Inspection on 16/08/06 for Bowmead

This inspection was carried out on 16th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 12/10/05

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 Key Unannounced Inspection 16th & 17th August 2006 08.50 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.V295089.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. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 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.V295089.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION 1. May accommodate up to 46 persons aged 65 years and over requiring personal care 12th October 2005 Date of last inspection 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. Six beds at the home are now used as an interim placement unit for people discharged from hospital but waiting for a place in another care home. Bowmead 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. The range of fees payable for local authority care is £451.99 to £584.99 (for dementia care homes). Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place over one and a half days. Records such as the pre-inspection questionnaire, care plans, complaints and health and safety were used among others to gain evidence for this report. A number of residents were spoken with and all expressed satisfaction with life at the home. No service user surveys were completed at this visit as the inspector met the independent quality assurance surveyors who were visiting the home to carry out the yearly survey for the registered provider. What the service does well: What has improved since the last inspection? Two of three requirements made at the last visit were met. It was pleasing to note that the majority of staff had photographs inserted in their personnel files. The files were in good order and contained necessary information to ensure residents are protected from risk of harm. Care records were improved and written in positive ways that demonstrated respect for residents’ lives and choices. Residents can be confident that records written about them are non-judgemental and person-centred. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 6 One good practice recommendation had been implemented: it was pleasing to note that residents’ cash sheets were in good order and accurate balances held for them. Residents’ personal allowances were all being paid to them regularly and the manager was clear about following up any difficulties with this. Residents can be confident that they are able to access personal allowances that give them greater choice and autonomy in their lives. 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.V295089.R01.S.doc Version 5.2 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.V295089.R01.S.doc Version 5.2 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): 2, 3, 4 & 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents benefit from having clear contracts that set out the information they need. Attention is needed to make sure admission arrangements ensure residents’ assessed needs can be met or action is taken quickly to find a more suitable placement. Attention is needed to ensure the home can meet the specialist needs of any resident admitted. Residents with specialist needs benefit from being treated with equality of opportunity. Attention is needed to ensure that residents admitted to the interim placement unit have the same rights and choices as other residents. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 9 EVIDENCE: Contracts were seen in residents’ files. Either residents or their relatives had signed these. Contracts included room numbers and the overall fee payable, although the manager said that residents subject to Social Services and Health support have their individual contributions worked out after admission. Social work or health assessments were seen for those residents recently admitted. These assessments gave information about the person including personal history and preferred name. A letter from a psychiatrist was seen in one resident’s file that gave lots of information in respect of personal history that staff would benefit from reading. It was suggested that this letter be placed at the front of her/his file for staff to read. Care plans had been developed from the assessments and matched the identified assessed needs. However one resident had been assessed as being able to manage in a care home although s/he had a clear diagnosis of dementia. The manager and staff said that there had been difficulties in respect of meeting this resident’s needs since admission and it was clear that a care home such as Bowmead wasn’t the most suitable environment. The manager said that some emergency admissions were accepted by the home on receipt of assessments although with minimal discharge information. These admissions were often of people with either mental health problems or clear diagnosis of a type of dementia. Both manager and staff were open about the difficulties they experienced in trying to care for these residents whilst short of staff and without too much negative impact on permanent residents’ lives. No evidence was seen of the home confirming in writing that it is able to meet these residents’ needs as required under regulation. Where such needs cannot be met by the home alternative accommodation must be sought as soon as possible. Equality and diversity issues were reviewed at this visit. No black or minority ethnic residents currently live at the home. Specialist diets are catered for and well managed by cooks and kitchen staff. Residents with communication needs are given clear assistance i.e. the manager said that staff have learned to ‘read’ the resident’s communication, aids are used where helpful and note taking also assists. Residents are enabled to have personal relationships with each other if they choose and these are given privacy and acceptance. Residents’ religious needs are observed wherever necessary and they can choose whether to attend any service held in the home or community. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 10 Until recently Bowmead housed a six-bedded intermediate care unit although South Bristol Rehabilitation Centre in Knowle managed this. This unit has now been transferred back to the Centre and the beds are being used as an interim placement unit. This means that older people in hospital needing a place in a care home can be discharged to Bowmead, thereby freeing up the hospital bed. The unit enables people to get an idea of life in a care home environment whilst they are waiting for a place to become vacant in the home of their choice. However a situation had occurred whereby a service user admitted to one of the interim beds had not wanted to stay, by choice. However s/he could not return to hospital because the bed had been given to someone else. A meeting is to be arranged with NHS staff, Bowmead management staff and the inspector to ensure service users admitted to the unit are given the same rights and choices as other residents. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 11 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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Attention is needed to ensure residents’ personal care needs are reviewed and updated regularly. Residents are looked after well in respect of their healthcare and medication needs. Residents’ benefit from being treated with dignity and respect. EVIDENCE: Three care plans were reviewed at this visit. Care plans on the whole were detailed and comprehensive with clear actions of how to manage both physical and mental health care needs. Care plans matched the pre-admission assessments seen in residents’ files. One care plan had not been fully developed although it was clear much work had gone into ensuring that residents’ needs had been identified with clear actions recorded of how to meet them. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 12 However it wasn’t clear how residents preferred names were used. One preadmission assessment referred to the resident’s choice of name but this wasn’t used immediately in care plan or daily records. Care plans didn’t show evidence of monthly review or updating, although sporadic six monthly review sheets were seen. It was noted that one resident’s needs had changed significantly over recent months but the care plan didn’t reflect this at all, although the manager said a new one was due to be prepared shortly to reflect the changing needs. The manager said monthly reviews were being done but not recorded although staff are urged to make sure that they are. A way must be found of ensuring care plans are reviewed each month. Further, evidence of changes found must be recorded to ensure residents’ changing needs have been identified and met. Clear healthcare records showed that residents are well cared for in respect of their health needs. In particular it was clear that one resident’s problems with sight and hearing had been clearly and swiftly managed despite difficulties with an eye infection and a hearing aid. Doctors’ appointment sheets were seen that showed GP’s were called quickly when necessary. Reasons for the visit and GP’s comments were seen recorded. Regular visits from opticians and a chiropodist were also seen recorded in care files. The home also promptly notifies The Commission for Social Care Inspection of incidents affecting residents’ health and welfare. One resident had a good mental health care plan that showed clear actions of how to manage behaviours appropriately. Medications administration was observed at breakfast. The manager gave out medications and did so appropriately, ensuring residents took their medication when she gave it to them. Medication Administration Sheets were all appropriately signed although some gaps were noted on one resident’s sheet for one medication only. No reason had been given for the gaps and the manager could shed no light on it. Medications are stored in a locked room within locked metal cabinets that are fit for the purpose. Medications treated as controlled were seen appropriately stored within the cabinet and signed for with witness signatures in a separate book. Quantities were checked and all found to be correct. Staff were observed throughout the two days of inspection and respectful attitudes were noted from all. Residents said that staff are good and treat them well. It was noted that residents were treated with helpfulness, dignity and respect by all staff. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 &15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents benefit from a stimulating and varied life where various formal and informal activities are made available. Contact with the local community ensures residents are able to exercise choice and some control over their lives. Residents’ benefit from meals that are well managed and provide daily variation, good nutrition and social contact for residents. EVIDENCE: Activities records were reviewed at this visit. These showed clear evidence of residents’ enjoyment of the particular activity or entertainment provided. It was noted that activities don’t always happen weekly (although a bingo session was held on one of the days of this inspection). Staff spoken with said that usually some activity is provided once or twice weekly. However records didn’t reflect this. A good range of activities was recorded including quizzes, bingo, games, DVD’s, a walk around Stockwood, entertainers and a visit to Almondsbury Garden Centre. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 14 Staff also spoke about the difficulty of providing regular key time with each resident. From the conversation it was difficult to know whether key time was provided one to one or used to offer group activities. Staff said that some residents don’t want key time or to join in with activities, preferring to stay in their own rooms. Staff also said that those who do choose to have key time prefer to sit and chat or have personal care tasks done for them e.g. bathing. Residents have a high degree of local contact with the community as the home is situated across the road from a diverse range of shops. These include an ethnic restaurant, supermarkets and post office, hairdressers and charity shop together with a cake shop and café. The area also benefits from a GP practice nearby and sheltered flats next door. The manager said that residents who are able to go out are well known in the local community as they shop there regularly. A local church group comes into the home and services are held for anyone to attend if they wish. Residents are free to choose if they want to go to the local shops or stay in. They can have visitors throughout the day whenever they wish. They have choice of sitting areas in the home or can stay in their rooms watching TV or reading. A choice of meals and activities is offered throughout the week. The inspector observed breakfast at the home. Some residents prefer to have breakfast in their rooms and this is taken to them on trays by staff. Cooked breakfasts are available together with cereals and toast. One resident was seen enjoying a full English breakfast and another had scrambled egg and toast. Each table held a pot of tea for residents to help themselves and age appropriate music was playing quietly in the background. Residents are offered two choices of midday meal each day and a high tea if they wish. Residents said the food is good at the home and meals are well cooked. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Satisfactory complaints management and recording ensures residents can feel confident in raising concerns about any aspect of their care. Arrangements for protecting residents ensure that residents are protected from risk or harm as far as possible. EVIDENCE: Residents spoken with at this visit said that they had no complaints and the atmosphere was cheerful. Only one complaint since the last visit was seen recorded in the appropriate file. This was in respect of agency staff attitudes and was well recorded with clear actions and outcomes. The complaint was responded to well within the 28-day timescale. This is good practice. No abuse issues were raised at this inspection. Staff spoken with said they felt confident in recognising and dealing with any potential abuse issue they may be confronted with. The manager endorsed this but went on to say that staff needed support to be able to identify personal relationships between residents that were loving and caring and not abusive. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents benefit from living in a well maintained, comfortable, clean, safe standard of accommodation. EVIDENCE: Bowmead has benefited from a high level of refurbishment and redecoration in recent years. This has resulted in a good standard of accommodation for residents to live in. The home has been identified for possible closure within the next two years but ongoing maintenance and refurbishment is continuing to ensure the home is comfortable and of a good standard. Most recently the dining room floor had been replaced with a wood effect linoleum that is water resistant and non-slip. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 17 Residents’ rooms were of different sizes and shapes. Some residents benefit from large airy rooms (that were once doubles) whilst others had smaller rooms. However all bedrooms were well appointed with appropriate furniture and fittings. One resident with dementia had highlighted in her/his care plan the need for more personal items in the bedroom. The inspector saw this room and noted photographs and items to do with the resident’s interests and hobbies. However the room had an unpleasant odour that the manager said came from the carpet. It was advised that this should be replaced. The manager immediately took action to ensure this would be done. This is commended. The remainder of the home was fresh, clean, hygienic and pleasant smelling. Some areas needed attention e.g. replacing ceiling tiles that had water staining from a previous leak, but the manager said she keeps a list of premises items that are gradually being repaired. The handyperson who was available on both days of inspection also does small repair works where necessary. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 18 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents benefit from sufficient numbers of care staff to meet their needs. Continuing National Vocational Qualification in Care training ensures residents’ needs can be met appropriately. Robust staffing checks ensure residents are kept safe from risk of harm or abuse. Attention is needed to ensure residents needs can be met from having appropriately trained staff. EVIDENCE: From the pre-inspection questionnaire it was clear that residents’ dependency levels could be high, particularly for those who experience mental health impairment. Staff spoken with were open about the difficulties of meeting these residents’ needs appropriately. Reasons given for this included: high numbers of agency staff used, the changing agency workforce with few ‘regular’ staff who can build up knowledge of residents and work more strategically, and lack of suitable training. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 19 From a review of rotas submitted with the pre-inspection questionnaire it was noted that a minimum of three care staff are on duty each morning, three in the afternoon and three in the evening. Other staff are available in ‘crossover’ times e.g. from 9–3 pm. The manager said if dependency levels are particularly high extra staff can be called in but these are likely to be from an agency. The home currently has three care staff vacancies. Residents didn’t comment on lack of staff although they had done so at previous visits. Overall residents said that the staff are good and try to meet their needs. The manager said that progress with National Vocational Qualification in Care training is slow due to staff vacancies and lack of time for remaining permanent care staff to do it. One temporary member of staff said she would like to do the training. However priority is currently given to making sure all permanent staff are given opportunities to take it up. From the pre-inspection questionnaire the number of staff with NVQ level 2 has reached 25 , that is 25 lower than the recommended minimum standard. A