Inspection on 14/05/07 for Bourne House

This inspection was carried out on 14th May 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

Bourne House 09/03/06

Bourne House 10/08/05

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 Janet Ranson Unannounced Inspection 14th May 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bourne House DS0000005561.V337053.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. Bourne House DS0000005561.V337053.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bourne House Address Taunton Road Ashton-under-Lyne Tameside OL7 9DR 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) 0161 330 7911 0161 330 7011 bournehouse2@aol.com Medincharm Limited Patricia Quinn Care Home 33 Category(ies) of Dementia - over 65 years of age (33), Old age, registration, with number not falling within any other category (33), of places Physical disability over 65 years of age (33), Sensory Impairment over 65 years of age (3) Bourne House DS0000005561.V337053.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service User to include up to 33 OP up to 33 DE (E) up to 33 PD (E) and up to 3 SI (E) 9th March 2006 Date of last inspection Brief Description of the Service: Bourne House is a two storey detached property that has been adapted and extended over the years to provide care and accommodation to 33 older people. The bedrooms are single and over half have en-suite facilities, for which there is an additional charge. They are situated on two floors of the building. There is a passenger lift to the first floor. On the ground floor there are three lounges and two main dining areas. Adapted bathrooms and toilets have been provided through out the home. Set in pleasant grounds, the home also has an accessible decked area that is available for the residents to use in the better weather. Car parking is available on the road or in the car park to the rear of the building. Bourne House is located in a residential area towards the outskirts of Ashton under Lyne. Fees for accommodation and care at the home range from £323.66 to £365.00. Additional charges are also made for hairdressing and chiropody services, newspapers, personal toiletries and trips. Bourne House DS0000005561.V337053.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the key inspection, which included an unannounced site visit. The site visit took place on 14 May 2007 and covered a period of seven and three quarter hours from 10:00am until 17:45pm. The home had completed a pre inspection questionnaire. Using some of the information contained in the questionnaire a number of general practitioners were surveyed as to their impressions of care for their patients. During the inspection time was spent talking to the residents, some of the care staff, the activities organiser and the registered manager. The inspector also looked at the home’s routine and how the staff worked and talked with the residents. A total of four residents identified needs were closely looked at. Individual details of their experiences and care were examined from when they first came into the home to their current care needs. The inspector looked around the building. A selection of staff and residents’ records was examined. These included records of care, medication records, employment and staff training records. The staff have worked hard to change the manner in which the risk assessments had previously been completed as required at the last inspection. What the service does well: The residents who spoke with the inspector confirmed their total satisfaction with the care they received and their accommodation. Bourne House provides a good standard of care from a well-trained, enthusiastic and committed staff team. They are lead by an experienced and qualified manager who in turn is supported by a team of senior carers. There is a dedicated activities organiser who maintains a high level of stimulation for the residents. The events and forthcoming entertainment are clearly displayed through out the home. The residents and their visitors benefit from a relaxed and informal situation. The environment is nicely presented, and the standard of accommodation meets fully with the residents’ expectations. The residents are encouraged to bring personal effects with them to personalise their rooms. Bourne House DS0000005561.V337053.R01.S.doc Version 5.2 Page 6 The manager uses the Internet to provide the carers with information and advice on care concerns and medical conditions. 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. Bourne House DS0000005561.V337053.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 Bourne House DS0000005561.V337053.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): 1, 2 & 3 Standard 6; Intermediate care is not provided at Bourne House Quality in this outcome area is good. The home’s system of assessment reflected individual preferences and social requirements. This meant that the home could be certain they could meet the prospective resident’s diverse needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual care needs assessments were contained within the four care files examined as part of the inspection. The home also has a process of assessing potential resident’s needs carried out by a senior member of staff. By completing such an assessment the home can be sure that individual needs can be met. A letter to the resident or their representative from the manager confirms this. Bourne House DS0000005561.V337053.R01.S.doc Version 5.2 Page 9 Those residents who spoke with the inspector confirmed they had looked around the home and had been invited to stay for a meal before they made a decision to live there. They also confirmed they had information regarding the services provided by the home. There is a system in place to advise the residents of any changes to the service. Copies of this documentation were to be found on the individual files. Bourne House DS0000005561.V337053.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, 9,10 & 11 Quality in this outcome area is good. The care planning process clearly identifies the residents’ individual health and social requirements. They provide the carers with action to be taken to provide appropriate care on a day-to-day basis enabling the residents needs to be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans were examined as part of the inspection process. They clearly set out the residents’ individual personal care needs. The care plans document the action to be taken by the carers to ensure all aspects of health, personal and social care are met and reviewed. At the last inspection there were requirements concerning the content of risk assessments. It was evident at this inspection that the managers had worked Bourne House DS0000005561.V337053.R01.S.doc Version 5.2 Page 11 hard on this area to improve and recognise individual risks. The documentation clearly provided areas of risk that are general to all the residents in addition to that of an individual risk. All the care planning documentation was in the process of being changed to a pre printed type. The manager had purchased a quality assurance system and was careful to point out they were “customising” it