Inspection on 08/08/05 for Bulmer House

This inspection was carried out on 8th August 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

Bulmer House 12/06/07

Bulmer House 10/10/06

Bulmer House 23/03/06

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 Martin Bayne Unannounced 8/8/05 10:00 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 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 H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bulmer House Address 4 Ramshill, Petersfield, Hampshire, GU31 4AP Telephone number Fax number Email 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 CRH 44 Category(ies) of DE(E): Dementia over the age of 65 years: 23 registration, with number OP: Old Age: 44 of places Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 8/2/05 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 is located at one end of the complex. The residential area is made of a two story building that is separated into four 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 H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The three requirements from the last inspection were followed up and these were found to be met. Time was spent with the manager discussing the ethos of the home and its aims and objectives were discussed. Standards in respect of care planning and risk assessment were tracked in respect of two residents. The inspector then spent time talking with residents until lunchtime. After lunch standards in respect of medication staffing and health and safety were assessed. In general there was very positive comments made by the residents about all aspects of life at Bulmer House. There were no requirements made at this inspection. What the service does well: What has improved since the last inspection? The introduction of the posts of activities coordinators for the residents with dementia has improved the care to these residents. The four-day foundation training in dementia has also improved the care to the residents with dementia. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 6 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. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 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 standard(s) 1 The home now provides full information to residents and relatives about the home and it’s aims and objectives. EVIDENCE: At the last inspection a requirement was made that the Statement of Purpose and Service User Guide be amended to include the staff qualifications and the size of the bedrooms. It was found at this inspection that these amendments have been made. A copy of the Service User Guide is kept in the lounge area of each unit and so is available to residents and their relatives. A copy of the last inspection report is pinned on the notice board in the main reception area of the home. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 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 standard(s) 7, 9 Care planning and risk assessment processes ensure that the needs of residents are met. Medicines are safely administered and correctly recorded. EVIDENCE: A requirement was made at the last inspection that risk assessments be incorporated into the care planning system with particular reference to risk of falling. The care planning and risk assessment procedures were discussed with reference to the tracking of the needs of two residents. A risk assessment form was found on both files that detailed now to minimize hazards particular to the residents concerned. The care plans were concisely written and provided sufficient evidence for a new member of staff to provide care to that person. It was reported that the care plans were developed with the residents, although residents had not signed the plans. The manager said that the County Council were reviewing the care planning system and the home was about to pilot a new format. The new format would be signed by residents and kept within residents’ rooms. They would also contain other recording sheets such as risk assessments and health monitoring forms. The care plans were found to be reviewed as required. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 10 Medication administration was observed and the procedure discussed. Medicines are taken by trolley to the residents and given out and then recorded. Only the senior staff administer medication. The medication administration records for one unit were viewed and found to have been accurately completed. Within each unit there is a medication cabinet. The home uses a unit dosage system supplied by their local pharmacist. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 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 standard(s) 12, 13, 15 Meaningful activities are provided for residents, with more focus now provided for the residents with dementia. Relatives and visitors are welcome at the home. Food provided meets the satisfaction of residents at the home. EVIDENCE: The residents spoken with all spoke highly of the home and how they were treated with respect by the staff. They also said that they could get up and go to bed when they chose. They informed that their relatives were free to visit at any time. The inspector spoke with two relatives who spoke positively about the home. Residents said that there were always plenty of activities. On the day of the inspection a group of residents went out to the local pub for lunch and in the afternoon a Bingo session was being held in one of the rooms at the front of the home. The home has a small library and one resident said that a supply of books was always available. A change since the last inspection has been the creation of activity coordinator posts on the units catering for people with dementia. Each resident on these units has been individually assessed and a programme of activities arranged. One of the residents on one of the units showed their life history book that had been developed with them. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 12 Residents told the inspector that the meals provided at the home were of a good standard, that there was a choice of main meal and that there was always plenty to eat. On the day, the inspector ate an enjoyable lunch with a group of residents in their dining room. Meals are brought to dining rooms in heated trolleys. The main kitchen provides meals for the home and also the day service on site of the home. The staff were observed assisting one resident at their preferred pace who could not feed themselves. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 13 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 standard(s) EVIDENCE: Not assessed on this occasion. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 14 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 standard(s) 19, 24 The home is well suited to meet it’s aims and objectives, providing a well maintained homey environment. EVIDENCE: The residential units are part of a complex that also contains a day service. The residential area is split into five units with an 11, 10, 7 and two 8 bedded sections. The first floor is for residents with dementia and the ground floor for people with frailty of old age. Each unit has their own lounge/sitting area, kitchen/dining area and communal bathrooms. All of the bedrooms have bedroom door locks and are for single occupancy. The home has a lift to the first floor. The doors leading out of the first floor have been alarmed so that staff are aware should a resident wander from one of these units. There are four bedrooms allocate for respite care, two on each floor. The home has an enclosed courtyard area and an enclosed garden that is accessible to the residents. The home was found to be in reasonable decorative order throughout and the gardens well maintained. Residents reported that the home was always clean and well maintained. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 15 During the inspection the inspector was invited into two residents bedrooms and it was evident that residents were able to bring their personal possessions and rooms had the required furniture. Radiators around the home have been covered to protect residents from burns. It was noted that electric fans were available in one the lounge areas affected by direct sunlight to help keep residents more comfortable. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 & 29 Current staffing levels meet the needs of the residents. A programme of training is in place for development of staff through National Vocational Qualification training. EVIDENCE: The manager reported that in general there were five carers and a duty manager employed throughout the day with an activity coordinator on duty each morning on the first floor. During the weekdays the registered manager is also on duty. The residents spoken with said that their needs were met by this level of staffing, so too the manager. The manager reported that the night staffing had been changed to three awake members of staff on duty, a night coordinator and two carers. Training of staff in NVQ was discussed. There are currently 7 carers who have achieved NVQ level 2, with a further 5 who will finish training in September. During that month 3 more staff will start training and a further 3 in February. By September the home will have nearly 50 trained to NVQ 2. All newly appointed staff receive induction and foundation training with the local authority. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 17 The recruitment procedure and documentation was followed through for the last member of staff who was employed at the home. It was found that all required checks had been carried out with documentary evidence on file. It was recommended that the staff application form be changed so as to request information now required under legislation, such as a reference from the person’s last employment of no less than three months in a position working with vulnerable adults or children. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The health and safety of residents is promoted through training of staff and testing of the fire safety system. EVIDENCE: At the last inspection a requirement was made as the records did not indicate which staff had attended fire training. The fire log book was inspected, which recorded the rests and inspections to the fire safety system. The records showed that the staff ad received the appropriate training in fire safety. During the inspection there were no hazards identified. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x x STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x 3 Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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. 1. Refer to Standard 29 Good Practice Recommendations It is recommended that the staff application form be amended to obtain references in line with changes in the legislation. Bulmer House H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 21 Commission for Social Care Inspection 4th Floor- Overline House Blechynden Terrace Southampton Hampshire 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 H54 S37250 Bulmer House V243842 080805.doc Version 1.40 Page 22 - 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!