Inspection on 21/11/07 for Bowbrook House

This inspection was carried out on 21st November 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

Bowbrook House 22/08/06

Bowbrook House 17/01/06

Bowbrook House 27/09/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Bowbrook House Bowbrook Shrewsbury Shropshire SY3 5BS Lead Inspector Mike Moloney Key Unannounced Inspection 21st November 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bowbrook House DS0000062569.V355307.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. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bowbrook House Address Bowbrook Shrewsbury Shropshire SY3 5BS 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) 01743 247071 01743 355995 English Care Limited T/A Bowbrook House Mrs Jennifer English Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One (1) named service user under the age of 65 years Date of last inspection 22nd August 2006 Brief Description of the Service: Bowbrook House is a home for older people situated on the southern edge of Shrewsbury close to the Royal Shrewsbury Hospital. It is owned and run on a day-to-day basis by English Care Limited. Bowbrook House makes their services known to prospective service users in the Statement of Purpose and Service Users Guide. The latest inspection report is available within the home. The care home rates are reviewed annually on 1st April each year and service users are notified one month in advance. The only additional charges to service users are for hairdressing, chiropody, newspapers and trips out. This is clearly laid out in the terms and conditions and individual invoices prepared. Fees as of 1st April 2006 are from £445 to £475 per week. All service users pay monthly Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service. What the service does well: 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. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 6 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 Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. Prospective residents and their representatives have the information needed to choose a home which will meet their needs They have their needs assessed and a contract which clearly tells them about the service they will receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records belonging to somebody who had been recently admitted to the home were looked at. These contained an assessment of need in addition to further information that had been obtained by the home. Such things as communication ability, personal care skills, hearing loss and mobility were amongst the things looked at when the home considered whether or not they could meet that persons needs. Looking at the records as well as talking to people living in the home it was clear that prospective residents are encouraged to visit the home before deciding whether or not to live there. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans for two of the service users were looked at. Both of these showed that the service users care plans had been reviewed each month and the areas considered included the person’s weight, mobility, diet, mental health, likes/dislikes and things that they need help with. A range of personal risk assessments for those people were also seen to be in place relating to manual handling, falls and nutrition. The files also contained records relating to medical issues and how and when they had been treated. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 9 The arrangements for the storage and giving of medication were looked at with the medication being kept in a secured, built in cupboard along with the records showing when it had been given out. There was appropriate storage for Controlled Drugs. Talking with the staff and looking at the training records established that they receive appropriate training in the management of medication. Talking with a number of the service users and observing the practices of the staff during the visit established that both health and personal care is given in a discreet and sensitive manner. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. Residents are able to choose their life style, have a variety of social activities available to them and are able to keep in contact with family and friends. Social, cultural and recreational activities meet resident’s expectations. Residents receive a healthy, varied diet according to their assessed requirement and have plenty of choice within the menu. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An activities organiser, who was not included in the normal shift staffing levels has been employed. Her job is to organise activities for the people living at the home as well as to occasionally help people when they attend hospital or other health-care appointments. Talking with her and looking at the weekly activities sheets that she keeps showed that a variety of activities take place in the home including such things as Scrabble evenings, ‘Music & Tipple’, Extend (which is a form of exercise for people who are less mobile), Communion, Bingo, tissue art and a baking session. More occasional activities have included a Halloween party and fireworks as well as visits by a ladies choir. Talking to both the Activities Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 11 Organiser and the manager each confirmed that they are currently looking at buying a small minibus or ‘people carrier’ so that more off site activities can be arranged and transport to and from appointments can be more flexible and less reliant on taxis. During the inspection one of what the hairdresser explained was twice weekly hairdressing sessions took place. Talking to the people involved it was clear that not all of those in the room were having their hair done but had joined the group to be part of the ‘chat’. A number of copies of that days newspapers were seen around the lounges and a number of people were seen reading them. People living in the home were all very complimentary about the staff, the manager, the accommodation and the food. A number said that they are able to join in with the activities should they wish but should they want to be somewhere quieter they not only had their own rooms but there were four lounges with a fifth, a conservatory, being built should they want to use them. Looking at the menus and talking to the chef confirmed that people are offered a choice of meals plus a vegetarian option. The chef also confirmed that special diets could be made available for those with any cultural, religious special or medical needs. The meals being prepared and served on the day of the inspection were seen to be well presented and, according to those asked, were very tasty. One person was particularly pleased that rabbit had been offered to him for the previous days dinner. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. Residents have access to a robust, effective complaints procedure, are protected from abuse and have their legal rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been no complaints received by the home since the last inspection. All of the residents spoken to said that they feel able to talk to the manager if they had a complaint to make. The home was seen to have a copy of the local policies and procedures for the protection of vulnerable adults. The records showed and the staff confirmed that they had received training in such matters. There had been one referral, not related to any issues within the home, into those procedures made by the manager. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This home is situated on the outskirts of Shrewsbury next to the Royal Shrewsbury Hospital. It is an older building that has been modified and extended to make it suitable for its purpose. Previous inspection reports and the home’s Annual Quality Assurance Assessment confirmed that all of the bedrooms have en-suite facilities. The home currently has four rooms that any of the people living there can use with a fifth, a conservatory, being built at the time of this inspection. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 14 The ground contain a car parking and to the rear there is a patio area for people to use during the better weather. The home has a laundry area that is appropriately equipped to deal with heavily soiled items. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is excellent. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing care needs of residents as well as being able to support a large number of their social activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Talking with the staff, looking at the staffing rotas as well as observing the level of activities available to the people living at the home confirmed that there are enough staff on duty at any one time to meet the needs of the service users. These staff not only included carers but catering staff, maintenance and administrative personnel and the Activities Organiser as well. The records of a number of newly appointed staff were looked at and these were seen to contain evidence of the pre-employment checks that are necessary to ensure that such staff are fit to work with vulnerable people. More checks are carried out than are required by law in that three references are requested as opposed to the required two. Within the home’s Annual Quality Assurance Assessment when asked what their strengths in this area are they make the statement, Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 16 “Robust recruitment process, often we loose staff in the recruitment procedure because they are unable to wait. We do not like this situation but keep to the procedures rather than put service users at risk”. Looking at the training records kept by the home as well as talking with the staff showed that the training necessary to meet the needs of the people living at the home is ongoing and that of the twenty-one care staff seventeen have achieved National Vocational Qualification level 2 in care or better with more senior staff working towards level 4. Throughout the inspection staff were observed listening to and chatting with the service users who were, as mentioned elsewhere in this report, very complimentary about them. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is excellent. The ethos of the home is based on openness and respect with effective quality assurance systems developed by qualified, competent owners/management to achieve positive outcomes for service users in all areas of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Talking with the manager/proprietor established that she has obtained the Registered Managers Award and hopes to finish the National Vocational Qualification 4 in care in the near future. Both of these qualifications are seen as appropriate for someone who manages a service such as this. The Care Manager is also working towards achieving these qualifications. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 18 Talking with her about various areas involved in the running of the home such as recruitment practice and how the home should be developed to meet the changing needs of those living there showed an in depth understanding of the way in which the home needs to be run. She also showed a good knowledge of the individual service users needs, issues and backgrounds. She explained how the home had started to use a quality assurance system that had been developed by a national trade association to help identify areas that they, as a home, may need to address. In talking with a number of the people living at the home it was clear that they talk with the manager and her senior staff on a regular basis and they were very complimentary about them. Similarly talking with the staff and looking at the records of their professional supervision meetings showed that they have regular communication with the proprietors. A short staff meeting took place during the morning of this inspection. The home does not hold cash for residents. A number of records were seen showing that safety checks had been carried out on such things as portable electrical appliances and fire safety equipment Records of fridge and freezer temperatures were seen to have been kept in. The home was also seen to have secure storage for hazardous materials and have developed instructions for their safe use. As mentioned elsewhere in this report the staff team receive appropriate safety training in infection control, the safe handling of medicines, first aid, food hygiene, manual handling and fire prevention. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 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 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 x 3 3 x 3 Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 20 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. Refer to Standard OP18 Good Practice Recommendations The registered provider should arrange updates for staff in adult protection. Bowbrook House DS0000062569.V355307.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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. 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