to better suite the needs of the organisation. Further documentation in two care plans set out the details of a resident’s specific medical condition along with specific information downloaded from the Internet explaining the condition. This is indicative of the extent the managers will go to provide the carers with information so they can provide individual care. Where identified, the resident’s health is monitored and addressed by the appropriate health care professionals. The district nurses are involved on a regular basis as are the chiropodist, audiologist, dietician and speech therapist. Specialist communication aids were in use and a further specialist communication tool was being considered. This means that where ever possible those people with communication difficulties could make their needs known. The senior staff are responsible for the administration of medication. There was evidence to show they had received training to correctly administer medications. Records are retained to show changes to medications and medical interventions. The home uses a monitored dosage system provided by Boots. Boots also provide the medical administration records and a system for returning medication that is no longer required. The medication storage and observed practice was satisfactory. Based on observation, it was apparent that the staff respected the residents’ privacy by knocking and waiting before entering rooms. The carers responded to the residents in a gentle and respectful manner. The home operates a “care pathway” system for those residents who have been assessed by a doctor as reaching their final stages of life. This involves other healthcare professionals in addition to the homes care staff enabling the resident to remain in their own room whilst receiving specialist care. Cards had been received by the staff from those families who acknowledged their appreciation of the care that had been received. Bourne House DS0000005561.V337053.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 & 15 Quality in this outcome area is excellent. The choices offered to the residents meet with their requirements and needs and enable them to exercise elements of control over their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a system of outlining the resident’s previous life history. The completed document details religious, cultural and recreational interests and is retained in the individual care file. Where ever possible the residents and their families are involved in this process. This helps the carers to better understand the residents needs and is considered to be very good practice. There is a full time activity organiser employed at the home. Posters displayed around the home provide details of forthcoming entertainment, pub lunches and trips to places of interest. Local community transport is used in addition to an adapted bus for trips further a field. At the time of the inspection the residents were enjoying a session of armchair movement to music provided by an external trainer. Bourne House DS0000005561.V337053.R01.S.doc Version 5.2 Page 13 Those residents who spoke with the inspector stated they enjoyed the entertainers and quizzes. One person said, “I like the trips out, the girls are very good” and another commented, “The singers are great, we can all join in.” Photographs provided evidence of the residents enjoying a recent entertainer. The residents also said they enjoyed the contact with children from a nursery and local school, this being mainly at Easter and Christmas. The residents’ friends and families are encouraged to join in with the various activities. At interview the activity organiser said she recognised that those residents with dementia did not always appear to take part or get enjoyment from the activity. Along with the manager she had looked on the Internet to find what was available to help her in this area. They had located an accredited training session and she was due to start the course in the next few days. This will provide her with the skills to further improve the quality of life for those residents who have dementia. It was apparent from speaking to the carers that the resident’s relatives were well known and welcome to the home. From observation the visitors were at ease with the staff and the other residents. Visitors could be seen throughout the home during the inspection. There was plenty of light hearted banter between the residents and the staff. The manager had forwarded certain documents to the inspector before the inspection. These included an example of the daily menu. Judging from this the inspector can conclude that the food provided meets with the required nutritional standards. The main meal of the day looked appetising. Those residents who spoke with the inspector said they enjoyed the food and the choices available at each meal. Bourne House DS0000005561.V337053.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, 17 & 18 Quality in this outcome area is good. The home has a satisfactory complaints system and residents feel that their views are listened to and acted upon. Staff knowledge and understanding of adult protection issues provides a safe environment to protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a policy and procedure concerning reporting and investigation of complaints. This is available to the residents in written form. According to the pre inspection questionnaire twenty-nine complaints have been investigated during the previous twelve months. The records clearly demonstrated how the complaints were logged and investigated within a timescale. The manager stated that all complaints had been recorded in this manner. A resident said he would speak to the manager or family if he had any concerns. He said he would expect to be listened to and have his concern addressed to his satisfaction. Bourne House DS0000005561.V337053.R01.S.doc Version 5.2 Page 15 The manager confirmed that four residents had recently attended the polling station to register their vote in the local elections. The remaining residents had voted by post. The home has a policy and procedure to respond to allegations of abuse. The senior carers have received formal training in the Protection of Vulnerable Adults (POVA) as required. The carers have also received this training. They clearly demonstrated their understanding of abusive situations, when interviewed by the inspector. The local authority has carried out one safeguarding adults’ investigation. This was in response to a concern from a healthcare professional and was in regard to a resident’s personal finance. The investigation was brought to a satisfactory conclusion. There have been no complaints about the home made directly the Commission for Social Care Inspection. Bourne House DS0000005561.V337053.