Inspection on 09/03/06 for Bourne House

This inspection was carried out on 9th March 2006.

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

Bourne House 14/05/07

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 Michelle Haller Unannounced Inspection 9th March 2006 09:00 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.V280448.R01.S.doc Version 5.1 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.V280448.R01.S.doc Version 5.1 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.V280448.R01.S.doc Version 5.1 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) 10th August 2005 Date of last inspection 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 DS0000005561.V280448.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. So that a full impression of the home can be achieved it is essential that this report be read in conjunction with the previous inspection dated 10th August 2005. The aim of this inspection was to look at the standards that had not been assessed at the previous inspection, re-examine some core standards pertaining to assessments, care-plans and diet and monitor the action taken in respect of any requirements outstanding from the previous inspection. This inspection was unannounced which means that the home was not informed prior to the visit and took place on the 9th March 2006, between 09:00 and 15:00. During the inspection four service users were interviewed in private, as were two relatives of service users and two staff members. Additionally discussions took place with the manager. A tour of the building was undertaken, and a selection of service user and staff records as well as other documentation, including staff rotas were scrutinised. Overall the home was found to be warm, comfortable, clean and well staffed. Service users needs appeared met and they had been supported in a achieving a high standard of personal care and grooming. Visitors and service users expressed complete satisfaction with the way the home was run and the services provided. Comments included: from a family member: ‘I’m thrilled to bits with the way they look after him’ and from a service user ‘I couldn’t be in a better place.’ What the service does well: The home ensures that service users and representatives are aware of what is on offer and that they have a choice about whether to remain in the home, and also a choice about which bedroom to occupy. The home tries to be flexible in accommodating the individual preference of each service user. Assessments for the most part are good and care plans provide sufficient information to staff about how the needs of services users are to be met. Personal, health and emotional care and support is provided in a warm, personal, dignified and compassionate manner. Bourne House is homely. Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 Page 6 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. Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 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.V280448.R01.S.doc Version 5.1 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 the following standard(s): 3 and 5 Assessments of service users needs are incomplete, as they do not include an assessment of communication skills. Service users and their representatives are given the opportunity to visit the home to assist them in making the decision about whether to move in. EVIDENCE: In the course of this inspection discussion with four service users and two service representatives was undertaken, five service user files, reports and records were examined in addition to other policies, procedures and correspondence concerned with the care of service users and the running of the home. The homes admission policy indicates that service users and their representatives are welcome to visit the home prior to moving in. Service users and representatives stated that the home has a good local reputation and so was their first choice when they were looking for residential care. They acknowledged that they were aware that the first month was not permanent but this had not been an issue as they felt lucky to get a place. Service users Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 Page 9 also confirmed that service user guides had been provided, that they were encouraged to visit the home before making their final decision. One service user was also keen to acknowledge the manager supported his move to another bedroom when the one he preferred became available. The files contained completed assessments however communication needs had not been assessed for any service users, and so staff were not made aware of specific communication issues. The importance of assessing communication was discussed with the manager, especially as it was evident that some service users had specialised communication needs. It was noted however that the speech and language therapist did visit the home following referrals from the district nurses, general practitioners or consultant, unfortunately these assessments were not included, or alluded to, in the main assessment file. Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 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 the following standard(s): 7, 10 and 11. The care plan and risk assessments in the home do not fully reflect the needs identified in the assessment of needs and so does not fully inform care staff of the needs of the service users and how these needs are to be fully met. Support and care provided in the home is provided in a manner, which promotes the physical, emotional and social wellbeing throughout the service users stay. Service users who are dying are treated with care and compassion ensuring that they are pain free and any distress alleviated or kept to a minimum. EVIDENCE: The care plans, reports, records and assessments for five service users were examined. In each case there was sufficient information to confirm that care plans are reviewed and the changing needs of service users made clear to care staff. Daily records also demonstrated that the progress of service users in relation to these needs was monitored. Risk assessments were also in place. The risk assessment pertaining to the use of bedrails was specifically examined and assessed as inadequate for it’s purpose as it was not possible to identify why the equipment was necessary, risks posed by the rails themselves, how Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 Page 11 these risks, if any, would be managed, neither was the success of this intervention analysed. This issue was discussed with the manager and identified as requirement outstanding from the previous inspection. The role of care assistance in meeting communication needs have been overlooked as Care plans did not provide evidence to suggest that staff were informed about how best to support service users with specialist and profound communication needs. Notwithstanding this, however, the general impression was that health care needs were met, with correspondence and reports detailing medical and nursing intervention, as well as routine checkups such as dentist, opticians, chiropody and other professions allied to health. Comments from service users included, ‘I feel well cared for’. And relatives stated ‘He couldn’t be looked after any better’. Service users commented during conversation that all health care, examinations and other intimate care always took place in private. Observations of the interactions between staff and service users indicated that staff treated service users with respect and dignity at all times. Staff also appeared gentle and understanding in relation to the effect the behaviour of some service users may have on others and took appropriate steps to reduce these effects. The manager and one member of staff were interviewed in relation to ‘end of life’ care in the home. The manager stated that senior staff took the responsibility for maintaining good contact with relatives, the general practitioners and district nurses. Occasionally specialist palliative care nurses have attended the service user to provide additional advice about pain and stress control if required. The manager also stated that service users are never left alone at this stage. Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 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 the following standard(s): 15 The food provided at Bourne House is of good quality and promotes the nutritional health and sense of well being for service users. EVIDENCE: Meals times at Bourne House are flexible and meet the needs of the service user, this was demonstrated on arrival, as at 09.00, service users were at different stages of having breakfast and it was observed that a full choice from just cereals to a full cooked breakfast was offered. The main meal on the day of inspection was braised steak, or liver, potatoes, broccoli and carrots. The liver was sampled and was very tasty and tender. Observations made over lunch indicated that all service users enjoyed the choices they made. Mealtime was unhurried, with service users given opportunity to eat their meals in their own time. Service users and relatives stated that the meals were very good and that hot and cold drinks and snacks were served throughout the day. Observations made during the inspection verified these assertions. The amount of food intake for the most frail service user was not fully documented, however, the home now has a sit and weigh scales and is able to Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 Page 13 weigh each person accurately, and weekly weight demonstrated that this persons weight is fairly stable. Furthermore it was asserted that in addition to small meals, nutritional drinks were also provided to and enjoyed by this service user. In the afternoon professional singers provided entertainment that was enjoyed by service users who chose to attend. Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 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 the following standard(s): 17 The service users legal rights are protected promoting their sense of self worth, individuality and continued civic responsibility. EVIDENCE: The manager stated that forms were sent at the time of elections to enable service users to participate in postal voting. It was also stated that relatives or key workers were approached to explain the process on an individual basis. Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 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 the following standard(s): 22 and 26 The equipment in the home meets the needs of the service users and the home is for the most part clean and hygienic, providing a safe, comfortable, homely and welcoming environment for service users. EVIDENCE: A tour of the communal and private areas of the home was undertaken. The majority of equipment, furniture and fittings were clean and well maintained. The manager stated that the home is undergoing gradual refurbishment and the priority for the coming months was replacement of a number of mattresses and bedsteads, and renewal of a carpet. Service users were observed mobilising around the home safely using the handrails, walking sticks and frames as required. Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 Bourne House provides staff in sufficient numbers and skill mix to meet the needs of service users and promote the heath and welfare of staff. EVIDENCE: On the morning of this inspection there were 31 service users resident in the home and the staffing compliment was one manager, four care assistants, one cook, one cooks assistant, one domestic and a handyman working in the home. Staff did not appear hurried and service users needs were seen to promptly. The duty roster indicated that this was the normal ratio of staff during the day until 21:00hours. All the staff on duty on this day had worked in the home for more than sixmonths and so was familiar with the service users and the routines of the home. Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 38 The quality assurance system in place at Bourne house provides opportunity for service users and others to comment on the service, some amendment to the questionnaire and analysis of these results would enhance the system. The risk assessment processes in the home does not fully safeguarded service users and staff. EVIDENCE: The home has devised a questionnaire and comment sheet that is distributed to service users, their representatives and others involved in the home. This questionnaire is not anonymous and issues raised are dealt with on an individual basis. In addition the results and comments are not analysed and neither is a report pertaining to the quality monitoring developed and made available. Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 Page 18 Better practice could be achieved if the questionnaires did not have space for a name as this would encourage anonymity and, if the results and comments were analysed. The analysis and consequences could be made available to service users and others involved with the home. A summery of the results could also be included in the Service User Guide. Health and safety in the home was fully inspected at the previous inspection and the main finding was lack of full consideration in the development of risk assessments. This situation continues. The manager stated that she had attended training but did not find the session useful, some discussion ensued about resources that maybe of assistance. Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x X 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 x X X X 3 X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X 2 Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14 schedule 3 (l) 15 Requirement Timescale for action 01/05/06 2. OP7 3. OP38 13 (4) The registered person must ensure that the communication needs of service users re assessed. The registered person must 01/05/06 ensure that a care plan relating to all the needs of service users consistently developed. 01/05/06 The registered person must ensure that all risk assessments are recorded in a manner which demonstrates all the aspects of the risk that have been considered and the reason for the risk management strategy decided upon. Previous timescale 01/11/05 not met. Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 Page 21 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 OP33 Good Practice Recommendations The registered person should consider aspects of best practice in relation to the gathering of information and presentation of the results in relation to the homes quality monitoring system. Bourne House DS0000005561.V280448.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs 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. 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