Inspection on 12/10/05 for Bowmead

This inspection was carried out on 12th October 2005.

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

Bowmead 12/07/08

Bowmead 14/08/07

Bowmead 16/08/06

Bowmead 05/05/05

Bowmead 07/12/04

Bowmead 18/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Bowmead 75 Hollway Road Stockwood Bristol BS14 8PG Lead Inspector Sandra Garrett Unannounced Inspection 12th October 2005 09:30 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 Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bowmead Address 75 Hollway Road Stockwood Bristol BS14 8PG 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) 0117 9039950 0117 9039951 brssbow@bristol.city.gov.uk Bristol City Council Mrs Loveta Elizabeth Allison Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46), Physical disability (1) of places Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate up to 46 persons aged 65 years and over requiring personal care 6 of the 46 beds to be used for intermediate care only for a period of six weeks up to ten weeks duration. One of the above six beds to be used for a person of 55 years or over. Date of last inspection 5th May 2005 Brief Description of the Service: Bowmead is a Local Authority home registered with the Commission for Social Care Inspection. It provides personal care only for older people over the age of 65 years, with a condition of registration that includes one resident under 65 years of age. The home recently included a six bed Intermediate Care Unit. This was set up to provide short-term care for older people who were not ready to return home after a hospital stay and needed some further support. However this unit has now been transferred to the management of South Bristol Rehabilitation Centre based in Knowle. Therefore the number of beds managed at Bowmead has now reverted to 40. The home is situated within the residential area of Stockwood in Bristol and is close to a parade of local shops that includes a café. These provide easy access for residents and there is a bus stop immediately outside the home. The home is arranged over two floors with lift access. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day and followed up outstanding requirements and recommendations made at the last visit in May ‘05. Opportunity was taken to tour the premises, examine a range of records and talk to residents and staff. Most of the residents were seen during the inspection and at least twelve residents were spoken with. What the service does well: What has improved since the last inspection? It was noted that the manager is working to find a way of making sure information about fees payable is entered on to residents’ contracts so that they are aware of the payments to be made. Some contracts were seen that showed appropriate information about this. A requirement made at the last visit in respect of signing for medications immediately after they are given, was met. A check of medication records showed very few gaps and ensures residents are kept safe in respect of being given medication. Staff at this visit were seen and heard treating residents with dignity and respect. It was clear that residents respond to staff in a positive way and the atmosphere was relaxed and jovial. A requirement in respect of ensuring water temperatures in residents’ bedrooms are satisfactory, was met. It was pleasing to note that all rooms now Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 6 deliver water to 43°c that is the recommended temperature. Further, external contractors had visited and completed a satisfactory check of all water temperatures to guard against Legionnellosis bacteria to ensure residents’ health is protected. This is good practice. 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. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 & 6 Attention is needed to ensure residents and their relatives/representatives are given the correct information about the home and its services at the point of admission. Improved information enables residents and their relatives/representatives to be more confident about fees payable when signing contracts. Attention is needed to ensure new residents’ cultural needs are recorded so that they can be clearly identified and met. EVIDENCE: It was noted that the Statement of Purpose is one that is used for all local authority care homes. Because of this any amendments are made centrally. It was however disappointing to note the amendments hadn’t been made to ensure all residents and their relatives or representatives are given correct information about services available. The Commission for Social Care Inspection will therefore take this issue up with the service manager responsible for management of Elderly Peoples Homes. The requirement is therefore suspended at this time. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 9 The manager said she is seeking to find ways of making information about fees payable accessible to residents and their relatives/representatives at the point of signing the contract. Some contracts were seen that included information about fees on them that residents had signed. One resident recently admitted spoke about her/his cultural needs. No care plan was available for this resident as s/he was still in the trial period. The manager explained how such needs were being met and was advised to clearly document them. It was pleasing to note that a care plan was submitted to the inspector following this visit that included details of cultural dietary needs. