Inspection on 20/09/07 for Bowgreave Rise

This inspection was carried out on 20th September 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

Bowgreave Rise 15/10/09

Bowgreave Rise 13/07/06

Bowgreave Rise 01/12/05

Bowgreave Rise 07/07/05

Bowgreave Rise 17/01/05

Bowgreave Rise 19/07/04

Bowgreave Rise 09/12/02

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 Bowgreave Rise Bowgreave Rise 1 Garstang Road Garstang Preston Lancashire PR3 1YD Lead Inspector Mrs Christine Marshall Unannounced Inspection 10:00 20 September 2007 th 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 Bowgreave Rise DS0000033165.V338618.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. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bowgreave Rise Address Bowgreave Rise 1 Garstang Road Garstang Preston Lancashire PR3 1YD 01995 603637 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) Lancashire County Care Services Mrs Joyce Reynolds Care Home 32 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (22) of places Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 32 service users to include up to 10 service users in the category DE (Dementia) and up to 22 service users in the category OP (Older Persons over 65 years) 13th July 2006 Date of last inspection Brief Description of the Service: Bowgreave Rise is a purpose built Local Authority home, located a short drive from the centre of the market town of Garstang. It is set in its own grounds, and has car parking space at the front and rear of the home. A garden area with seating can be found at the back of the home. The home provides personal care for older people, including people with dementia, and is equipped to suit the needs of its residents. All of the bedrooms are single rooms. Toilets and bathrooms are conveniently situated. There is a passenger lift to the upper floors, grab rails, raised toilet seats and ramps for easy access. There is ample communal space, with a large dining room and large lounge offset by smaller spaces around the home. A designated area is provided for people with dementia, with a dining room and two small lounges. The home is furnished to a satisfactory standard, and has a friendly ambiance. The most recent inspection report is available in the reception area of the home. At the time of this visit, (20/09/07) the information given to the Commission showed that the fees for care at the home are according to Local Authority funding scales, with added expenses for hairdressing, chiropody and newspapers. The home’s registered manager is Mrs Joyce Reynolds. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 5 Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process of Bowgreave Rise included a site visit to the home which was completed in one day, and unannounced, which means that the manager, staff and residents did not know it was taking place until the inspector arrived. Shortly before this visit, a thematic inspection visit took place, which was a special observation of people with dementia. This special inspection showed that the people who live on the dementia unit were very well cared for. A report about this special themed inspection was written. Time was spent sitting and talking with people who use the service and observing the day-to-day routines of the home and care staff, as they provided support. A tour of the home was undertaken and included bedrooms, lounges and dining areas, toilets and bathrooms. This was to assess whether the home provided a comfortable, homely environment for the enjoyment of everyone, and to ensure their safety. The manager completed a pre-inspection Annual Quality Assurance Assessment (AQAA) questionnaire before this key visit, which gave good information about the operational management of the home and helped in the planning of the visit. Comment cards were sent to the home for residents, relatives and visiting professionals to fill in; a good number were returned to the Commission; these showed that they were happy with the care at Bowgreave Rise. Comments from the residents included – “It is smashing.” “Aye, it’s grand here.” “I am very comfortable.” Discussions took place with the registered manager and members of the care staff and administration records were looked at. Everyone at the home was friendly, welcoming and co-operative throughout the visit. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? The home has been under review by the Local Authority, and therefore improvements and plans for the home have been on-hold. The outcome of this review is due within the next few weeks. There are now two members of staff allocated to work on the dementia unit, which means that the people who live there are appropriately supervised and cared for. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 8 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. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 9 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 Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 10 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): Standards 1 & 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home gathers enough information about prospective residents to ensure that their needs can be met. EVIDENCE: Although Standard 1 was not fully assessed on this visit, it was found that although the Statement of Purpose gave goodinformation about the home, it needed to be reviewed to reflect the current availability of bedrooms on the dementia unit, and also to provide more information about the services that are provided for people with dementia , plus any special considerations that might be in place for the people whio want to live at the home. A requirement has been made in respect of this at the end of this report. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 11 Pre-admission assessments were looked at and were completed satisfactorily; they include all aspects of physical, social and psychological care. These assessments are done by a delegated social worker and agreed by the resident and/or their family. The residents were unable to say that they knew about these assessments, but they said that they were happy about being in Bowgreave Rise. Members of staff aslo knew about the assessments and what was in them. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents health and social care needs are met and people are treated with dignity and respect at this home. Residents are supported and protected in their daily lives. EVIDENCE: Care plans are written records that describe the care that is given to each resident. Three of these were looked at and all of them were reviewed and updated. The senior carer on duty said that they knew about the care plans and that these generally reflected the care that was being given to each person. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 13 The residents were mostly unable to say that they knew about their care plans, but they did say that they were not really interested in them because they were well looked after. Health care opportunities are offered to all residents and there are records of GP, chiropody and physiotherapy visits. The medication system at the home is a monitored dosage system (MDS). The Pharmacy Inspector visited the home on 9th May 2007 and made two requirements under the Care Homes Regulations 2001 and one recommendation about safe practice. All of these have been complied with and the records were satisfactory; the home’s policy and procedure for medications have been updated to reflect the system. The residents were treated with respect, privacy and dignity, and there was a good personal interaction between resident and carer. Those residents who were able, and visiting relatives said that they were happy with the care given at the home. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are supported so as to promote the quality of their daily lives. EVIDENCE: There were records of activities programmes for the residents that included gardening club, themed parties, quizzes, church visits, board games, manicures and outings. The manager was advised that there needed to be more specific activities for the people on the dementia unit and she said that this was already being considered and developed. The activities programme at the home could be improved if there was a delegated activities coordinator to lead the programme, to devote time to this very important part of residents’ care. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 15 A recommendation has been made in respect of this at the end of this report. All residents are treated equally in that they were offered activities, therapies and outings, regardless of their level of understanding or mobility. However, as stated above, the home is now trying to promote more suitable activities for the residents who have dementia. Some residents were able to say that they enjoyed the activities, others said they were not really bothered and liked a quiet life. All residents seemed to be supported in their contact with the community, and a religious minister was at the home on the day of the visit. The home provides meal choices and nice dining areas. There was equality of opportunity, facility and choice for those residents on the dementia unit, who were served their meal in a nice dining room, with table settings and the same choices of food as those residents on the general care side of the home. The lunchtime meal was presented in an appetising way and the mealtime was relaxed and unhurried. The residents generally said that the food was good and that they had choices. Comments included – “The food is not bad at all.” “It’s (the food) ok.” “The meals are very nice.” There are four-weekly menus in place that are varied and nutritious. The kitchen was kept extremely clean. Diabetic and vegetarian diets are catered for thus again providing equality of choice for all residents. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s policies, procedures and practice make sure that residents are supported and protected. EVIDENCE: There are policies and procedures in place for complaints, whistle-blowing and adult abuse issues, and staff said that they were aware of these. Residents who were able and visiting relatives confirmed that they knew about the complaints policy and had no complaints whatsoever to offer. The Area Manager is currently investigating one complaint and the outcomes are due in the next two weeks. Training files showed that every member of staff have had abuse awareness training on induction to the home and staff confirmed this. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are provided with a comfortable, clean and hygienic environment and bedrooms are personalised. This means that residents feel at home with their belongings around them. EVIDENCE: Whilst registration is approved for 32 people, at this present time the home can only accommodate 31, because one of the bedrooms on the dementia unit is used as a staff sleeping duty room. The manager explained that there are planned changes by the local authority that will make the sleep duty room available again for residents. The Commission has requested information about this from Lancashire County Care Services at County Hall Preston. This must Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 18 be addressed in order to comply with the home’s conditions of registration, which states that the home can accommodate 10 people in this category and only 9 bedrooms are