CARE HOMES FOR OLDER PEOPLE
Burrowbeck Grange Nursing Home Scotforth Road Lancaster Lancashire LA1 4XN Lead Inspector
Mrs Christine Marshall Unannounced Inspection 13:00 22 February 2006
nd 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 Burrowbeck Grange Nursing Home DS0000065247.V271667.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. Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Burrowbeck Grange Nursing Home Address Scotforth Road Lancaster Lancashire LA1 4XN 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) 01524 841876 01524 848699 jim.brown@optimacare.co.uk Optima Care Limited Miss Christine Bewsher Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (22), Physical disability (1) of places Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 23 service users to include up to 22 service users in the category OP (older persons 65 and over) 1 named service user in the category PD (physical disability) 3rd November 2005 Date of last inspection Brief Description of the Service: Burrowbeck Grange Care Home with Nursing is a detached property, in an elevated position, situated on the main A6 Lancaster Road. The home offers nursing care for 23 residents. There are 17 single bedrooms, one of which has en-suite facilities, and 3 double bedrooms; these are on ground and first floor levels. All bedrooms and lounge/dining areas are furnished to a good standard. There are adequate bathing and toilet facilities in place. There is wheelchair access to the home and there is a passenger lift in place. The registered providers are Optima Care Ltd, the Responsible Individual is Mr Jim Brown and the Registered Manager is Mrs Christine Brewsher. Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the second of two inspection visits, scheduled from 1st April 2005 to 31st March 2006. All of the people spoken to and who were able at the home said that they preferred to be called residents. This unannounced inspection took place over a two-hour period during the afternoon and was carried out by the home’s designated lead inspector. A tour of the home included some bedrooms, lounge and dining areas, and bathrooms. All areas were clean, hygienic and pleasantly furnished. Comment cards were received from residents, relatives and GPs prior to the inspection; all were very positive and showed that everyone is satisfied with the care that they receive. All of the residents appeared to be happy with their environment and care. The manager, nurses and care staff showed that there is a very good team approach to the care given to the residents. Everyone was very friendly, welcoming and co-operative throughout the visit. What the service does well:
Burrowbeck Grange provides a pleasant environment for the people who live there. There is a relaxed atmosphere throughout the home. The lounge and dining room are very homely. The fabric and furnishings of the home are of a good standard and the home is kept clean and hygienic. The staff are gentle, friendly and professional in their approach to care and the residents who were able said that the staff were all very caring and considerate. Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 6 Daily routines for the people living at Burrowbeck Grange are flexible and the residents’ personal routines and lifestyles are respected. A small number of residents were able to make comments and these were complimentary. A visiting relative said that they were more than happy with the care given at the home. What has improved since the last inspection? What they could do better:
The home’s up-dated statement of purpose and service users guide has not yet been finalised; this needs to be done so that prospective residents can get the right information about the new providers, Optima Care Ltd. Bathrooms remain in need of some refurbishment and as this was noted in the last inspection report, should be addressed as a matter of priority. The carpets in the corridor between rooms 14 to 20 are rucked and must to be pulled tight to prevent any accidents to residents or staff. The responsible individual must provide Regulation 26 monitoring visit reports each month; this will show that the home and the care provision is being checked for quality. Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 7 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. Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 8 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 Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 4. The home’s statement of purpose and service users guide is not yet complete and needs to be fully updated and relate to the new providers which are Optima Care Ltd. Pre-admission assessment information is not always fully completed and may not give a full picture of the person who is being assessed. EVIDENCE: Although information is available for all prospective residents and their relatives, the home is currently using a statement of purpose and service users guide that is adapted from that of the previous providers; this should be fully updated so that it relates wholly to Optima Care Ltd. The final version of the new statement of purpose and service users guide is due to be printed in the near future. Pre-admission assessments are done before any person is offered a place at the home, however not all of the sections of information are fully completed and this could lead to missed information.
Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 10 The registered manager agreed to make sure that all sections of the assessment were fully completed in the future. Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 10 The residents’ health and social care needs are met and people are treated with dignity and respect: They are supported in their daily lives. EVIDENCE: Care plans are written records of the care that are given to each person that lives at the home, and two of these plans were looked at. Each care plan contained assessments for all aspects of physical, mental, personal and social care and a photograph of the resident. Reviews of the care plans had the signatures of the resident and/or their relatives. It is recommended that the actual time of daily report writing is recorded so that an accurate picture of any care that is given can be established. The manager agreed with this and intends to initiate this with immediate effect. Care staff said that they knew about the residents’ care plans and that they were used to make sure that the right care is given to each resident. Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 12 There is a very gentle and respectful mode of interaction between the staff and the residents at this home. All of the residents appeared to be well cared for and content. Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 13 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): 15 The residents’ benefit from meals that are well planned and appetising. EVIDENCE: The home’s menu is set to take into account the preferences and stated choices of the residents. There are always options if the set menu is not to the liking of any resident. Residents who were able said that the food was good and that they had plenty of choice. The lunchtime meal looked appetising and the residents said that they had enjoyed it. Special diets such as diabetic or pureed food is available. Burrowbeck Grange Nursing Home DS0000065247.V271667.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 & 18 Residents and their relatives are able to voice their complaints and know who to speak to if they have any concerns. EVIDENCE: There is a written complaints procedure in place and a copy of this is displayed in the entrance of the home. There have been no complaints either to the manager of the home or to the Commission for Social Care Inspection. Staff induction programmes include training on abuse awareness; staff confirmed that they are given this training, which ensures that the residents are protected and supported. Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 21 The environment is generally kept safe, however some carpets are in need of attention to make sure that the residents and staff do not trip up and some bathrooms are in need of refurbishment. EVIDENCE: The home is maintained to a good standard, but the carpets on the first floor, adjacent to rooms 14 to 20, are in need of pulling straight to make sure that residents and staff do not trip up. The manager said that this is being attended to as a matter of priority. The home’s bathrooms are scheduled for refurbishment and this is currently being costed, with a view to beginning the work in the near future. Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 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 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): 29 & 30 Staff have the appropriate training, qualifications and experience necessary to give a good care service and residents are protected by safe recruitment procedures. EVIDENCE: There are over 50 of the care staff who have attained National Vocational Qualifications (NVQ); this means that they are trained to a nationally recognised standard and are competent in providing good care for the residents. Staff recruitment files were examined and each contained all records that are required under Schedule 2 of the Care Homes Regulations; this means that all staff are put through employment checks before they start to work at the home. Staff went about their duties quietly and efficiently and said that they were given opportunities to undertake training and development. Although a staff training matrix is in place, an action plan for all of the staff to complete/renew the core training programmes such as health & safety, moving & handling and food hygiene should be developed.
Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 17 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, 35 & 38 The home makes sure that the best interests of the residents are protected in that there are regular health and safety checks that focus on the quality of care that is provided. EVIDENCE: There is a quality monitoring system for the home and all health and safety checks are done. The home does not hold any personal monies for residents. Current safety servicing certificates are in place. Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 18 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 2 X 3 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X X X x STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 19 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 2 Standard OP1OP4 OP19 Regulation 4&5 16 Requirement An up to date statement of purpose and service users guide must be produced. The carpets in the corridor between rooms 14 to 20 are rucked and must be pulled tight to prevent any accidents. The responsible individual must forward a monthly report to the Commission. Timescale for action 01/04/06 01/04/06 3 OP33 26 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3 Refer to Standard OP21 OP3OP7 OP30 Good Practice Recommendations Bathrooms are in need of some refurbishment. Care records should be fully completed and include information on residents’ strengths as well as needs. An action plan should be developed with timescales for all staff to complete core training programmes. Burrowbeck Grange Nursing Home DS0000065247.V271667.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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