Inspection on 08/05/06 for Bowburn Care Centre

This inspection was carried out on 8th May 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

Bowburn Care Centre 29/04/09

Bowburn Care Centre 07/05/08

Bowburn Care Centre 10/05/07

Bowburn Care Centre 06/04/05

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Bowburn Care Centre Durham Road Bowburn Durham Co Durham DH6 5AT Lead Inspector Belinda Parker Unannounced Inspection 8th May 2006 08:45 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 Bowburn Care Centre DS0000061553.V291894.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. Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bowburn Care Centre Address Durham Road Bowburn Durham Co Durham DH6 5AT 0191 377 8214 0191 377 8063 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) Guardian Care Homes (UK) Limited Mrs Jacqueline Bolton Care Home 80 Category(ies) of Dementia (13), Dementia - over 65 years of age registration, with number (33), Old age, not falling within any other of places category (34) Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 13 Service Users above the age of 50 but under 65 years (DE) NAMED INDIVIDUAL: The home may accommodate a named individual as set out in a letter to the registered person dated14th March 2006 That establishes the basis on which the individual’s needs will be met by the home Where necessary the homes Statement of Purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else, other than the named individual, who falls outside the registered category. 26th January 2006 Date of last inspection Brief Description of the Service: Bowburn Care Centre (Formerly Morgan House) is a purpose built two-storey building situated in the village of Bowburn on the outskirts of Durham. The home was registered 16th February 2005 with the Commission for Social Care Inspection to provide accommodation for 80 service users. Bowburn provides residential and nursing care for older people over 65 years and for 13 people over 50 years of age with Dementia. The home is divided into separate units to meet the collective needs of the service users the home accommodates. Sleeping accommodation is on both floors with service areas, communal lounges and dining areas located on the ground floor. There is a large courtyard garden for service users to sit in and enjoy. Fees range from £364.50 - £479.00 Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors on 08/05/06 carried out this unannounced key inspection over a combined period of thirteen hours. During the inspection a number of records where examined. Discussion took place with the manager, four service users, six staff members, two relatives and two nurse practitioners visiting the home. The building was toured to ensure that people living in the home had a comfortable, clean and safe environment to enjoy. Five out of ten surveys and four comment cards sent out to service users and other visitors prior to the inspection were returned to CSCI. One requirement made at the last inspection has not been implemented. What the service does well: What has improved since the last inspection? Since the last inspection there has been an improvement in the service provided. The manager and staff team have worked hard to develop the service. Service users and relatives spoken to during the visit were satisfied with the what the home had to offer. The environment was clean and comfortable in most areas with some minor issues brought to the attention of the manager. A service user’s quality of life and standard of comfort has been improved with the purchase of specialist equipment. A family member spoken to is pleased that the needs of his relative are being met appropriately. Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 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. Bowburn Care Centre DS0000061553.V291894.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 Bowburn Care Centre DS0000061553.V291894.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): 1 and 3 (Standard 6 is not applicable the home does not provide intermediate “Quality in this area is good. This judgement has been made using evidence available including a visit to the service”. The information available to prospective service users’ and their relatives is satisfactory to enable them to make an informed decision about admission to be made. It is clear from discussion with the manager and a service user that everyone who is involved with the prospective service user is included in the pre-admission assessment process. EVIDENCE: The home had in place a Statement of Purpose that requires updating to reflect changes in the management and staffing structure within the home. The Service User Guide is colourful and user friendly. Both documents provide prospective service users and the people who live in the home with detailed information on the service and facilities offered. Each service user’s bedroom contained a copy of these documents for information. Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 Page 9 Four care plans examined all included a full assessment of individual service user’s needs prior to admission. However the assessment did not show any signed evidence to show that the service user was in agreement with the assessment of their needs. The manager said prospective service users and their relatives are involved in the assessment process prior to admission. A service user spoken to said he had been involved and received adequate information to enable him to make an informed choice as to whether he wished to move in to the home. Bowburn Care Centre DS0000061553.V291894.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): 7,8,9 and 10 “Quality in this area is good. This judgement has been made using available evidence and a visit to the service”. There is a clear and consistent care planning process in place that adequately provides staff with the necessary information to meet the care and health needs of individual service users’. Medication in the home is managed appropriately promoting good health. Communication between staff and service users is good. This creates a relaxed and friendly environment for the people who live in the home. EVIDENCE: Four care plans examined contained evidence to show that the care and health needs of individual service users are met. Only one care plan of the four included a signature to show that a relative was in agreement with the plan of care. Care plans are evaluated on a monthly basis providing evidence to show if the needs of an individual have changed. Therefore providing care staff with up to date information to meet the changing needs of the people living in the home. Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 Page 11 A medication audit carried out during the inspection showed that the policy and procedure for the safe handling of medicines for the protection of service users was adhered to by staff. Four service users spoken to on the day of the inspection said the staff treated them with respect at all times and assisted them to make choices if asked to do so. Bowburn Care Centre DS0000061553.V291894.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): 12,13,14 and 15 “Quality in this area is adequate. This judgement has been made using available evidence and a visit to the service”. The range of activities in the home has improved providing the people who live there with a more fulfilling social life. Further development of specialist activities and the opportunities for external activities in the community should be considered. Choice and independence is promoted well in the home. Communication between relatives and the home is good Visiting is flexible. This ensures good contact is maintained between the people who live in the home and their family and friends. EVIDENCE: The activities co-ordinator provides a varied programme of activities for the people who live in the home. And would like to attend training to develop more appropriate activities for people with Dementia. The activities co-ordinator said she tries to motivate service users to join in but it is their choice as to whether they wish to participate. Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 Page 13 The activities co-ordinator said a lot of fund raising takes place in the home for the benefit of the people who live there. One service user spoken to mentioned she would like to go out in the garden but no staff were available to accompany her. Staff cover on the day of the inspection had an effect on freedom of choice for this individual. A comment card received prior to the inspection raised this issue regarding levels of staffing and supervision of service users. A relative commented, “Sometimes I feel there should be more staff”. Service users where observed at lunchtime having their meal. The lunchtime meal was attractively presented, portion size was good, choice of meal and desert. The atmosphere in the dining room in Hutton unit was observed to be relaxed. Tables where attractively set including a small vase of flowers on each table. Four of the five surveys returned where complimentary towards the choice and quality of the food, (One survey was completed by a relative so this question was not applicable). Comments from service users during discussion and surveys returned included: “Foods alright ”, “ Meals are good”, “ Food is nice”. A relative spoken to said, “ The food looks so nice. I could eat it myself ”. A service user said, “ The staff ask you the day before what you would like from the menu for your meals the following day”. The cook in the kitchen on the day of the inspection was unable to clarify if a choice of meals is offered to service users with special dietary needs. No records were maintained to provide evidence to show that this was happening. Bowburn Care Centre DS0000061553.V291894.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): 16 and 18 “Quality in this area is good. This judgement has been made using available evidence and a visit to the service”. Clear processes are in place to ensure that the people living in the home are protected from abuse. The home has a satisfactory complaints system in place. To enable service users and other visitors to make their views known on the service delivery. EVIDENCE: The home has a clear complaints procedure in place. The complaints procedure is included in the Service User Guide and displayed in the home for service user and visitors’ information. A complaints record and outcome of concerns or complaints is maintained in the home. Visitors to the home can write comments or concerns in a book available in the reception area. A relative spoken to said she usually speaks to the manager if she has concerns and so far any issues have been quickly resolved by the manager. Staff personnel files examined included evidence to show that all staff have had a Criminal Records Bureau check. These checks had been carried out prior to commencement of employment. Training records examined showed that all staff have attended POVA (Protection of Vulnerable Adults) training. These processes ensure the people living in the home are protected from abuse. Bowburn Care Centre DS0000061553.V291894.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): 19 and 26 “Quality in this area is good. This judgement has been made using available evidence and a visit to the service”. The home meets its stated purpose in providing clean, comfortable and safe surroundings for service users, staff and visitors. EVIDENCE: On touring the home it was pleasing to see that there had been an improvement in the standard of cleanliness within the home. Two bedrooms had a slight odour and the dining room floor in Tilley unit was sticky. We discussed with the manager that following meals the dining room floor area should be cleaned to maintain a safe environment. The domestic hours should be reviewed to ensure that all daily cleaning tasks are completed. A cleaning rota is available in the kitchen and evidence of an audit by management being carried out on a regular basis is available. A report Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 Page 16 available following a visit from the Environmental Health officer was viewed and found to be satisfactory. Service users and relatives spoken to where happy with the standard of cleanliness in the home. Surveys received by CSCI prior to the inspection showed general satisfaction with hygiene in the home providing a clean and comfortable environment for service users and visitors. Since the last inspection it was pleasing that a specialist bed has been provided for a service user who has specific needs. The addition of this equipment has improved the standard of comfort and safety for the service user. Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 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 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, 28, 29 and 30 “Quality in this area is adequate. This judgement has been made using available evidence and a visit to the service”. Instability in staffing levels remains an issue. This has an effect on the continuity of care for the people who live in the home. Processes in place for protecting service users are satisfactory preventing them from being at risk of harm or abuse. EVIDENCE: The manager said it is difficult to recruit qualified staff for the home. But satisfactory arrangements are in place to ensure there is a qualified nurse available throughout the day. Qualified staff cover on night duty is satisfactory. Service users needs are being met but the home needs to continue to strive for stability in the staff team and continuity of care for the benefit of the people who live there. Comment cards received and discussion with relatives showed that they would like to see a familiar staff team. Staff training records examined showed that the home is continuing to work towards care staff achieving NVQ2 in Care. Mandatory and other training for staff is in place. A training programme is available but requires updating to show ongoing training for 2006/07. This ensures service users’ living in the home receives care and support from skilled and competent staff. Staff spoken to during the inspection were satisfied with management arrangements within the home and the training provided. Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 Page 18 Service users are protected from abuse by thorough recruitment processess being followed. Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 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 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): 31, 33, 35, 36 and 38 “Quality in this area is good. This judgement has been made using available evidence and a visit to the service”. The manager has a clear sense of direction for the home. The systems for consultation on the service offered in this home could be improved. The manager is aware of the importance of developing this area especially for relatives and other visitors. Management of money held on behalf of service users is satisfactory. But should be reviewed with regard to freedom of access and protection of service users’ rights. Good Health and Safety monitoring ensures the people who live in, work and visit the home can enjoy a safe and comfortable environment internally and externally. Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 Page 20 EVIDENCE: The manager is a qualified nurse who has many years experience in working with older people. The manager is positive towards developing his own skills and abilities to enable him to provide a good service to the people who live in and visit the home. The home has self-auditing systems in place to review aspects of its performance. But this needs to be developed to include seeking the views of service users and their relatives on the service provision. The manager said he is currently developing a format to enable relatives to make their views known. Two Nurse Practitioners visiting the home said they where happy with the care provided. They felt channels of communication between them and the home could be improved. A comment card received from another health professional raised this point. Records examined for money held on behalf of service users’ living in the home were accurate with appropriate signatures for all financial transactions. Money banked on behalf of service users is held in a non-interest pooled account. Service users at present can only access money held on their behalf from Monday to Friday. Both these practices are restrictive in not allowing 24hr access to their money and taking away the right to earn interest on money banked on their behalf by the home. Staff supervision records were available but the majority of staff had not had formal supervision from their line manager since November 2005. These records failed to show any assessment or discussion about the person’s role , work performance or career development. It was not clear as to whether the service they were providing was beneficial in meeting the needs of the people who lived there. Health and safety monitoring in the home is good. Records maintained were up to date. Service certificates for systems and disability equipment were available for inspection. Service users, staff and visitors are provided with a safe and comfortable environment. Other records viewed for the protection of service users were up to date. Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 2 1 x 3 Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 Page 22 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. Standard OP36 1. Regulation 18 (2) Requirement The registered person must ensure staff working in the home receive formal supervision with their line manager on a regular basis. To ensure staff are delivering a good standard of service to the people who live in and visit the home. The manager should receive formal supervision from his line manager on a regular basis. (Outstanding since the last inspection). The registered person must ensure money paid into the bank on behalf of service users is in the name of the individual service user and not pooled. The registered person must develop a process to enable relatives and other stakeholders to make their views known. The registered person should continue to recruit qualified staff for the home to provide continuity of care. Timescale for action 01/07/06 OP35 2. 20 (1 a) 01/08/06 OP33 3. OP27 4. 24 (3) 01/08/06 18 (1 (a) 01/06/06 Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 Page 23 OP26 5. OP15 6. 23 (d) 16 (2,I ) OP12 7. 14 (2,n) OP1 8. 4(1)c Sch 1 The registered person must ensure all areas of the home are free from any offensive odours. The registered person must ensure choice of meals are provided and a record maintained of service users with specialist dietary needs. The registered person must provide a range of activities inside the home and outside in the community to meet the needs of all service users. Providing a fulfilling social life. The registered person must ensure the Statement of Purpose is reviewed and updated at regular intervals. To provide prospective service users and their relatives with up to date information about the service offered. To enable them to make an informed decision about whether they wish to move into the home. 01/06/06 30/06/06 30/07/06 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard OP36 Good Practice Recommendations The registered person should review the formal supervision format for all staff to include: • • • OP35 2. All aspects of practice Philosophy of care in the home Career development 1. The registered person should ensure service users can access money held on their behalf outside office hours if they so wish Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Bowburn Care Centre DS0000061553.V291894.R01.S.doc Version 5.1 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. 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