Inspection on 10/08/05 for Bourne House

This inspection was carried out on 10th August 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

Bourne House 14/05/07

Bourne House 09/03/06

Bourne House 17/01/05

Bourne House 26/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

SignHealth

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE Bourne House Taunton Road Ashton under Lyne Tameside OL7 9DR Lead Inspector Steve Chick Announced 9 & 10 August 2005 th th 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. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bourne House Address Taunton Road, Ashton-under-Lyne, Tameside, OL7 9DR 0161 330 7911 0161 330 7011 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) Medincharm Limited Offoxey Farm, Tong, Shropshire, TF11 8QA Patricia Quinn CRH Care Home 33 Category(ies) of DE(E) Dementia - over 65 - 33 registration, with number OP Old Age - 33 of places PD(E) Physical isability - over 65 - 33 SI(E) Sensory Impairment over 65 - 3 Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service User to include up to 33 OP up to 33 DE (E) up to 33 PD (E) and up to 3 SI (E) Date of last inspection 17th January 2005 Brief Description of the Service: Bourne House is located in a residential area towards the outskirts of Ashton under Lyne and provides accommodation to up to 33 older people. All bedrooms are single and over half have en-suite facilities, for which there is an extra charge. The home is a two storey detached property set in pleasant grounds. Car parking is available on the road or in the car park to the rear of the building. Over the years the home has been extended to the rear. There were three lounges and one dining area. Externally, a ‘decked’ area was available for service users. The home is run by Medincharm Ltd. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection five service users were interviewed in private, as were five relatives of service users, four staff and three visiting professionals. Additionally discussions took place with the manager. The inspector also undertook a tour of the building and scrutinised a selection of service user and staff records as well as other documentation, including staff rotas and maintenance records. ‘Comment cards’ were received from eight relatives, ten service users and four General Practitioners. What the service does well: What has improved since the last inspection? The manager has continued to consolidate her management style and has worked hard to involve service users and relatives in the running of the home. Training opportunities for staff, notably through the NVQ modules, is well supported. Records relating to the care needs and actual care given are well maintained. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 6 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. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 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 Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 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) 1, 2, 3 and 4. Service users have access to appropriate information before moving in and are informed of the terms and conditions of the home. A decision to accept a prospective service user is based on an appropriate assessment. EVIDENCE: The home had produced a statement of purpose and service user guide which had been found to be appropriate at previous inspections. These documents were not scrutinised at this inspection. A random selection of service users’ files was scrutinised. All had a copy of the home’s terms and conditions, which had been signed either by the service user or a representative of theirs. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 9 Each file had a copy of an appropriate assessment undertaken by a professional based in the community. There was also documentary evidence that the home assessed whether or not Bourne House could meet the assessed needs of each service user. Bourne House does not offer intermediate care. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 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, 8, 9 and 10. Bourne House maintains appropriate care planning and health records. Service users’ health needs are maintained by appropriate working relationships with community based professionals. Service users are treated with respect and dignity and their right to privacy is upheld. EVIDENCE: Each service users’ file which was scrutinised had a written care plan which had been reviewed at appropriate intervals. Each care plan had been signed by the service user, indicating their involvement in the process. The care plans presented as being in appropriate detail and covered an appropriate range of needs. One visiting social work professional specifically commented on the good quality of the care plans. The daily records were appropriately maintained to enable a check on the level of care being offered to each service user. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 11 All relatives spoken to, and all the relatives ‘comment cards’ indicated that they were kept informed of important matters relating to their relative. One visitor commented that his relative had “made a remarkable recovery” and was “well looked after and happy”. Another reported that the best thing about Bourne House was that they “care about the service users , look after them and are supportive of the whole family” The son of two service users reported “Their health and quality of life has improved immensely since they moved there [to Bourne House]”. There was documentary evidence that service users had access to the full range of medical and para medical services. All service users and relatives spoken to were confident that appropriate medical support was obtained. All the GP ‘comment cards’ received were positive about their working relationships with the home. One visiting medical professional commented that “they usually do everything [requested], some occasional blips but [those are] always dealt with when raised.” Bourne House used a pre dispensed monitored dosage system to administer service users’ medication. The PCT ‘Prescribing Support Technician’ had undertaken an inspection of the medication systems a month before this inspection. Their report identified no significant issues. Service users spoken to during the inspection all reported that the staff treated them with respect and dignity, and that their privacy was respected. This was also confirmed by visitors spoken to. All but one of the service users’ comment cards also indicated that service users’ privacy was respected. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 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, 14 and 15. A good range of social activities was available at the home. Staff are supportive of contacts between service users and their friends and relatives. Service users can exercise choice over their lives, within the context of communal living. Bourne House provides appropriate food. EVIDENCE: The manager reported that a wide range of social activities and outings was available for service users. Discussion of social activities was recorded in the regular ‘residents’ meetings and were publicised in the regular ‘newsletters’. This was confirmed in discussion with service users, staff and visitors. Eight service user comment cards reported satisfaction with the activities in the home, one reported ‘sometimes’ and one ‘no’. One relative wrote to the Commission for Social Care Inspection saying “… [staff] have been a tower of strength … the help and care the staff give to all the residents and relatives is something special … and with all the extra entertainment and trips organised Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 13 throughout the year this has to make Bourne House one of if not the best residential homes …” Bourne House has a written policy encouraging visiting at all reasonable times. This was confirmed by service users, visitors spoken to and all relatives comment cards received. One visitor commented that staff were always friendly and another regular visitor also commented on the welcome, saying “[its] like a second home for me! … all staff are very friendly.” One written comment received described Bourne House as “A very happy and welcoming home … “ Staff reported that they were expected to ensure that all service users are able to exercise choice and control over their lives. Within the context of communal living this was confirmed by service users spoken to. Two meals were sampled during the inspection. They were pleasantly presented and tasty. A significant majority of service users spoken to and service users’ comment cards were positive about the food. The cook reported no unreasonable restrictions on the budget allowed for food. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 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 and 18. Bourne House maintains an open atmosphere where complaints and concerns can be raised. Complaints and concerns are appropriately dealt with. Service users are protected from abuse and exploitation. EVIDENCE: Bourne House has an appropriate written complaints procedure. All service users and visitors spoken to were confident that any complaint would be appropriately dealt with within the home. The manager and staff were experienced as being open and approachable. One visitor described an “easy rapport” with the staff, which would help to make raising any concerns easier. The home has a written procedure regarding what to do in the event of any suspicion of abuse or exploitation of any service user. Staff who were interviewed demonstrated a good understanding of the need to be vigilant about poor practice, and of what action they must take. All staff were aware of the ‘whistle blowing’ policy, but were confident that the manager and owner would take appropriate action. All service users spoken to and all service user comment cards expressed the view that people were safe at Bourne House. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 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, 20, 21, 22, 23, 24, 25 and 26. Bourne House is well maintained, clean and hygienic. The communal areas and service users’ bedrooms are pleasantly decorated, homely and predominantly safe. Appropriate bathing and toilet facilities are available. Some specialist equipment was not available. EVIDENCE: During the inspection a tour of the building was undertaken. The building presented as being appropriately maintained and decorated. The home has three lounges and an easily accessible ‘decked’ patio. Several plant containers which had been planted up by the service users were in this area. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 16 All service users’ bedrooms are single, with many having en suite facilities. Inspection of a selection of bedrooms indicated an appropriate degree of variation and personalisation. Service users who were asked said that they liked their rooms. Two bedrooms have unprotected radiators which could pose a risk if service users were to become trapped against them. It was reported that the shape of the radiators (curved round the contour of bay windows) was causing difficulties in appropriately covering them. The manager reported that the registered person was exploring options to resolve this problem and in the mean time risk assessments had been undertaken which indicated that the occupants of these rooms were not at high risk of falling against the radiators. Bourne House provided appropriate bathing and toilet facilities. In general appropriate aids and adaptations were available to assist service users with restricted mobility. The home does have a small passenger lift which cannot accommodate a service user in a wheelchair. Staff get round this problem by transferring the service user to a smaller wheeled chair for their journey in the lift. There was no equipment to weigh service users who could not weight bear. This would make it difficult for the home to effectively monitor non weight bearing service users where there were nutritional concerns. The home presented as clean and hygienic, with no unpleasant odours. All service users and visitors who were asked, confirmed that this was the usual state of the home. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 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 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, 28, 29 and 30. Bourne House provides appropriately qualified staff in appropriate numbers. Recruitment procedures are rigorously followed to protect the interests of service users. EVIDENCE: The staff rota for the week beginning 25th July 2005 was scrutinised. This demonstrated that staffing was maintained between four and five carers during the day (08:00 – 21:00) and two carers at night (21:00 – 08:00). Additionally there is a manager, domestic and kitchen staff and a handyman. Two relatives comment cards indicated that they did not think there were always sufficient staff on duty. However this was not identified as a problem by the other respondents, nor service users nor visitors spoken to during the inspection. Eight carers hold NVQ II or higher, (33 ). It was reported by the manager that another 10 carers were on the NVQ course and expected to complete in November 2005. This would give a figure of 75 qualified. A range of other training courses were available for staff. It was reported by the manager that most staff are keen to take advantage of these opportunities. Staff who were interviewed also confirmed the availability of training. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 18 A selection of files relating to recently recruited staff was scrutinised. There was documentary evidence that thorough vetting had been undertaken before staff commenced work at the home. Service users and visitors who were spoken to during the inspection were positive about the attitude and approach of the staff team. One written comment to the Commission for Social Care Inspection said “ … now very comfortable thanks to the good work by the staff at Bourne House. “ Another reported “ … they all show lots of compassion and patience and cannot be faulted in any way.” Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 19 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 is fit to be in charge of the home and helps to create an open and responsive ethos. Service users’ financial interests are safeguarded. The recording of risk assessments is not always done with sufficient rigor. EVIDENCE: The registered manager has several years experience in a management role and is working towards the Registered Managers Award. She demonstrated a good understanding of the needs of older people. One visiting professional expressed the view that the manager was good at “pushing for services for service users “. Another commented that service users’ needs were “individually addressed … the manager is accommodating and communicates well [with me].” Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 20 Staff described the manager as open, supportive and responsive to new ideas. “Pat is brilliant, approachable and you can go to her [with problems].” “Pat is very approachable, available and helpful.” Similarly relatives and service users were positive about the management style of the home. Comments included “Pat is tops, so helpful”, … “[the] girls are very nice. Pat works hard”. There was documentary evidence of regular structured meetings with service users and relatives, covering a wide range of relevant issues. The home had started to provide a regular newsletter which was a useful means of communication both within the home and for relatives. A selection of records relating to money held on behalf of service users was scrutinised. The system presented as well managed and design to protect the interests of the service users. One example of a written risk assessment relating to the use of bed rails was seen which did not address all the possible areas of risk. Discussion with the manager indicated that this was an administrative error and more thought had gone into the decision to use bed rails than was recorded. While this oversight would not have a negative impact on the service user, it does diminish the transparency and accountability of the decision making process. The Health and Safety Executive have identified the inappropriate use of bed rails as a predictable risk to service users. The manager was referred to information on the HSE website. Records relating to routine maintenance of equipment throughout the home presented as being appropriately maintained. The Greater Manchester Fire and Rescue Service had visited in June 2005 and made several requirements relating to fire precautions. It was reported by the manager and handyman that all of these had been complied with. Staff confirmed the availability and mandatory use of disposable gloves and aprons to minimise the risk of cross infection. Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 21 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 3 3 3 3 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 3 3 3 2 3 3 3 3 STAFFING Standard No Score 27 3 28 3 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 Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 22 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 22 Regulation 14 (2) Requirement The registered person must ensure that equipment is provided to monitor the weight of all service users. The registered person must ensure that all risk assessments are recorded in a manner which demonstrates all the aspects of the risk which have been considered and the reason for the risk management strategy decided upon. Timescale for action 01/01/06 2. 38 13 (4) 01/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton under Lyne OL7 0QD 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 Bourne House F54 F04 s5561 Bourne House v236999 090805 Stage 4.doc Version 1.40 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!