Inspection on 22/09/05 for Breadstone House Care Centre

This inspection was carried out on 22nd September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Breadstone House Care Centre 28/01/09

Breadstone House Care Centre 29/09/08

Breadstone House Care Centre 25/06/08

Breadstone House Care Centre 22/10/07

Breadstone House Care Centre 30/11/06

Breadstone House Care Centre 16/03/06

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

CARE HOMES FOR OLDER PEOPLE Breadstone House Care Centre Breadstone Nr Berkeley Glos GL13 9HG Lead Inspector Mr Adam Parker Unannounced Inspection 22nd September 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Breadstone House Care Centre DS0000063838.V254718.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. Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Breadstone House Care Centre Address Breadstone Nr Berkeley Glos GL13 9HG 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) 08453 455782 Blanchworth Care Homes Ltd Mrs Denise Rose MacKereth Care Home 43 Category(ies) of Dementia - over 65 years of age (43) registration, with number of places Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8/2/05 Brief Description of the Service: Breadstone House Care Centre is a registered Care Home with Nursing. It is registered to accommodate older people with dementia. The home is situated off the Gloucester to Bristol road and is approximately 20 miles from Gloucester. It is a detached house situated in attractive grounds. The communal areas are situated on the ground floor and include 3 lounges and a dining room. There are 25 single bedrooms (7 with ensuite) and 9 double bedrooms. Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three hours on one day in September 2005. The clinical manager was present throughout the inspection and was able to assist where required. Care records were examined as well as the procedures for making complaints and the arrangements for looking after service users’ money. Records relating to the supervision of staff were also looked at. A tour of the premises was undertaken and as well as the clinical manager, one member of staff was spoken to and three of the service users. What the service does well: What has improved since the last inspection? What they could do better: Service users who are privately funded must have a thorough assessment completed to ensure that the home can meet their needs. Care staff need to have more regular supervision sessions. More attention needs to be given to the cleanliness of certain areas of the environment. Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 6 Care plans are needed for certain types of medication given on an ‘as required’ basis. 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. Breadstone House Care Centre DS0000063838.V254718.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 Breadstone House Care Centre DS0000063838.V254718.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&3 The home’s statement of purpose allows interested parties to access information about the home. The failure to complete assessment documentation for a self-funding service user has potentially compromised the home’s ability to meet their needs EVIDENCE: Since the last inspection the home has adopted a recommendation to include information in the statement of purpose about assisted baths in the home. Examination of care files showed that service users are assessed prior to admission by the home, in addition to obtaining copies of assessments from health and social care professionals. However in one case of a privately funded service user the pre-admission assessment had not been completed, dated or signed. Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 9 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 Service users needs are set out in individualised care plans to enable health and personal care needs to be met as well as privacy and dignity to be upheld. The home has done well in adopting the use of hip protectors for some service users who are at risk of falls, to minimise injury. More attention is needed to providing care plans for service users on certain types of medication to ensure that administration meets their needs. EVIDENCE: Care plans were examined and these were found to be well written and provided information for staff on how to on meet service users’ needs in an individual way. Care plans had been reviewed on a monthly basis. A number of risk assessments were examined for such issues as smoking, falls, wandering out of the home and nutrition. Where risks were identified care plans had been drafted in response to this. The home uses hip protectors for service users who are identified as being at risk of falls and the use of this initiative should be commended. Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 10 Care files contained records of service users having access to services to meet their health needs such as general practitioners, chiropodists and community psychiatric nurses. The home had not adopted a recommendation from the previous inspection about care plans for service users prescribed certain types of medication on an ‘as required’ basis. Two service users were identified as having ‘as required’ medication prescribed. Staff were observed treating service users with respect and shared rooms had curtains in place to maintain privacy. Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 11 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): No standards inspected in this section. EVIDENCE: Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 12 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 The home has a satisfactory complaints system with information about this available to service users and their representatives should they wish to make a complaint. EVIDENCE: The home has a log for the recording of complaints. There had been one complaint made in the last twelve months. The clinical manger reported the complainant was happy with the outcome of the investigation. Information about the complaints procedure is displayed in the entrance hall. Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 13 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 & 26 The home provides a safe well-maintained environment for service users’ comfort, although this would be further enhanced by attention to some cleaning issues identified. EVIDENCE: The inspector toured the home and found that it was generally clean and well maintained, although the carpet outside the kitchen was in need of cleaning and there was an odour in room 19. On the day of the inspection new flooring was being laid in one of the communal lounges. The laundry was well ordered and included handwashing facilities. Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 14 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): No standards inspected in this section EVIDENCE: Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 15 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): 35 & 36 Service users’ financial interests are safeguarded through the procedures used in the home. During this year staff supervision sessions have fallen behind schedule, this may compromise the management of care staff in the home. EVIDENCE: The home has facilities for the safekeeping of service users’ money and valuables and keeps accurate and appropriate records relating to this. The supervision of staff has fallen behind schedule with some staff not having a session since January 2005. It is acknowledged that the registered manager spent several weeks managing another home in the Blanchworth Group during the spring and this may have had an impact on staff supervision sessions. Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 16 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 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 2 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 2 X X Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? No 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 OP3 Regulation 14 1a,17 1a Sch3 P1a 23 (2) (d) 16 (2) (k) 18 (2) Requirement Timescale for action 30/11/05 2 3 4 OP26 OP26 OP36 The registered person must ensure that self-funding service users are not admitted to the home unless a full assessment is completed. The registered person must 30/11/05 ensure that the carpet outside of the kitchen is cleaned. The registered person must 31/12/05 ensure that the odour in room 19 is eliminated. The registered person must 31/12/05 ensure that staff receive supervision sessions. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 18 No. 1 2 Refer to Standard OP9 OP36 Good Practice Recommendations Care plans should be drafted to guide staff in the administration of hypnotic of anxiolytic medication prescribed for service users on an ‘as required’ basis Care staff should receive six formal supervision sessions per year. Breadstone House Care Centre DS0000063838.V254718.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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