Inspection on 20/09/07 for Bowland Lodge

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bowland Lodge 17/09/09

Bowland Lodge 20/08/09

Bowland Lodge 25/07/06

Bowland Lodge 26/01/06

Bowland Lodge 27/09/05

Bowland Lodge 05/10/04

Bowland Lodge 22/04/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Bowland Lodge Western Avenue Newcastle Upon Tyne Tyne & Wear NE4 8SP Lead Inspector Alan Baxter Unannounced Inspection 09:30 20 and 21st 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 Bowland Lodge DS0000000434.V344209.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. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bowland Lodge Address Western Avenue Newcastle Upon Tyne Tyne & Wear NE4 8SP 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) 0191 273 4187 F/P 0191 2734187 Mr Ram Perkesh Malhotra Mr Darshen Kumar Malhotra Mrs Linda Parkin Care Home 36 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (12), Old age, not falling within any other of places category (21) Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One OP bed to be used to accommodate a named person in category DE, for a period of eight months from 5th December 2005 25th July 2006 Date of last inspection Brief Description of the Service: Bowland Lodge is a care home that provides personal care to 36 older people and people with dementia. The home is located within a residential area of the west end of Newcastle upon Tyne. The three-storey property is converted from two adjacent Victorian houses. A new passenger lift has recently been installed. There is easy access by public transport and to local amenities and shops. The fees payable are from £373 to £383 per week, with extra payments for hairdressing, toiletries and newspapers. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 25th and 26th July 2006. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 20th and 21st September 2007. During the visit we: • • • • • • Talked with people who use the service, relatives, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the manager what we found. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 6 What the service does well: This home has strong links with its local community and provides a service mainly to the people of that community. This means that residents are in familiar surroundings, can continue to use local shops, pubs etc. where they are already known, and are close to their families, who are encouraged to visit and be part of the home. The home makes sure that it can meet all a person’s assessed needs before it admits them to the home. The staff treat every resident as an individual, respect their different lifestyles, and provide each resident with a unique package of care. Each resident has a detailed care plan for each area of need that has been assessed. This is in place when they come into the home. Residents’ health needs are carefully assessed and are fully met. Residents are treated with great respect by the staff, and their privacy is upheld. The spiritual needs of residents are assessed and met. There is a religious service in the home every week. Residents are encouraged to take as much control of their own lives as they are able, and to be as independent as possible. Some residents are even helped to return to living independently in the community. Residents are very happy with the food and say there is plenty of choice. Their relatives and friends may join them for meals, at no charge. Any complaints are taken very seriously by the manager and staff and are quickly resolved. Residents are protected from abuse. The home is kept clean and tidy and a pleasant environment for residents. The home deals well with people from ethnic minorities and people with particular persuasions. Sessional workers who speak Cantonese and Hakka are employed. The home is well staffed, and always meets the required minimum staffing levels. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 7 The home is well managed, and the manager leads by example. She operates an ‘open-office-door’ policy. The staff group is knowledgeable and well motivated, and nearly all have achieved a National Vocational Qualification (NVQ). Attached health and social care professionals rate the service highly, and say that the home works closely with them and follows any advice given. None of the residents spoken with had any complaints, and none could suggest any ways to improve the service being given. Residents are generally well groomed. Residents’ health and safety are protected. What has improved since the last inspection? What they could do better: Care plans must be kept up to date at all times. Menus must be revised and must be followed. Staff must be kept up to date with their statutory training needs. Staff members must have individual training and development plans. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 8 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. Bowland Lodge DS0000000434.V344209.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 Bowland Lodge DS0000000434.V344209.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): 2, 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Every resident is given a written contact, so that they know their rights and responsibilities. Each new resident has his or her needs fully assessed before they move in, to make sure that the home can meet all those needs. The home does not provide intermediate care. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 11 EVIDENCE: Contracts: All eleven residents who returned a questionnaire said that they had been given a written contract when they first came into the home. All said that they were given enough information about the home before they decided to move in. Assessments: The care records of four residents were examined. All had been fully assessed by their referring social workers/care managers before the home had agreed to admit them. All had comprehensive assessments and social services care plans on file. In addition, there was evidence that the manager also carries out her own assessments of needs before admission, to make sure the home can meet all the needs. These assessments included ‘activities of daily living’, handling, diet, mental health (CAPE), spiritual, risk and social assessments. The home has a useful ‘preparation for admission’ document that records the process from initial referral, through visits to the home, and eventual admission to the home. This is good practice. All pre-admission visits to the home are fully minuted in the care record. The manager is planning to produce a DVD of the home for the information of potential new residents. Intermediate Treatment: The home does not provide Intermediate Treatment, so this standard does not apply. Bowland Lodge DS0000000434.V344209.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): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health, personal and social care needs are set out in individual plans of care, but these must be kept up to date. Residents’ health care needs are fully met. Residents are protected by the way the home deals with their medicines. Staff treat residents with respect. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 13 EVIDENCE: Care Plans: The care plans of four residents were inspected. A very good match was found between the list of assessed needs and the list of care plans. Care plans are sensitive and give an appropriate amount of detail to guide carers. They also cover all areas of the individual resident’s needs, including social and spiritual issues as well as health and physical needs. Care plans are in place on the day of admission to the home. This is good practice. The care plans are evaluated every month and any changes needed to the plan are recorded in these evaluations. However, the care plans themselves are not being updated as a result of these evaluations. This may cause confusion. Care plans must be kept up to date at all times. A requirement is made to this effect. Health Care: Study of the care records of the above residents showed that their mental and physical health needs are properly assessed by the social worker and the home. Specific risk assessments are in place for preventing pressure sores and for dealing with any problems of incontinence. Care records also show that these assessed needs are fully met, using the normal range of community based health provision (general practitioners, district nurses, opticians, chiropodists and dentists) and, where necessary, referral to specialists such as consultant psychiatrists, speech and language therapists, rehabilitation and intermediate care services, dieticians and occupational therapists. The manager keeps a central log of all contacts with health professionals, from the most routine chiropody appointment to an emergency admission to hospital, and is thus able to show the full range of health-related activities within the home. This is good practice. The home has three beds that are registered for persons under pensionable age who suffer from alcohol-induced dementia, and is developing expertise and experience in this specialist area. Residents may choose their own doctor. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 14 Residents are weighed every month, and nutritional care plans put in place, where necessary. An annual ‘flu jab is offered to all residents. All eleven residents who returned questionnaires said that they always receive the medical support that they need. Ten said that they always receive the care and attention that they need; one said ‘usually’. Medication: Study of the Medication Administration Records (MAR) showed that all medicines administered to residents are promptly recorded in the Medicine Administration Record (MAR); that all handwritten entries in the MAR are signed and dated; that a list of staff names, along with the initials used by them in the MAR, is being updated to allow for proper audit; and that a photograph of each resident has been attached to his or her page in the MAR, as a means of correct identification. The manager is pro-active in asking general practitioners to review residents’ medications. She also prevents the build up of unnecessary stocks of medicines by requesting drugs such as painkillers and laxatives on an ‘as and when required’-only basis. This is good practice. Only one person is currently prescribed with a ‘controlled drug’. The storage of and recording of controlled drugs were checked and found to be acceptable. All senior staff and most care staff have been trained in the administration of medicines. The home gets support from the Speech and Language department of a local hospital, who give invaluable advice with issues such as residents’ swallowing difficulties. Privacy and Dignity: Residents spoken with all said that the staff treat them with respect at all times. They also said that staff respect their privacy and always knock before entering residents’ bedrooms. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ previous lifestyles and preferences are respected, and the home is flexible to individual needs and wishes. Group activities have improved. The home actively encourages families to visit their relatives in the home. Residents are helped to exercise choice and control over their lives, and are encouraged to be as independent as possible. Residents enjoy their meals. The menus are nutritious but need to be more varied and detailed. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 16 EVIDENCE: Social Contacts and Activities: It was a requirement of the last inspection report that a wider and more varied social activities programme must be introduced for residents and activities and other opportunities for social stimulation must be better recorded. This has been carried out. Although a planned activities programme is not used, the manager nominates at least one activity daily, based on the known likes and interests of the resident group. Particular favourites are ‘theme’ days, where staff celebrate a particular place or country in costumes, decorations, food etc. Recently the home has had both ’Chinese’ and ‘Hawaiian’ days. Photographs of such events are displayed in the dinning room. There is also a DVD record of some events, that is played back to the residents for their amusement. The home has a large minority of male residents, and sport is very popular. Staff will place bets for residents, if requested. Each resident has had an individual assessment of their social needs, and a personal care plan drawn up to meet their social needs. The home organises regular trips out, to the countryside, the coast and to hotels for afternoon teas. Different entertainers visit the home about every six weeks. There are many old photographs of the home and of the local area, and lots of other memorabilia, making it a stimulating environment for residents. The home has a large and very affectionate cat, and a rather depleted fish tank. A mobile library visits regularly. There is a weekly religious service held in the home. The home has sessional workers who work with the home’s Chinese resident. The workers speak Cantonese and Hakka. Other carers use a basic phrase book, with pictures, to communicate with the resident. It was noted that staff give very generously of their own time to support residents’ activities and lifestyles. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 17 It was a recommendation of the last inspection report that the home should employ an activities co-ordinator. This has not been carried out. However, the overall improvement in activities makes this less necessary. Minutes of residents’ meetings show that they are fully involved in deciding on activities. It was agreed that the staff member allocated to lead each day’s activities should be also responsible for making an entry in the home’s daily diary, recording these activities. In the future, the manager hopes to have Sky television installed, and more garden furniture and a greenhouse purchased. Eight of the eleven residents who returned questionnaires said that there are usually activities for them in the home; the others said ‘sometimes’. Community Contact: The home actively encourages families to visit their relatives in the home. An example of this very positive policy is the fact the family members may take meals and other refreshments in the home free of charge. The home has many links with the local community and most of the residents are local people. This means that residents are in familiar surroundings, can continue to use local shops, pubs etc. where they are already known, and are close to their families, who often already know each other. Visitors are welcome at any reasonable time (and, indeed, with prior arrangement, at an unreasonable time). However, residents may also refuse to see any visitor, if they so choose. Staff will escort residents where they are unable to go out independently. The home is buying a minibus to increase its ability to get residents out into the community. Autonomy and Choice: There is ample evidence in the care records and from discussions with residents that they are encouraged and supported to exercise choice and control over their lives. Residents chose what to eat and when; when to get up and go to bed; what they are called; what they wear; where and when to go out; whether or not to see visitors; whether or not to join in activities, and many more examples. Risk assessments are carried out as necessary, but the ethos of the home is that living must contain some level of risk. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 18 Residents may handle their own financial affairs; three currently do so. Advocacy services are advertised on the home’s notice board. Residents may bring personal possessions with them when they enter the home. Meals: It was a requirement of the last inspection report that a four-week menu must be introduced, and vegetables specified. This has not been carried out. Menus continue to be limited to a two-week period and still don’t specify the vegetables offered. A four-week menu is required, to improve variety and choice, and this must also include each day’s vegetables. The menu should also be followed, unless there is good reason. This requirement is repeated in this report. It was noted, however, that the cook is very flexible, puts at least two (sometimes three) choices on each day’s menu, and makes every effort to meet individual requests. Also, that there is plenty of food (“too much food”, said one resident), and the meals are nutritious and tasty. The dining room tables are nicely set and the food well presented. Most residents have a cooked breakfast daily. Three of the eleven residents who returned a questionnaire said that they always enjoy the food; the others said ‘usually’. The meals take account of the needs and wishes of any residents from an ethnic or cultural minority. Two residents need a soft diet, and their meals are pureed. As noted in standard 13, above, relatives and other visitors are welcome to take a meal or snack with the residents, without charge. This helps give a communal feel to the home, and makes mealtimes an even more enjoyable experience for the residents. Residents may have a snack or a drink at any time of the day or night, upon request. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 19 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are confident that any complaints will be taken seriously and properly attended to. Residents are protected from abuse. EVIDENCE: Complaints: The home’s policy is to pick up and deal with small concerns promptly, to prevent such problems becoming more serious. All eleven residents who returned questionnaires said that they knew how to make a complaint. Nine said that they knew who to speak to if they were unhappy (one said ‘usually’; another said ‘sometimes’.) The home’s complaints records were examined. Two complaints have been logged in the past year. Both were responded to, promptly and appropriately, with a letter of apology being sent to the complainant in the first one (laundry quality); and appropriate action taken in the second one (a missing item, quickly found and returned). Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 20 The manager demonstrated a positive attitude to complaints Protection: No allegations of abuse of residents have been received in the past year and there has been no use of physical restraint of any resident. No staff member has been disciplined or dismissed in the past year. The home’s policy and procedure on the prevention of, and response to, allegations of abuse are robust, and include a policy on ‘whistle-blowing’ (the reporting by staff of bad practices or abuse). Seven staff have attended a thirteen-week day release course on protection of vulnerable adults (POVA) and the manager is arranging for another four care staff to attend similar training. Other staff have covered adult protection issues as part of their National Vocational Qualification training. The home’s policy on physical intervention with residents by staff is currently being reviewed, to clarify what constitutes acceptable physical intervention by staff in Bowland lodge. Residents said that they feel safe in the home. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe and generally well-maintained environment. The home has improved the provision of hand-washing facilities. The home is kept clean, tidy and hygienic. It is kept odour-free. EVIDENCE: The Premises: The location and layout of the home is suitable for the home’s stated purpose. It is accessible, safe and generally well maintained. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 22 There is a programme of maintenance and renewal of the fabric and the decoration of the home. Improvements in the past year include the start of external stonework painting; the redecoration of all the bathrooms, with non-slip flooring being put down; the redecoration and re-carpeting of three first floor bedrooms; the redecoration and refurbishing of one of the large ground floor lounges; and improvements to the entrance lobby. All bedrooms on the ground floor are being redecorated. Plans to replace all the windows of the home are on hold, pending a structural engineer’s report on the condition of the stonework. The ground floor lounge used as a smoking lounge has been redecorated and has had improved ventilation installed, and it meets the requirements of the recent legislation on smoking in public places. Lavatories and Washing Facilities: It was a requirement of the last inspection report that a wash hand basin must be provided in the toilet opposite room 29. This has been carried out. Hygiene and Control of Infection: The building was toured. All areas seen were clean, hygienic and free from unpleasant odours. The smoking lounge has benefited from improved ventilation. Systems are in place to control the spread of infection. The laundry is appropriately sited. There is suitable provision of hand washing facilities. Disposable gloves and aprons are available to staff. Care should be taken to make sure that paper towel dispensers are kept supplied at all times. One resident told the inspector that the home is kept “spotlessly clean”. Domestic staff are congratulated on keeping such high standards of cleanliness in such a large old building. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and the skill mix of staff in the home meet residents’ needs. Residents are in safe hands at all times. Residents are well protected by the home’s recruitment practices. Staff have been given a good level of training and are competent to do their jobs, but some refresher training is needed. EVIDENCE: Staff Complement: Staff rotas were examined. Daytime staffing levels are unchanged, at the agreed level of four carers at all times between 8am and 8pm. Nighttime staffing levels have been increased to three carers on duty overnight. The manager, Mrs Parkin, confirmed her opinion that these levels meet the needs of the current group of eighteen residents. The manager is supernumerary to the rota. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 24 Domestic cover is provided each day, at the rate of 85 hours per week. There is 30 hours laundry cover between Mondays and Fridays. There is a settled staff group, with very little staff turnover. Four of the eleven residents who returned questionnaires said that there were always staff available when they needed them; the other seven said ‘usually’. Staff Qualifications: Study of the home’s staff training records showed that 94 of the care staff have achieved National Vocational Qualification (NVQ) level two in care. This obviously exceeds the required 50 . This is good practice. In addition, seven staff now hold NVQ level three, and a senior carer is doing NVQ level four. Again, good practice. Recruitment and Selection: It was a requirement of the last inspection report that any gaps on the employment history of job applicants must be explored and the reasons recorded; and that each applicant must provide two work references, including current/most recent employer. These requirements have been carried out. The personnel records of two staff employed in the past year were studied. All the required elements were in place, including fully completed application forms; Criminal Records Bureau (CRB) checks; written references etc. The manager is amending the interview record to include prompts to check that any gaps in an applicant’s application form or employment history are picked up and challenged. Staff Training: As noted in standard 28, above, there has been a commendable emphasis placed on NVQ qualifications for all care staff. A side effect of this is, however, that some of the routine statutory training that all staff are obliged to keep up to date has been missed. This training includes fire safety, moving and handling, first aid, control of infection and food hygiene. It was agreed with the manager that such training needs to be brought up to date for all staff within the next six months. A requirement is made to this effect. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 25 Study of staff training records also showed that no individual staff training and development plans are in place. This is also made a requirement in this report. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 26 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed. The home is run in the best interests of the residents. Residents’ financial interests are protected. Staff are receiving the required level of supervision. The health, safety and welfare of the residents and staff are protected. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 27 EVIDENCE: Day to Day Operations: The manager, Mrs Parkin, is studying for the Registered Manager Award, and hopes to finish this by the end of the year. She will then start studying for the NVQ level four in care. She has nine years experience in managing care homes, and twenty years experience in the care of the elderly. There are clear lines of accountability within the home, but the manager is aware that she needs to delegate some functions that could well be taken over by other staff members. The home is currently seeking to employ a part-time administrative assistant. Quality Assurance: There is a range of ways in which the home seeks the opinions of its residents. Regular meetings are held with the resident group and relatives are welcome to attend and speak at these. Meetings are written up by the manager, and show that any resident requests are responded to. Examples of this were changes made to menus and meal times, and the fitting of bedroom door locks, where wanted. Residents are also consulted as to the choice of decoration and furnishings. The manager is hoping to set up a residents’ committee, hopefully chaired and run by the residents themselves. A suggestions box is being introduced. More formal consultation, in the form of a survey sent to all residents, takes place. At the time of this inspection, a survey was being sent out to all residents and relatives. The manager operates an ‘open door’ policy and residents and relatives can speak to her at any time. The home’s inspection reports are displayed in the home for anyone to read. Residents’ Money: The person in charge of the home is able to access money held on behalf of residents at their request or as part of an authorised inspection of the home. Residents sign for their transactions, where able. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 28 There was evidence of visits by the Lord Chancellor’s Visitors, on behalf of the Court of Protection, to check that Power of Attorney is being properly carried out. This is a safeguard for residents. A spot check of the accounts of money held on behalf of two residents showed that both were correct to the penny. The manager and proprietor conduct an internal audit of residents’ money every month. Receipts are kept for all transactions. Staff Supervision: Formal staff supervision takes place every two months, as is required by this standard. Meetings are recorded in good detail. Minutes showed that the manager is very supportive of good practice, but also clearly identifies any areas where improvements are needed. Staff are encouraged to give their opinions and input to these meetings. Safe Working Practices: Documentary evidence was seen of the usual range of servicing and maintenance contracts, such as lifts, hoists, alarms and fire equipment. All are being kept up to date. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 29 The required staff training in health and safety-related issues such as moving and handling, food hygiene and fire safety is discussed in standard 30, above. The home’s fire logbook is also kept up to date, and records show that the necessary checks and tests of fire equipment and systems are undertaken. Staff are taken through the home’s fire safety policy and procedures in every supervision session. Risk assessments for health and safety, Control of Substances Hazardous to Health (COSHH), and fire safety are in place. The home’s accident book is well recorded, with every accident being followed up by the manager personally. Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 30 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 31 YES 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 OP7 Regulation 15.2 Requirement Care plans must be updated in line with changes noted in their monthly evaluations. A four-week menu must be introduced, with vegetables specified on the menu. The menu must be followed unless there is good reason. 3. OP30 18.1 All staff must be brought up to date with statutory training needs. All staff must have an individual training and development plan. 31/03/08 Timescale for action 30/11/07 2. OP15 16.2 30/09/07 4. OP30 18.1 31/12/07 Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 32 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 Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Bowland Lodge DS0000000434.V344209.R01.S.doc Version 5.2 Page 34 - 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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