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 & 26 Quality in this outcome area is good. The home provides the residents and their visitors with a safe, warm and welcoming environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector looked around the home. It was observed that all areas of the home were clean, tidy and comfortable. It was obvious that the residents were encouraged to personalise their rooms with the presence of photographs, ornaments, books, pictures and furniture. The residents’ rooms were larger than average, light and airy. There were no offensive odours noted. The rooms to the rear of the home overlooked an untidy and overgrown part of the grounds. Whilst it is accepted that the residents do not go into this area Bourne House DS0000005561.V337053.R01.S.doc Version 5.2 Page 17 (as advised by a member of staff) it was unpleasant for the residents to look at. There were no obvious hazards to health and safety but the stair carpet was beginning to show signs of wear on the treads. Elsewhere woodwork required redecoration due to the constant wear from wheelchairs. The manager stated that there were plans to replace carpets, improve parquet flooring in the hallway and replace worn armchairs. She also said there was an intention to replace the carpet in the dining areas with a specialist hygienic floor covering. It was noted there were aids through out the home to meet with the residents assessed needs, including adapted toilets and bathing facilities. Specialist equipment to prevent pressure sores was in place where this need had been identified. Those residents who spoke with the inspector said they were satisfied with their accommodation. One resident said they had asked to move to another area of the home and this request had been carried out. It was evident that those residents who are independently mobile were able to move around all areas of the home at will. Bourne House DS0000005561.V337053.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 & 30 Quality in this outcome area is good. The residents receive care from an enthusiastic, well-trained staff who respond to the residents and visitors in a respectful manner. The home’s recruitment policy and procedure provides protection to the residents from potential abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From observation during the inspection the numbers of staff on duty met with the residents’ assessed needs. A rota was available for inspection. It confirmed the staff on duty at any one time. According to the submitted information six staff had left the home since the last inspection. The inspector spoke with some of the staff. They confirmed they had attended all required mandatory health and safety training. They also mentioned other specialist training for example; anti discrimination practice; oral hygiene and awareness; stoma care and pressure sore training. Individual certificates of attendance were available. It was good to note the carers’ enthusiasm to supplement their knowledge and understanding of their role. Bourne House DS0000005561.V337053.R01.S.doc Version 5.2 Page 19 The home is committed to the National Vocational Qualification system. According to the pre submitted questionnaire fifty percent of the carers had achieved levels 2 and 3. The manager and her deputy had recently completed the level 4 (registered managers award). Each resident has a carer allocated to them. This person is known as a key worker. A photograph of each key worker was on the back of each bedroom door. The carers told the inspector that they had a special relationship with “their” residents and families. This is a good model of care, which not only provides care for the individual but also support for their family and friends. The carers told the inspector they enjoyed working at Bourne House. They felt supported by the management who were very “approachable”. They also said the lines of communication were good with regular staff meetings and formal supervision. The staff felt the home had a good reputation for looking after the residents. It was apparent that the workers respected the residents they cared for and also the other people they worked with. Some of the staff support the residents to go on trips, on their days off. A small number of staff files were examined. They contained the required documentation and there was evidence of references including satisfactory checks with the Criminal Record Bureau. The files were organised and well maintained. Bourne House DS0000005561.V337053.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 & 38 Quality in this outcome area is good. The manager of the home has the skills, experience and qualifications to run the home in the resident’s best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has the appropriate skills and experience to manage Bourne House where she has worked for the past four years. Her previous experience was as a deputy manager in a large not for profit organisation. She has achieved her National Vocational Qualification at level four and the required Registered Managers Award. There was further evidence to show that she continues to update her knowledge and skills by attending various courses. Bourne House DS0000005561.V337053.R01.S.doc Version 5.2 Page 21 The home has a system to protect financial interests for those residents who are no longer able to deal with their money. An administrator maintains satisfactory records of expenditure. The inspector observed a financial transaction involving a visitor and the administrator. The care plans and risk assessments were found to be up to date and regularly reviewed as are the homes policies and procedures. The home uses part of a quality assurance system that is specifically designed for care home’s purposes. Quality satisfaction surveys are sent out at regular intervals. There was evidence that comments contained within the surveys were acted upon wherever possible. The residents also have meetings where they are encouraged to contribute their thoughts about various issues. A newsletter is devised for the purpose of keeping the residents and their visitors up to date with the various comings and goings, birthdays and future events. The newsletter is also used to inform people of the outcomes to the various quality surveys. The registered provider remains in contact with the home, visiting several times a week. Reports of regulation 26 visits made to the home by the registered provider or their representative were available for inspection. No hazards to health were noted during the inspection. The health, safety and welfare are further ensured by the systems in place to report any accidents and incidents. Bourne House DS0000005561.V337053.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 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 3 X 3 X 3 X X 3 Bourne House DS0000005561.V337053.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. 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. Refer to Standard OP19 OP19 Good Practice Recommendations The registered person should make arrangements for the grounds to be maintained particularly those to the rear of the property. The registered person should ensure the décor in the home is maintained in good order particularly the woodwork in the main hallway. Bourne House DS0000005561.V337053.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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 Bourne House DS0000005561.V337053.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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