CARE HOME ADULTS 18-65
Bunyan Lodge 66/68 Kimbolton Road Bedford Bedfordshire MK40 2NZ Lead Inspector
Ansuya Chudasama Unannounced Inspection 27th November 2005 12:30 Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 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 Bunyan Lodge DS0000014994.V262658.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 Adults 18-65. 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. Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Bunyan Lodge Address 66/68 Kimbolton Road Bedford Bedfordshire MK40 2NZ 01234 346146 01234 342557 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) Apex Care Homes Limited Mrs Marilyn Dorling Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (15) Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 5th April 2005 Brief Description of the Service: Apex Care Homes LTD owns Bunyan Lodge residential care home. The establishment provides care to fifteen adult service users (male and female) with a mental disorder. The accommodation consists of two Victorian semidetached houses, dining room, office and a kitchen. The basement has a games room, laundry, and storeroom. The home has fifteen single rooms for the service users, which are located on the first and second floors, with shaft lift access. The home has a smoking room for service users who wish to smoke. The rear of the house has attractive lawns, gardens, and a patio area. The front of the house has a driveway with parking facilities. The home is situated in a residential area close to the town centre with its amenities and good bus and train services. Bunyan Lodge DS0000014994.V262658.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 just under two hours. The inspection comprised of a tour of the lounge and dinning area of the home, and the majority of the time was spent talking to the service users, and staff. The home had one vacancy for one service user. Staff and some of the service users records were also seen. This report should be read in conjunction with the last inspection report undertaken on the 5th April 2005. What the service does well: What has improved since the last inspection?
Most of the requirements and recommendations were met by the home. All the service users in the home now have their own bank accounts. Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 6 The dining room had been reorganised and looked very pleasant and had four new tables. The lounge had new settees and looked very homely. The vacancy room for a service user had also been decorated. 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. Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards were assessed on this occasion but these were assessed at the last inspection. EVIDENCE: Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards were assessed on this occasion but these were assessed at the last inspection EVIDENCE: Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17, Service users have opportunities for personal development to enrich their social and educational opportunities. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: The service users were observed having their Sunday lunch. They were given two choices, which consisted of a roast dinner and a curry to meet all service users needs. Both meals were sampled and these were delicious. One service described their “meals cooked to perfection” when writing to the Queen of England to inform her of how hard the manager had worked at the home to meet their needs. The home encouraged families and service users to maintain good contact with each other and with the home. The service users spoken to stated that they liked having their own bank accounts and now they were more independent. They also stated that they were encouraged to make their own decision and choices. For example they chose the holidays, outings, meals and their
Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 11 clothes. It was also stated that the manager ensured that their rights were respected. The service users in the home attended day resource therapeutic placements, social clubs, outings, and they also enjoyed going out to walks. Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards were assessed on this occasion but these were assessed at the last inspection EVIDENCE: Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards were assessed on this occasion but these were assessed at the last inspection EVIDENCE: Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The environment was well maintained and met service users needs. EVIDENCE: The home was very clean and homely. The lounge had new settees, the dinning room had been painted and had new tables and chairs and looked very pleasant. Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Service users benefit from well supported and competent staff to ensure that their needs are being met EVIDENCE: The staff spoken to stated that they enjoyed working at the home and with the service user group. A service user described the home as being “a beautiful residence peacefully care for by very efficient staff”. It was also stated that they found the manager very supportive. They received regular supervision and good training from the manager. The home had two full time vacancies for support staff. The hours were at present were being worked by relief and the home’s staff. The staffing rota for today showed that two staff started at 7am and one staff started at 9am. This meant that there were only two staff on duty from 7am to 9am. Staffing levels must meet the ratio of one staff (to the highest whole number) to six service users at all times. The time scale of the 31/12/2004 was not met. Three staff files were inspected. One file had all the information required. Another file inspected had a member of staff who worked at this home as a senior carer and a nurse at another home. However the inspector was unable to find a contract for working at this home. Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 Service users health and safety needs were being met by the home. EVIDENCE: The home undertook fire alarm testing, emergency light testing and fire drills. The service users were involved in fire drills and they also watched videos and had discussions with staff regarding health and safety issues. The staff spoken to had undertaken the mandatory training in safe working practices. It was stated that the staff had health and safety training on a regular basis. The home also undertook quality audits on health and safety on a monthly basis. Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X x X X x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 2 2 3 4 CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Bunyan Lodge Score X X X X Standard No 37 38 39 40 41 42 43 Score X X X X X 3 X DS0000014994.V262658.R01.S.doc Version 5.0 Page 18 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA33 Regulation 18 Requirement The registered provider must ensure that staffing levels must meet the ratio of one staff (to the highest whole number) to six service users at all times. Time scale of the 31/12/2004 not met The registered provider must ensure that all staff have a contract with the home. Timescale for action 25/02/06 2 YA34 18 25/01/06 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 Bunyan Lodge DS0000014994.V262658.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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