Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: BUPA Care Homes West Ridings Lingwell Gate Lane Lofthouse Wakefield West Yorks WF3 3JX The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Railton
Date: 3 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home
Name of care home: Address: BUPA Care Homes Lingwell Gate Lane West Ridings Lofthouse Wakefield West Yorks WF3 3JX 01924826806 01924825743 fletchea@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): BUPA Care Homes (CFHCare) Ltd Name of registered manager (if applicable) Mrs Sandra Elizabeth Hustwick Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: 1. The maximum number of service users who can be accommodated is: 180 2. The registered person may provide the following category of service only: Care Home with Nursing, Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category, Code OP, maximum number of places 180. Dementia, Code DE, maximum number of places 180. Mental Disorder, excluding Learning Disability or Dementia, Code MD, maximum number of places 180. Physical Disability, Code PD, maximum number of places 180. Care Homes for Older People
Page 4 of 24 care home 180 Over 65 0 0 180 0 180 180 0 180 The maximum number of service users who can be accommodated is: 180 The registered person may provide the following category of service only: Care Home with Nursing, Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category, Code OP, maximum number of places 180 Dementia, Code DE, maximum number of places 180 Mental Disorder, excluding Learning Disability or Dementia, Code MD, maximum number of places 180 Physical Disability, Code PD, maximum number of places 180 Date of last inspection Brief description of the care home BUPA West Ridings, although under one registration, comprises six, 30-bed units and provides a total of 180 places for older people, some of whom may suffer from dementia, mental health problems, have a physical disability and/or require nursing care. There is a manager for each of the six units who are directly supervised by the Registered Manager. Ground floor accommodation is offered to all service users and some of the bedrooms have patio doors leading to the gardens. Other bedrooms face inner courtyards which have garden furniture for the use of service users during the summer months. Each unit has communal areas including lounges, dining rooms and quiet lounges. All bedrooms are personalised and there are assisted bathing facilities for those who require them. Prospective service users are invited into the home to test drive the services offered and visitors are welcome. There is a reception area provided with administrators and the registered manager?s office. This building also houses the central kitchen, laundry and training rooms. The home is situated in Lofthouse on the outskirts of Wakefield, is on a main bus route and is close to Outwood train station. There are some local shops nearby including a post office, public houses and health centre. West Ridings is only a few minutes journey from the centre of Wakefield and all services and amenities and is also close to the M1/M62 link roads. On 19 November 2007 the providers said the range of fees for living in the home is between #380and #600 and that there are extra charges for hairdressing (from #7) and for newspapers and Chiropody (#9). Further information about the services provided and the role of the CSCI can be obtained by contacting the home or visiting www.bupa.com Care Homes for Older People Page 5 of 24 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We started the visit at 09:30 and ended at 16:30. During the visit there was the opportunity to speak to people living in the home and some visiting relatives. There was also the opportunity to speak to the Clinical Manager,Responsible Individual for the service providers, the managers of the houses, senior care staff, care staff, nurses, and activities co-coordinators. Other people spoken to included the Chef, kitchen staff, laundry staff and domestics. A sample of six peoples records including assessments, care plans, reviews and medical records. A sample of six staff records were also seen and included application forms, references, Police and POVA (Protection of Vulnerable Adults List) checks, induction training and supervision notes. Other information included staff rotas, staff rotas, training records, menus, and maintenance records. Other documents considered included the homes Annual Quality Assessment Report, Care Homes for Older People
Page 6 of 24 Service History, Record of Complaints, and Annual Quality Assurance Assessments and Regulation 26 Providers Visit Reports. The inspectors would like to take the opportunity to thank everyone living in the home , the visiting relatives, the Clinical Manager and all the staff for their hospitality and co-operation throughout the visit. What the care home does well: What has improved since the last inspection? What they could do better: Some of the daily records contain descriptive words to reflect and show peoples choices and preferences and any decisions they make about how they live their daily lives, however, some daily records dont do this. To keep people safe staff giving medicines need to be diligent as some medicines in sealed blister packs in one house were observed to be left in the lounge unattended. On the day of the visit some staff had to go and work in other houses to cover for staff sickness,. To make sure people receive the care they need staff moving to other