more structured plan of maintenance and renewal for the home and incorporate this into the home development plan In order to ensure that staff remain aware and up to date, they should receive refresher training relating to the protection of vulnerable adults. this should include information about local and national guidance and the homes own policies and procedures. Bosworth D55 S26769 Bosworth V220838 230505 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF 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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