CARE HOMES FOR OLDER PEOPLE
Bowerswood Retirement Home Longmoor Lane Nateby Garstang Lancashire PR3 0JD Lead Inspector
Ms Jenny Hughes Unannounced Inspection 23rd September 2005 1:00 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 Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 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. Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Bowerswood Retirement Home Address Longmoor Lane Nateby Garstang Lancashire PR3 0JD 01995 606120 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) Bowerswood House Retirement Home Limited Mrs Nicola Mary Theobald Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 24 service users in the category OP (older persons 65 and over). 28th April 2005 Date of last inspection Brief Description of the Service: Bowerswood House is a large, old house, approached down a narrow lane, and set in its own gardens surrounded by countryside, giving lovely views through the large windows in the lounge. It has been adapted to suit the needs of older people, for example, a passenger lift has been installed, and grab rails fitted around the home. It is a two storey house, with single, and a few double rooms, sited on the ground and first floors. All of the rooms are ensuite, with bathrooms being conveniently located. There is sufficient communal space with a large lounge, a dining room, and a spacious seating area inside the entrance to the home. There is ample car parking space, and Garstang is a short drive from the home. Staffing is provided over 24 hours, every day of the year. Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 3 hours, and was one of the two inspections which must be made each year. Additional inspections may be made if necessary. The inspection was unannounced, in that the owners were not aware that the inspection was to take place. A tour of the home was made, and rooms were inspected at random. Staff and maintenance records were viewed. Four staff on duty were spoken to, along with the handyman. Seven residents were spoken to. The manager was available, and discussed plans for the home’s development. What the service does well: What has improved since the last inspection? What they could do better:
Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 6 The manager needs to show that she is asking and getting the views of residents and service users as to their satisfaction with the home. The views of other people involved could also be sought, such as GP’s, District Nurses, or social workers. The information could then be used to improve things if need be. Formal monitoring of staff should be done, in the form of regular one to ones with each staff member. The manager has improved many aspects of the provision since she took over ownership of the home, and is aware that there are always further improvements that can be made. 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. Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 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 Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 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): These standards were not inspected at this visit. EVIDENCE: These standards were not inspected at this visit. Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 9 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): 9 The medication at this home is well managed, promoting good health. EVIDENCE: The pharmacy inspector visited the home on 4th August 2005, to inspect the way the home dealt with recording and administering medicines to residents. He was satisfied with the way things were done following his guidance. At this visit all records were available and up to date. Advice was given by the pharmacy inspector that signed prescriptions should be seen by staff, and checked that it is the correct medication, before the pharmacist dispenses. The manager is presently liaising with the local pharmacist to do this. Staff are aware of the medication procedures and were able to explain how they put it into practice. Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected at this visit EVIDENCE: These standards were not inspected at this visit Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 11 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): These standards were not inspected at this visit EVIDENCE: These standards were not inspected at this visit Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 12 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 The standard of the environment in this home is good, with the aim to constantly improve it. It provides residents with an attractive and homely place to live. EVIDENCE: The large garden around the home is well maintained and attractive, with seating where residents can enjoy the good weather. “I like to have a walk round if its not too cold” said one resident. There is a major refurbishment programme at present, with the new owners aiming to update the décor around all of the home. Residents confirmed that they have been asked what décor they prefer, and the manager tries to provide what is asked for. Some of the bedrooms have been redecorated, and the manager has a clear plan of action for the rest of the home. A handyman is employed to deal with the day to day work that staff note in a maintenance book, such as new light bulbs, or minor fixes to fixtures and
Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 13 fittings which have broken. A loose carpet strip in a bedroom was reported during the visit, and the handyman immediately secured it to make sure the resident was safe from tripping over it. Environmental Health had visited the home in January, and confirmed that there were no problems. Fire regulations are complied with, and staff records show that they all have fire awareness training, which is provided by Fire Prevention Services. The home was clean and fresh smelling at the visit. The manager has employed extra domestic staff, so that there are now two people covering this work, to make sure standards are maintained. “The cleaners are very good you know. They keep on top of things,” commented a resident. Two store cupboards containing cleaning materials were found unlocked. Staff must make sure these are secured after use to prevent any risk of residents gaining access to toxic substances, or of falling over equipment. The laundry area is away from the kitchen and dining area, and was clean and tidy. Staff spoken to were aware of the correct way to work to prevent and control infection. Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 14 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): These standards were not inspected at this visit EVIDENCE: These standards were not inspected at this visit Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 15 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 and 36 Formal systems for consultation with residents and relatives are not yet in place, although there is evidence that resident’s views are sought and acted upon. Staff are monitored and demonstrate a clear understanding of their roles. EVIDENCE: There are some methods in place to get the views of the residents, and their families, as to how they feel about how they are looked after in the home. These are presently through the residents meetings, which are held monthly, and also by using an ‘open door’ policy, where the manager and senior staff are always happy to discuss anything that concerns the residents or their families. Minutes of the residents meetings are put on the notice board in the
Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 16 lounge for all to see. A relative agreed that she felt able to approach the manager at any time. The manager needs to show that she seeks the views of all people involved in the home and its residents in as many ways as possible. For example a satisfaction survey would link to comments from individual and group discussions, and the results may help improve the service being provided. The manager showed the inspector how she is developing a survey, which has yet to be used. A plan has been made about who is to take formal one to one sessions with each member of staff. These would be a discussion on working practices and training needs, with individual records made, so that each session can look at what has been achieved since the last time, and what needs to be done next. The manager confirmed that regular informal discussions take place, and the formal one to one sessions were to start as soon as possible. Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 17 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 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 2 X X Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 18 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 33 Regulation 24 Requirement The manager must provide effective quality assurance systems based on consultation with residents and their representatives. (previous timescale of 30th June 2005 not met) The manager must provide regular formal staff supervision (previous timescale of 30th June 2005 not met) Timescale for action 30/11/05 2 36 18 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 19 Good Practice Recommendations The manager should ensure that store cupboards containing hazardous materials are locked when not in use. Bowerswood Retirement Home DS0000063244.V250400.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1 Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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