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 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 Residents are well looked after in respect of their health and personal care. Attention is needed to ensure care plans are regularly reviewed and updated in order to highlight residents’ changing needs. Improvement in recording medication administration now ensures residents are kept safe from harm. EVIDENCE: Three care plans were examined. These were clear and detailed, and used respectful and person-centred language throughout. Care plans contained photographs of each resident together with information about what they like to be called. Healthcare needs and how they are met were well-documented and included GP and district nurse visits plus chiropody, dental, sight and hearing. It was noted from the quality assurance survey carried out in July ’05 that residents consulted said they were not aware of a written care plan that was reviewed regularly. However residents had signed their care plans (or their relatives/representatives if they were unable to do so). Care plans had also been signed by home staff to confirm that the home can meet individual residents’ assessed needs. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 11 Monthly reviews of care plans were seen although it was noted that these were not being recorded consistently. Residents may be at risk if their needs change and this is not checked and followed by care plans being updated. A requirement made at the last visit in respect of signing medication administration sheets was met. The sheets were all examined and few gaps noted. All were signed correctly. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 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 Residents’ benefit from a good standard of social activities, entertainment and outings that are well-documented. EVIDENCE: Activities records were examined and it was noted that a good selection of activities, entertainment and outings were provided between June–October ’05. These included among others: • • • • Spending time in the garden during the summer months Visits from an organist, pianist and dance troupe Regular sing-a-long sessions and dancing Trips to Bristol Zoo and Longleat. Residents and one visitor spoke about the trip to Longleat that they all enjoyed. The visitor said he was impressed with the trip and the way staff cared for everyone that made it a good day out. Residents spoke positively about the activities and entertainment available to them and the staff commitment to this. Activities records themselves were in the main well documented with clear information about how residents enjoyed the particular activity. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 13 It was noted from the independent quality assurance survey report, that activities scored lower at 74 than all other areas surveyed (that scored over 80 each). However the inspector’s findings from this visit didn’t correspond with the survey. It was noted that some residents who responded to the survey had stated that they sometimes preferred not to take part in activities. This may therefore account for the difference. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 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 Residents’ benefit from a well managed and documented complaints process that ensures all their concerns are treated seriously. Attention is needed to ensure that residents who may be suspected of abusing others, also have their rights protected. EVIDENCE: Two complaints had been recorded since the last inspection. These were in respect of housekeeping issues and staff attitudes. Records showed clear details of the complaint, investigation and actions taken that were carried out and reported back to the complainants in a timely manner. Following the visit it was noted that an adult protection incident had occurred. Although prompt action was taken to prevent further occurrences, it was however done without a clear assessment of the situation and appropriate consultation. Further an appropriate meeting to decide strategy on how to protect residents was not convened under the policy guidance ‘No Secrets’ in Bristol’. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 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): 24, 25 & 26 Improvements made to the building and décor throughout the home ensures residents benefit from a homely and comfortable environment. Improvements in respect of maintaining appropriate water temperatures in residents’ bedrooms, now ensures residents are kept safe from harm. EVIDENCE: Bowmead has benefited from lots refurbishment over the past two years. The home was clean and hygienic at this visit and smelled fresh and pleasant. Residents’ bedrooms were all decorated individually with evidence of personal possessions in place that made them look homely. The smoking room had been decorated since the last inspection and looked bright and clean. Several residents were seen sitting in the room and expressed satisfaction with the décor although they said it was not the wallpaper they had originally chosen. The manager explained the reason for this – as both female and male residents use the room, a ‘unisex’ wallpaper was chosen to suit everyone. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 16 It was noted from a check of water temperatures that all were delivered at 43°c, following a requirement made over the last two inspections. Further it was noted that an external contractor had visited to carry out a Legionellosis check to ensure the water supply is kept free from this bacteria. A list of water temperatures for each room showed that all were reaching the correct level to prevent contamination. This is good practice. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 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 & 30 Regular monitoring of staffing levels ensures residents’ needs are met. Staff benefit from opportunities to gain qualifications and have regular training. Attention is needed to ensure staff records are kept to make sure residents are fully protected. EVIDENCE: It was noted that staffing levels remain low. However appropriate numbers of staff were on duty at this visit and one resident said s/he felt s/he was ‘being looked after fine, most of the time staffing levels are ok’. A visitor commented that: ‘the staff are friendly but always busy’. Agency and casual staff are used to ensure residents’ needs for care, activities and key time are met. It was further noted from the quality assurance survey report that the topic entitled ‘Management and Staff’, scored highest with 86 satisfaction level. Residents’ comments in the report stated: ‘good staff – work hard; and ‘this place is a godsend’. This is commended. The manager said that training in developing national vocational qualification in care was progressing and two new staff had started to do it. This is good practice. A requirement made at the last visit to ensure all staff photographs are kept on file in the home was partly met. Some files seen contained new, clear photographs although others had none. The requirement is therefore continued with a short timescale. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 18 The manager said that two sessions on effective recording skills had taken place at the home recently. Feedback from staff had been positive about the training that staff said they found useful. The manager also said that she was liaising with the community psychiatric nurse from the In-Reach team to come and do more sessions with staff on managing behaviour that challenges as some residents have mild forms of dementia or mental health issues. This is good practice. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 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): 32, 33, 35 & 37 Residents’ benefit from a manager who demonstrates an open and inclusive approach that ensures the home is a safe, supportive and pleasant space for them to live in. Attention is needed to improve the management of residents’ finances to ensure that they are better protected Care records need further improvement to ensure they reflect the quality of residents’ lives within the home. EVIDENCE: The manager was on duty at this visit and was welcoming and open to the inspection process. Throughout the day the manager and other management staff were observed dealing with a constant flow of issues and questions raised by residents, visitors and staff. At all times the attitudes were welcoming, open and inclusive especially towards residents. This is good practice. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 20 As mentioned earlier in this report, a firm of independent consultants had carried out the home’s quality assurance survey by in July ’05. It was noted that not only residents took part in the survey as visiting healthcare professionals were also asked to comment. The manager supplied a copy of the survey report at this visit. From all the six topics covered, high levels of satisfaction with living at Bowmead were noted. A random check of residents’ cash was done at this visit. All amounts were correct and cash sheets showed signatures for each transaction regular balance checks. However it was noted that some residents had low balances and from income received it was clear that they may not be regularly getting their personal allowances paid to them. A good practice recommendation is therefore made, as staff should ensure that residents are enabled to have the monies due to them paid regularly. A number of daily progress records were examined. These showed some improvement following the effective recording skills training. Records were clear and detailed and more positively written. Some good records were seen about behaviours and how they were dealt with and residents’ enjoyment of the trip to Longleat. However the main focus of care records is still meeting of personal and health care needs, rather than including some information that describes residents’ whole experiences of life in the home. In particular some key time records (of one to one social time), were brief and could have been interpreted as lacking imaginative ways of spending time with residents to help improve the quality of their lives. A continued focus on casual use of language that could be disrespectful to residents was also noted. Health and safety records showed clear evidence of regular checks to ensure residents are kept safe, together with regular contractors’ visits to maintain equipment. Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 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 3 3 3 X X 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 X 14 15 3 X 3 X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 X 3 3 X 2 X 2 3 Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 22 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. 2. Standard OP7 OP29 Regulation 15(2)(b) 19(1)(b)( 1)Sch 2 12(4)(a) Requirement Timescale for action 30/11/05 3. OP37 Each resident’s care plan must be reviewed at least monthly Photographs of each staff 30/12/05 member must be kept at the home (not met from the May ‘05) inspection) All care records for each resident 31/03/06 must be written in a positive way that focusses on their abilities not deficits and their whole experience and enjoyment of life in the home. (Not met from the May 05 inspection) 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 2. Refer to Standard OP35 OP18 Good Practice Recommendations Staff should take action to ensure that residents have the correct amounts of their personal allowances paid to them at least monthly All incidents of abuse should be dealt with in line with the procedure as set out in the ‘No Secrets in Bristol’ guidance Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bowmead DS0000036948.V257104.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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