Inspection on 23/03/06 for Bulmer House

This inspection was carried out on 23rd March 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 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

Bulmer House 12/06/07

Bulmer House 10/10/06

Bulmer House 08/08/05

Bulmer House 08/02/05

Bulmer House 12/07/04

Bulmer House 05/03/04

Bulmer House 02/02/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Bulmer House 4 Ramshill Petersfield Hampshire GU31 4AP Lead Inspector Isolina Reilly Announced Inspection 23rd March 2006 09:00 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 Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 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. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bulmer House Address 4 Ramshill Petersfield Hampshire GU31 4AP 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) 01730 261744 Hampshire County Council Mrs Maxine Dyer Care Home 44 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (44) of places Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2005 Brief Description of the Service: Bulmer House is a purpose built residential home providing accommodation and personal care for up to 44 older persons, 23 of whom may have dementia. The home is part of a resource centre and a day service owned and run by Hampshire Couty Coucil and is located at one end of the complex. The residential area is made of a two story building that is separated into five units within the building. The kitchens, laundry area, small library area, large reception area, hairdressing room and treatment room are located on the ground floor together with two of the residential units. All of the residential units have their own sitting rooms, kitchen dining area and communal bathrooms. All of the bedrooms are for single occupancy. On the ground floor one of the units is for ten beds and the other for eleven. On the floor above are three units, two with eight beds the other with seven for the residents with dementia. Four of the beds within the home are designated for respite care, two on the ground floor and two on the first floor. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This second announced inspection took place over one day. The manager was informed of this visit by telephone two days before. The inspector looked around the home, view records, procedures, spoke with service users, a visiting friend, a visiting district nurse, staff and observed the interaction between them. The manager helped the inspector during the visit. This and the previous inspection report of 8th August 2005 can be read together for a full summary of how the home has done against the key National Minimum Standards. The manager and staff confirmed that the service users within the home were referred to as residents. What the service does well: What has improved since the last inspection? What they could do better: The manager is in the process of doing a full audit of the service. This will identify future areas for improvement and the manager is going to be giving out comment cards to be filled in by residents, visitors, family, staff and other health and social care professionals so their opinions on how the home is run and it can be improved is included in future plans. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 6 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. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 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 Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 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): 3 and 6 The home has a satisfactory residents’ assessments including risks and a wellmanaged admission process. The home does not provide ‘Intermediate Care’. EVIDENCE: Four service users files were seen and the admission records sampled demonstrated that full needs and risk assessments are completed by the referring Adult Services Care Manager. The records from the home’s admission assessment were also present and found to be detailed and reflect the needs identified in the Adult Service’s Care needs assessment. These documents are the basis for the home to build a relevant care plan. Two of the residents’ files seen had recently been admitted to the home. The residents and staff explained that their families are encouraged to view the home prior to them coming to stay. The residents and visitor spoken with confirmed they were made welcome, shown around the home and introduced to other residents and staff. The files seen showed that a full assessment had been recorded prior to and on admission and reflected the information given by the Adult Service’s Care Needs Assessment. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 9 All the residents spoken with confirmed that they liked the home, felt comfortable and safe. The manager confirmed that the home does not provide ‘intermediate care’ rehabilitative short-term type care for Social Services. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 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): 8 and 10 The residents are well looked after in respect of their personal and health care needs in such a way as to promote privacy and dignity. Key standards seven and nine were assessed and met at the previous inspection on the 8th August 2005. EVIDENCE: The residents spoken with were all very complimentary of the care provided by the home. Stating that staff are very helpful, always polite, appear to know what they are doing and look after them well. They also said that the staff are always respectful and mindful of their privacy and dignity. The visitor spoken with also confirmed this. The inspector observed the staff interacting with the residents and found them to be attentive, respectful and professional. There were staff around most of the time in the communal areas. The District Nurse spoken with stated that the home is very good at noticing early if the residents need medical care and call them in appropriately within good time. She also stated that the home is particularly good at providing Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 11 general palliative care (care of the dying) needs. There were also records of doctor/nurse visits and information on outpatient, dental, optician and chiropractic appointments. The manager explained that one resident had needed emergency dental treatment and the relative had taken them to see their normal community dentist. A record of this event was seen on the individual’s care plan and in the home’s diary. The doctor from a local surgery visits once every two weeks to holds a clinic at the home and other doctors will undertake home visits when requested. There was evidence on file of residents having received physiotherapy treatment and exercises, and been assessed by occupational therapists as part of the home’s strategy to prevent falls. The staff and one resident spoken with confirmed this. The home has an external person who undertakes regular exercise programmes at the home to help with general mobility. The manager explained that they are able to use the knowledge and expertise of this person to assist with the prevention of falls at the home as he has gained specialist knowledge in this field. Records were seen on files of regular health care checks and access to health services. The residents and staff spoken with confirmed this. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 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): 14 The home is run so that residents are able to exercise personal autonomy and choice. Key standards twelve, thirteen and fifteen were assessed and met at the previous inspection on the 8th August 2005. EVIDENCE: The manager confirmed that where possible residents look after their own finances, although many of them have their family or financial person to do so. Many of the residents spoken with stated that had been given the choice to bring in their own furniture and furnishing and some had done so. Two records were seen on file that contained a list of all personal effects that the individual had bought with them to the home. However, one resident stated that she was not allowed to bring in one piece of furniture. This was discussed with the manager who stated that chair in question was risk assessed at a high fire risk and hence the resident was advised that this particular piece of furniture could not be kept in her bedroom. The inspector observed one resident getting great pleasure out of playing her own piano that she had been able to bring with her from home. Other residents stated they enjoyed the playing and were observed moving to the music and sing along. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 13 The manager confirmed that over the last few months, residents’ individual care plans have been made available in their bedrooms for them to read at any time. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 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 and 18 The home has a satisfactory complaints procedure that residents are able to use and staff have a fair understanding of Adult Protection issues that protects residents from abuse. The home has an open and positive approach to listening to residents views and improving. EVIDENCE: The resident and visitor spoken with stated that the staff are very good and listen to their concerns. The visitor felt that the staff were patient, caring and willing to listen. The staff spoken with were aware of the home’s complaint procedure. The home’s complaint procedure is available in colourful easy to read leaflet that is available in large print but does not includes the address for the Commission, although the contact details for the commission is available in the home’s statement of purpose and service user guide which all residents have a copy of. Copies of the home’s complaint procedure are in each resident’s bedroom at the back of their care plan and can be found in the various offices around the building. The home has received no complaints since the last inspection. The complaint log was seen and found to be satisfactory and details of each complaint were available in the file. The inspector was shown many compliments and thank you cards that the home had received over the last year. This were complimentary of the care that loved ones had received. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 15 All the residents spoken with stated that they always felt safe at the home and the visitor also confirmed this. The visiting district nurse was complimentary, stating this was a good home and good at looking after the residents medical needs. The staff spoken with confirmed that they have received instruction and are aware of the protection of abuse of vulnerable adults. They have informed how to recognise and report concerns or suspicions, some staff had covered this subject in their induction. The manager confirmed that some staff had undertaking the four-day training course in Adult Abuse and the other staff will be attending a training course that is to be held at the home in the near future. There has been no allegation of abuse at this home. The home has an up to date copy of the Hampshire County Council ‘Protection of Vulnerable Adults’ policy and procedure and it’s own local procedures for reporting a concerns. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 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): The above key standards were assessed and met at the previous inspection on the 8th August 2005. EVIDENCE: Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 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): 30 The staff training continues to improve ensure that they have the necessary knowledge and skill to meet the needs of the service users. Key standards twenty-seven, twenty-eight and twenty-nine were assessed and met at the previous inspection on the 8th August 2005. EVIDENCE: The residents spoken with described the staff as ‘caring, friendly, helpful and respectful.’ The staff spoken with stated that they have been working at the home for some time and recall that the induction programme run by the home was useful. Two staff members spoken with had recently started working at the home and were in the process of doing their induction programmes and awaiting training courses in the near future. The manager showed the inspector a matrix of training undertaken by the staff at the home and staff spoken with confirmed this. The manager confirmed that the home’s induction programme meet the Skills for Care minimum standards for induction. The staff spoken with confirmed that the home continues to provide and support them to achieve qualifications in care to National Vocational Qualification level 2 and 3. The home will have met 50 per cent of care staff with qualifications when the current five care staff complete their course. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 18 The staff spoken with confirmed that they undertake training regularly and find it useful. The inspector was able to see training certificates and other records of training undertaken by the staff. Since the last inspection, the home has delivered update training in specialist areas of dementia and infection control. The home has a positive supportive ethos and staff training. The training records also show that staff have received training in relevant health and safety subjects including food hygiene, moving and handling, hoist and use of glide sheets, understanding principles of care, applying value base of care, control of substances hazardous to health (COSHH), loss and bereavement, continence training and medication. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 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): 33 and 35 There is a good system for involving service users in the day-to-day running of the home and is undertaking an auditable quality assurance system. There is a satisfactory system in place for the safe storage and monitoring of money should the service users request this service. Key standards thirty-one and thirty-eight were assessed and met at the previous inspection on the 8th August 2005. EVIDENCE: The staff spoken with confirmed that there is a clear line of authority within the home. The manager was able to share with the inspector the partially completed formal quality assurance process that feeds into the home’s service and Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 20 development plan for next year she anticipates it will be completed by the end of March 2006. This is a new process that will be undertaken annually. The residents spoken with stated that they felt their opinions were valued within the home and some participate in the residents’ meetings. The inspector was able to see the resident meeting minutes. The staff felt they were included in the day-to-day decision making within the home, stating that changes and or issues are discussed at regular staff meetings that are minuted. The minutes were available in the office for reference. The manager explained that she has yet to sent out quality survey questionnaires to residents, relatives and friends, health and social care professionals. These will inform the planning and development plans for the home. The inspector was able to view the service plan for this year’s trading and found it to easy to read, the manager confirmed that many of the development action points have been met. Some of the residents stated that their family or financial appointees rather than them or the home look after their money. The manager confirmed that that they look after some residents’ spending money that is kept secure in the home safe and in separate wallets. The home has kept a record of the money in, out, receipts and balances for each resident. The manager counted the money of one resident, out in front of the inspector and the balance was found to be accurate. The manager explained that none of the managers were appointees for any client. Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 22 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. Standard Regulation Requirement Timescale for action 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 Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Bulmer House DS0000037250.V287144.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!