houses should be aware of what is written in peoples care plans. To make sure people living in the home and those caring for them are protected staff moving to work on the units caring for those with Dementia should have Dementia Care and Behavior Management training. To prevent people living in the home from becoming agitated or having their lives disrupted something should be done about the loud telephone buzzers in the lounges. This is particularly relevant in the houses caring for people suffering with Dementia or mental health problems. Care Homes for Older People Page 8 of 24 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 24 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. To make sure the service can meet peoples personal and healthcare needs these are assessed before coming to live in the home. The home does not provide a specialist rehabilitation service. Evidence: To make sure peoples needs can be met by the service these are assessed before coming to live in the home. The clinical manager says a qualified nurse is employed to go and assess people before they come to the home. The clinical manager and Annual Quality Assurance Assessment confirmed this and also show the home does not provide a specialst rehabilitation service for those requiring intermediate care. Care Homes for Older People Page 11 of 24 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are set out in their individual plan of care and they are protected by the way medicines are dealt with. Evidence: A sample of six peoples records show their personal and health care needs are set out in their individual plan of care. The monthly reviews show they are looked at regularly to see if they still reflect peoples care needs. Some of the daily records contain descriptive words to show and reflect peoples choices and preferences. One unit manager and one care staff said they know whats in the care plans of the people on the units where they normally work. However, when they are moved to other units to cover for sickness, as on the day of the visit, they would not know what was in other peoples care plans on other units or how they should to be cared for. People are protected by the way medicines are dealt with as sample of peoples medicines were checked and found to be correct. The Clinical Manager and Unit Managers said people are trained in how to give medicines safely. The staff training records confirmed this. On the day of the visit some medicines sealed in blister packs were observed to be left
Care Homes for Older People Page 12 of 24 Evidence: unattended in the lounge for Short period. Care Homes for Older People Page 13 of 24 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples lifestyle matches their expectations and they have a choice from a varied and balanced menu. Evidence: The menus show there is a varied and balanced diet provided. The menu choice checklists show people have a choice of menu. This was confirmed by one person living in the home who says the meals are very good and they have a choice. Another person says they get plenty to eat. One visiting relative says the meals are very good indeed. The chef says the menu is rotated every four weeks and changed seasonally.The menus and the Annual Quality Assurance Assessment confirmed this. The Annual Quality Assurance report shows people and their relatives are happy with the quality of the meals provided. The daily records of six people show they take part in activities that are arranged on a regular basis. Discussion with the activities organizer shows there are two people employed to arrange and provide activities on each of the six houses. The Clinical Manager and the Annual Quality Assurance Assessment confirmed this. People were observed throughout the visit being treated with dignity and having their wishes respected. Some of the daily records seen used descriptive words to reflect and show peoples choices and preferences, some others
Care Homes for Older People Page 14 of 24 Evidence: did not. People were observed enjoying their meals in clean and pleasant surroundings. Care Homes for Older People Page 15 of 24 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples concerns are taken seriously and acted upon and they are protected by the Safeguarding Policies, Procedures and practices. Evidence: People are protected from any kind of abuse by the Safeguarding Policies and Procedures. People are also protected as all staff receive Safeguarding Training. The training records confirmed this. To continue to protect people living in the home, the Annual Quality Assurance Assessment shows many Safeguarding Referrals are made to the Local Authority by the home but most have been dealt with through the case management process. Records show there is currently one Safeguarding Referral being investigated by the Coroners Office. People and their relatives have access to the complaints policy and procedure as a copy of the Service User Guide is given to everyone using the service and includes the Complaints policy and procedure. Peoples concerns are take seriously and acted upon as the record of complaints show they are properly recorded and appropriately dealt with. One visiting relative says they have never had to complain but knows how to make a complaint if they had to. Care Homes for Older People Page 16 of 24 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well maintained home that is comfortable, clean and safe. However, peoples quality of life is disrupted by the noisy telephone