available on the unit. A requirement has been made in respect of this at the end of this report. A tour of the home showed that the general environment was good; furnishings were comfortable and there are aids and adaptations in place to give acces to all areas of the home and to help with the residents’ toilet and bathing needs. This makes sure that there is equal access for those residents who suffer from mobility problems or who have difficulty with bathing routines. However, the bathroom on the dementia unit was still not in use and the refurbishment of this is part of the Council’s planned changes for the home. It must be addressed as a matter of priority, so that the resdients on this unit do not have to go to another floor of the home for their bathing routines. A requirement in respect of this has been made at the end of this report. Bedrooms were personalised and comfortable and a number of residents were able to say that they were happy with their rooms. Policies are in place for the prevention of any cross infection. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents care needs are met through adequate levels of appropriately trained and experienced carers. EVIDENCE: Staff provision includes male, female and overseas personnel, showing that there is equality of opportunity at this home. The level of care staff with National Vocational Qualifications (NVQ) at the home were almost 100 which is above the required 50 and therefore very good indeed. All staff had been given Dementia Awareness and Abuse Awareness training along with mandatory training in Moving and Handling and Fire Safety. All staff training records that were examined confirmed that induction and training programmes were in in place. This is commendable. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 20 All records that were examined in the staff recruitment files were satisfactory and staff siad that they had undergone all of the employment checks before starting work at the home. The duty rota showed that on occasion, there was a slight drop in staffing levels, however the manager gave assurances that this was due to vacant posts which were being recruited for as soon as was possible. A recommendation has been made in respect of this at the end of this report. . Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are supported by an experienced manager and there are quality systems in place to make sure that they are protected. EVIDENCE: The manager is very experienced in managing care homes and holds the Registered Managers Award. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 22 The residents said that she was friendly and approachable and often seen around the home. There is a quality monitoring system is in place and the manager undertakes regular quality surveys. The results of these surveys, including graphs and a sample of stakeholder comments, are posted on the home’s notice board for residents and visitors to see. There are regular staff and resident meetings and staff confirmed that they had meetings. Records of residents personal monies that are kept at the home and monitored by the manager. Staff supervision programmes are in place and records of these were seen. Staff also confirmed that they had regular supervision. The manager was aware of the responsibilities of maintaining all health and safety certificates of service for fire, equipment, electric, gas and nurse call systems. However, as stated under the set of standards 1 to 6, the dementia unit is registered to accommodate ten residents but one of these bedrooms is used as a staff sleep-in room. Information in respect of this has been requested from the Lancashire County Care Services County Hall, Preston. Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 23 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 24 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. 1. Standard OP1 Regulation 4 Requirement An up to date Statement of Purpose must be produced to reflect the actual number of available bedrooms on the dementia unit and also to give adequate information about the dementia services that are provided at the home. If prospective residents are not given full information about the home and its services, then they may not be able to make a judgement about whether or not the home can meet their needs. The dementia unit must have a functioning bathroom for the residents to bathe in. It is not appropriate or convenient for residents to be taken off their unit to another level of the home for a bath. Plans must be put in place for this to be addressed. The registered categories of the home must be complied with, in that ten bedrooms for dementia residents must be provided. This is non-compliance with the Care Home Regulations 2001 and DS0000033165.V338618.R01.S.doc Timescale for action 01/12/07 2. OP21 23 01/12/07 3. OP38 23 01/12/07 Bowgreave Rise Version 5.2 Page 25 plans must be put in place to address this as a matter of priority. 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 OP12 Good Practice Recommendations It is strongly recommended that an activities co-ordinator be appointed to develop and promote social and diversional activities for the residents. In particular, activities should be designed for the benefit of people who have dementia. It is recommended that the vacant post for carers at the home be filled as a mater of priority so that the residents can be assured of adequate levels of staff at all times. 2 OP27 Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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. Extracts may not be used or reproduced without the express permission of CSCI Bowgreave Rise DS0000033165.V338618.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!