Inspection on 26/04/06 for Bowerswood Retirement Home

This inspection was carried out on 26th April 2006.

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

Bowerswood Retirement Home 23/09/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Bowerswood Retirement Home Longmoor Lane Nateby Garstang Lancashire PR3 0JD Lead Inspector Ms Jenny Hughes Unannounced Inspection 26th April 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bowerswood Retirement Home DS0000063244.V286096.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. Bowerswood Retirement Home DS0000063244.V286096.R01.S.doc Version 5.1 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.V286096.R01.S.doc Version 5.1 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). 23rd September 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. Information about the service the home provides is available in the form of a standard brochure, and also a detailed and clearly written guide which tries to cover everything a resident needs to know about daily life in the home. CSCI reports are readily available from the manager to anyone who asks to see them. As at 14th March 2006, the fee scale ranges from £325 to £370, with additional charges for chiropodist and hairdresser visits, and extra newspapers and toiletries requested. Bowerswood Retirement Home DS0000063244.V286096.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit to the home, in that the owners were not aware that it was to take place. The length of the visit was for 6 hours. Before the visit took place, the manager was asked to complete a preinspection questionnaire, and surveys were received from residents and their relatives, and visiting professionals. During the inspection visit, staff records and resident care records were viewed, alongside the policies and procedures of the home. The manager, residents and care staff were spoken to, along with a relative who called during the visit. Their responses are reflected in the body of this report. A tour of the home was made, viewing lounges, dining room, bedrooms and bathrooms. Everyone was friendly and cooperative during the visit. What the service does well: The home has some long-term experienced staff who lead by example with good practices and attitudes. Younger staff are enthusiastic and encouraged to develop by management with training courses. The management of the home is open, with easy communication between residents, relatives and staff. All of the residents said that the staff were friendly and kind. Care plans for residents are clear for staff to understand how to best look after each individual, and personal routines are respected. Meals are home-cooked, varied, with well-balanced choices. They are well presented, with meal times being pleasant and unrushed. The environment is warm, homely and safe. Very attractive grounds are kept well maintained. Bowerswood Retirement Home DS0000063244.V286096.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. Bowerswood Retirement Home DS0000063244.V286096.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 Bowerswood Retirement Home DS0000063244.V286096.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 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information the home gives to people about the services available, and the way it gathers information about people who want to live there, means that proper choices can be made about the suitability of the home. EVIDENCE: Individual records are kept for each of the residents, and there is a set procedure for admitting someone to the home, with a pre-admission assessment form being seen on three selected files. These are used by management to check that staff can give suitable care to each person, before the manager agrees that the home is the right place for them to live. The needs of someone who had been in hospital were properly discussed and assessed, and the staff at the home were able to then make good arrangements to care for the person. Bowerswood Retirement Home DS0000063244.V286096.R01.S.doc Version 5.1 Page 9 One service user said “I came and looked round the home with my daughter before I came, and the manager talked to me about what help I needed – she was very good” GP’s responses to a survey said that the home always communicates clearly and works in partnership with them, and make the right decisions if they cannot manage the resident’s care needs. Staff spoken to were aware of the needs of the residents they were looking after. “The senior staff always let us know what help any new resident needs. You need to know to feel confident you are doing the right thing”. Bowerswood Retirement Home DS0000063244.V286096.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 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs for everyone living at Bowerswood is well organised, meaning people benefit from individualised care and support. EVIDENCE: Individual care plans are available, identifying the areas of need for each person, and with clear instructions for staff for what they must do to meet that need. The assistant manager regularly reviews the way things are recorded, and tries to improve the information and instructions to staff to make improvements to the lives of the residents. One resident admitted to hospital was able to return to the home following a detailed care plan and specific staff training to meet that person’s needs. Appropriate equipment such as a hospital bed and an air mattress were put in place before re-admission. Ongoing liaison with nursing staff and clear records and information meant that the care provided was very effective. Bowerswood Retirement Home DS0000063244.V286096.R01.S.doc Version 5.1 Page 11 Care plans were signed and dated by the resident or their representative, to show that they were involved in deciding what the care needs were. Reviews are carried out regularly, signed and dated. The staff can look after people who have special needs, for example someone who is