call system in the lounges. Evidence: A short tour of all the houses found them to be clean and free from any unpleasant odors. People were observed relaxing in the lounges, dining rooms and in their own rooms that are comfortable and homely. One person says they like their rooms. One visiting relative says the home is always clean and comfortable. However, some people in some of the houses were disturbed by the loud telephone buzzer in the lounges. This was particularly relevant for those living in the home who have Dementia as they were observed to become restless and agitated by the noise. The clinical manager said they will review to noise levels and the effect of the buzzers in the lounges on people living in the home. Care Homes for Older People Page 17 of 24 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care needs are generally met by the numbers and skill mix of staff and they are protected by the way staff are selected and recruited. However, people are not always cared for by staff who know them or know what their plan of care says. Evidence: Peoples needs are met by staff that are trained and qualified, however, staff should aware of peoples care plans when they are moved to other houses. One senior carer says they do not always know the people living in other house or how they should be cared for. People are cared for by staff that are trained. The staff training records confirmed this and the induction training records show all new staff now have Moving and Handling training within the first two days of starting work. People are protected by the staff training provided as records show they have training that includes Fire Safety Awareness, First Aid, Infection Control, Health and Safety, Dementia Care Awareness, Behavior Management and Safeguarding training. However, discussion with the clinical manager found staff moving to the houses caring for those with Dementia to cover for sickness may not have received Dementia Care or Behavior Management training. One visiting relative says the staff are wonderful and very caring. One person living in the home says the staff are very good and very helpful. Another says staff are great. Throughout the visit positive relationships were observed to be fostered between people and those caring for them. People would
Care Homes for Older People Page 18 of 24 Evidence: benefit from having more qualified care staff as the training records and the Annual Quality Assurance Assessment shows only 39 of care staff have a National Vocational Qualification Level 2 or above. Care Homes for Older People Page 19 of 24 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well managed home that is run in their best interests and where their health and safety is promoted and protected. Evidence: People live in a home that has an experienced and qualified manager. The Registered manager is supported by the Clinical Manager and the Responsible individual that has an office in the home. To make sure peoples care needs are met th care management documentation including assessment, care plans and health care documents have been implemented. Some of the daily records include descriptive words to reflect and show peoples choices and preferences and any decisions they make about their daily lives. The Annual Quality Assurance Report shows people and their relatives have the opportunity to comment on the quality of services provided and their views are reflected in the report. The minutes of the residents and relatives meetings show people have the opportunity to comment on the running of the home. The minutes of the staff meetings and supervision records also show they have the opportunity to
Care Homes for Older People Page 20 of 24 Evidence: comment on the running of the home. Peoples health and welfare is promoted as the Regulation 26 providers visits show regular health and safety checks are undertaken. The maintenance records also show people are also protected by the fire alarm checks and servicing of the mechanical hoists. The staff training records also show peoples health and safety is promoted as staff receive Moving and Handling , Food Hygiene, Infection Control, First Aid and COSHH (Control of Substances Hazardous to Health) training. To protect people living in the home staff are supervised and the supervision notes and records show they receive regular line management supervision. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 2 3 7 9 14 Care staff should know what is in peoples care plans and know how people should be cared for to keep them safe. To keep people safe medicines even in sealed blister packs should not be left unattended. The daily records would benefit from the use of descriptive words to reflect and show peoples choices and preferences, likes and dislikes or any decisions they make about how they live their daily lives. The lives of people living in the home should not be disrupted by the level of noise produced by the telephone buzzer system in the lounges People moving to other houses to cover for sickness should be aware of peoples care plans and how they should be cared for. And to make sure peoples needs are fully met staff covering on the houses for those with Dementia should have Dementia Care and Behavior management training. People would benefit from being cared for by more trained staff to National Vocational Qualification Level 2 or above. 4 20 5 27 6 28 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 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!