requirement made at the last two visits in respect of staff photographs to be kept at the home was met. All staff records were checked and recent photos seen in each with few exceptions. Those exceptions were for staff who had just joined or who had been on sick leave when the photos were taken. The manager said she would make sure that all staff files contained a clear photograph. Staff files also contained personnel information including Criminal Records Bureau disclosures, application forms, references and proof of identity. This is good practice. During the discussion with staff in respect of residents’ dependency levels they admitted to having had little training in the care of older people with mental health impairments or dementia. Some staff had done dementia awareness training some years previously. In the inspector’s opinion provision of recognised training in mental health and dementia awareness and care would give care staff greater confidence in meeting these residents’ needs and reduce the difficulties of caring for them. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home benefits from having a trained and experienced manager who is registered with the Commission for Social Care Inspection. Suitable mechanisms for enabling residents to comment about their satisfaction with life in the home enables residents to be sure their views and opinions will be taken into consideration. Residents’ finances are well managed that ensures they are protected from financial abuse. Whilst care recording is objective and factual attention is needed to ensure key time records reflect the quality of service users lives. Residents’ health and safety is promoted by clear policies and procedures that keep them safe. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager said she had finished her training in National Vocational Qualification in Care level 4 but had not yet submitted the final piece of work. She said that she had also done the Registered Managers Award at the same time so will have the dual qualification. This is good practice. The inspector met the quality assurance surveyors who were visiting the home during the inspection. Because the visits coincided the inspector decided not to complete the Commission’s own survey as this would be too much questioning for residents. An independent company carries out the home’s quality assurance survey for the registered provider and a copy of the report will be sent to the inspector on completion. A check of residents’ cash was carried out with the manager. All cash balances checked were correct except for one minor error that was immediately put right. A good practice recommendation made at the last visit in respect of ensuring residents get their full weekly personal allowances had been implemented. The manager said she takes up issues with residents if they don’t bring in enough money for residents to spend. It was pleasing to note that residents were all getting the total of their weekly allowances paid regularly. A requirement made at the last visit in respect of care records was met. Care records were written more positively and gave information about residents’ daily lives. Other records were factual and to the point but not judgemental or negative. However record keeping in general reflected the difficulties staff face in trying to meet both residents’ needs and to keep records up to date. Examples included: lack of effective key time records, gaps of up to ten days in some progress records, the lack of care plan monthly review records and no clear updating of care plans when residents’ needs change. In the inspector’s opinion the lack of these records could reflect a break in the continuity of care and could also indicate crisis management, because of continuing admission of residents with higher dependency levels due to mental health impairments. Health and Safety records were examined and the gardener/handyperson was seen doing weekly checks at this visit. Fire records were up to date and a fire drill had been held in June’06 with 10 staff taking part. Regular fire training for all staff was recorded including use of a video followed by a questionnaire and a tour of the building. Weekly checks of fire fighting equipment, fire alarms, door guards and emergency lighting were seen recorded. Further, weekly checks of water temperatures were recorded. Staff training records showed staff had undergone health and safety training including manual handling, basic food hygiene, fire safety and First Aid. Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 22 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 2 X 2 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 3 Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP4 Regulation 14(1)(d) Timescale for action Where residents are admitted 01/10/06 with mental health impairments or dementia the home must confirm in writing it is able to meet the residents’ assessed needs. Where needs cannot be met alternative accommodation must be sought. Each resident’s care plan must 01/10/06 be reviewed regularly enough to make sure changing needs are acknowledged and met. A way must be found of ensuring these are recorded (Timescale not met since the October ‘05 inspection) Requirement 2. OP7 15(2)(b) 3. OP30 18(1)(c)(i) All care staff are to be given 28/02/07 training in mental health needs of older people, managing behaviours that challenge and dementia awareness and care Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 24 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 OP6 Good Practice Recommendations Residents admitted to the interim placement unit should be offered a trial visit to ensure that they are given the same choices as permanent residents Social needs identified in care plans should be met and recorded. Key time records should be written regularly and show how residents enjoy this time. OP37 Bowmead DS0000036948.V295089.R01.S.doc Version 5.2 Page 25 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.V295089.R01.S.doc Version 5.2 Page 26 - 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. 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