blind. They do this by making sure there are clear instructions for staff on things like not changing the position of furniture, and making sure they always tell the resident where things are. Staff use touch and direct speech with ease to make the resident feel part of the happenings in the home. This way the resident can retain some independence and feel included and equal to other residents in the home. Residents can choose to go where they wish in the home, and may see visitors in the lounges or dining rooms, or in their own room. Some residents prefer to stay in their own room, where staff were seen to knock and wait for an answer before entering. “I like to sit in my room quietly, but sometimes I sit in the lounge and join in what’s going on there”, commented a resident. “The doctor’s going to look at my knee next time he calls” said another resident. “He’ll come to my room though. I don’t want to sit in the lounge with him”. Medication was stored in a lockable trolley. Records were clear and up to date, and information leaflets about the medication were available. Staff assisting with the administration of medication had all been trained. “I have had medication training, you have to before you can help with any medication” stated a carer. Bowerswood Retirement Home DS0000063244.V286096.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, 15 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents daily lives and social activities are well catered for, and all people benefit from living in a home that works hard to ensure that people are provided with opportunities to live lives that are fulfilled. EVIDENCE: The individual care plans include information on each person’s life history, their religious needs, and which hobbies and activities they prefer. The activities in the home are based on people’s interests, such as singing with visiting entertainers, board games, bingo, and gentle exercises. During the visit a T’ai Chi instructor visited, and several of the residents enjoyed an hour long session of very gentle exercise with him in the lounge, chatting and laughing and listening to his advice on ways to keep as mobile as possible. Staff joined in and helped residents along. A staff member commented “We always join in with residents doing the activities to encourage them. I quite enjoy myself as well!” Some residents chose not to join in, and were able to watch, or sit in another lounge area. One resident had a walk in the garden. “I like to sit in my room Bowerswood Retirement Home DS0000063244.V286096.R01.S.doc Version 5.1 Page 13 quietly”, commented a resident, “but sometimes I sit in the lounge and join in what’s going on there”. “I like to join in”, said another, “I like this man who does T’ai Chi – its good to get a bit of exercise, keeps you going. We had a sing-a-long the other day as well.” A resident who is registered blind stated “I like to sit here (in the large entrance hall). There’s always people calling to see residents, I can hear what’s going on and can tell the staff. I do like listening to my radio (on the table in front of the resident). I don’t join in any activities, I like to keep myself to myself. The staff always make sure I know where everything is in front of me, and I know what’s happening in the home.” A staff member then explained to the resident that she was placing a drink on her table, and a cake if she wished. The resident commented, “ The food’s really good”. A visitor was sitting in the garden in the sunshine with a resident, and said, “The residents are very well looked after – we never have a problem. The girls are very friendly, and I can always speak to the manager or assistant if I want to” Staff address any diverse and individual needs in order to make sure each person is cared for equally, and feel as much at home as possible. A male resident explained, “I don’t want to be doing things in here, but I like to go and do some work in the greenhouse and the garden. The girls sometimes bring me things in if they’ve been shopping. They got me this pate this morning because they know I like it. They’ll put it on some bread for me.” Visitors call in the home through the day, all recorded in the visitors’ book by the front door, with some service users enjoying trips out with family. “My daughter comes to see me”, commented a resident, “We usually have a walk around the garden. I can ring her from my phone in my room to see when she’s coming. I love my room, and the girls are friendly here”. The sample meal taken was roast beef and Yorkshire pudding, and a choice of sweets. The dining room overlooked the large garden, and created a calm, relaxing atmosphere to eat a meal in. Staff quietly served individuals, tactfully helping where needed. “The meals are usually very nice,” stated one resident. Another explained, “I often eat my meals in my room. I prefer to do that”. The cook is a long-term employee, and knew the residents likes and dislikes, with records kept in the kitchen of this. She had tried preparing meals such as curries or pasta for a change, but found people preferred plain meals, although she was willing to make such meals if requested. “I try to have a good varied menu, and always speak to residents to make sure they like it. They come and tell me anyway – they would never hold back on that one!” Bowerswood Retirement Home DS0000063244.V286096.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, 18 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident their concerns will be listened to and acted upon. Staff have an understanding of Adult Protection issues, which protect residents from abuse. EVIDENCE: There is a complaints procedure in place, with a complaints book to record any complaints, which may come to the manager’s attention. The home’s complaints book has no records of complaints. Residents spoken to said they would “tell any of the staff” if they were not happy with something. Staff spoken to knew about the Adult Protection procedure, and what to do if they had any concerns. They said they would always act if they thought a resident was at risk. Also if it was a member of staff causing concern they would inform the manager. All staff attend abuse awareness training. Bowerswood Retirement Home DS0000063244.V286096.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 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a well-maintained environment, which provides aids and equipment to meet the care needs of the residents. It is a very pleasant, safe, and homely place to live. EVIDENCE: The large garden around the home overlooks the surrounding countryside, and 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. The home continues to be refurbished to plan, and was well under way at the time of the visit. The main lounge had been decorated, and new curtains had been ordered for the large bay windows. The entrance hall was being painted, Bowerswood Retirement Home DS0000063244.V286096.R01.S.doc Version 5.1 Page 16 and many of the bedrooms had been redecorated, all in discussion with the residents. “I think I’d like a pale green carpet in my room,” said a resident while being shown her nearly finished room by a carer, “It would go with the yellow walls. Or a beige one. I chose the colour for my walls”. Residents’ rooms all had several personal items in them, from small pieces of furniture to pictures and ornaments. Some bathrooms had been refurbished, and the kitchen had been completely refitted with new cupboards. Grab rails, assisted bath, raised toilet seats and a lift all go towards helping the mobility of people around 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 fittings that have broken. He also makes sure the garden is always neat and tidy. Environmental Health had visited the home in September 2005, and confirmed that there were no problems. A fire officer had visited the home in March 2006, and confirmed that fire regulations are complied with. 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 keep things nice,” commented a resident. 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.V286096.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 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is properly staffed, which means that the residents are supported by sufficient numbers of well trained staff. EVIDENCE: Staff files showed that the necessary recruitment checks had been carried out to ensure the protection of residents. References and Criminal Records Bureau checks were available, and notes of the interview were made. All new staff have induction training, and are given a staff handbook, which gives guidance and information on their terms and conditions, and working practices in the home. The staff group are a mix of long term experienced and younger enthusiastic male and female carers. Basic training has been attended by staff, including moving and handling, first aid, food hygiene, and fire safety. In-house training is also provided, such as infection control, opticians training, health and safety, diabetes awareness, and dementia care. NVQ Levels 2 and 3 are attended, and 50 of the staff have achieved NVQ qualifications. Bowerswood Retirement Home DS0000063244.V286096.R01.S.doc Version 5.1 Page 18 Staff spoken to said, “The training and support you get from the management is really good. You don’t have to do things if you’re unsure, they make sure you’re confident first. There’s always someone you can ask. It’s a nice place to work. We try to make this like a big family home”. Domestic and kitchen staff are an important part of the overall care team, and are involved in helping to guide residents, and generally chatting as they go about their work. Bowerswood Retirement Home DS0000063244.V286096.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 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an experienced manager and senior staff who work to improve services and provide an increased quality of life for residents. EVIDENCE: The owner and manager is a Registered General Nurse, and has worked in residential care for about 14 years, 8 of those in supervisory and management positions. A visiting relative confirmed that she is always able to speak to the manager and staff about the care provided, and felt it was a friendly place to be. A survey is used to get feedback from residents and their relatives, and the ones seen were all positive about the home. Resident meetings are also held, Bowerswood Retirement Home DS0000063244.V286096.R01.S.doc Version 5.1 Page 20 with family welcome if they wish, and minutes are taken of the discussions and any suggestions made. Visiting GP’s confirmed that staff demonstrate a clear understanding of the care needs of service users, and they were satisfied with the care provided to residents. Procedures in the home are regularly updated and the management team are open to suggestions on ways to improve systems. The manager is not responsible for handling any residents’ finances, and they either manage them themselves, or family help in this area. Clear records are kept of any personal allowances. Supervision of staff in the form of regular one to one meetings take place, with full records made. These are targeted to each staff member’s individual needs, and identify training needs and confirm correct working practices. Fire safety issues are discussed, with clear instructions in place. Two staff are named fire marshals. Bowerswood Retirement Home DS0000063244.V286096.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 X X 3 X X X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Bowerswood Retirement Home DS0000063244.V286096.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? 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. Refer to Standard Good Practice Recommendations Bowerswood Retirement Home DS0000063244.V286096.R01.S.doc Version 5.1 Page 23 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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