Inspection on 22/04/05 for Bushell House

This inspection was carried out on 22nd April 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

Bushell House 25/05/07

Bushell House 04/10/05

Bushell House 09/11/04

Bushell House 27/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Belvidere Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Bushells House Mill Lane Goosnargh Preston PR3 2BJ Lead Inspector Susan Dale Unannounced 22 April 2005 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. Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bushells House Address Mill Lane, Goosnargh, Preston, PR3 2BJ 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) 01772 865225 The Trustees Of Bushell House Mrs Susan Jones Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Not applicable Date of last inspection 09/11/05 Brief Description of the Service: Bushells House is situated in the village of Goosnargh and provides personal care to a maximum of thirty-one service users of both sexes. The home is large, luxurious and set in a beautiful garden; there are numerous communal rooms such as the library and dining room, nearly all the individual rooms are large and very well appointed. All the bedrooms are for single occupancy and many of the rooms have en suite facilities. Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 3 hours and was unannounced. A partial tour of the premises took place and care and staffing records examined. Ten service users and 3 staff were spoken to as well as a relative and the registered manager of the home. The records of 3 service users were examined in detail and key personnel spoken to. The staffing records belonging to new staff were examined to ensure that appropriate recruitment procedures are being followed and a training programme is in place. What the service does well: What has improved since the last inspection? All the radiators and pipe work has now been covered to ensure safe surface temperatures. Two bedrooms have been decorated. A Gardening Club has commenced for the benefit of service users and staff. A `Suggestion Box’ has been placed in a prominent position outside the library for use by service users, staff, relatives and any visitors to the home. Plans are in place to invite relatives/advocates, health professionals (where appropriate) to a review of the provision of care to service users. Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 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. Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 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 Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 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) 3 The assessment is thorough and takes into account the individuality of each service user, providing encouragement within a safe environment. EVIDENCE: An initial assessment is undertaken to ensure that each service user will be able to have their physical and emotional needs met whilst they reside within the home. The assessment takes into account the service user’s previous history and background. The assessment is recorded and takes into account any potential risks and how the risks can be minimised. There was evidence that the assessment is carried out with the full co-operation of the service user or an advocate acting on their behalf. Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 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, 8 & 10 Service users’ health, personal and social care needs are fully met and the details are recorded and reviewed on a regular basis. EVIDENCE: Following the assessment, an Individual care plan is recorded for each service user and a staff member allocated as the service user’s `key worker’ maintains the details. It is the key worker’s responsibility to ensure that the care plan is followed as closely as possible and that it is reviewed on a regular basis. Three service users’ records were examined. One of the service users had been admitted to the home fairly recently another service user was a great age and had far more dependency with regard to their physical needs. The care plan took into account the physical and emotional needs, their hobbies likes and dislikes and how each need could be met. Plans are in place to invite at regular intervals key professionals/relatives to a service users’ review and letters have been prepared in advance. A separate recording is maintained of any visits by health practitioners such as the G.P., District Nurse or Occupational Therapist and each time a health Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 Page 10 professional has been contacted. Risk assessments had been reviewed and adjusted according to the ability of the service user at the time of the review. A relative spoken to at the time of the inspection, commented stating, “They are so wonderful here”. Her mother had recently had a fall and been admitted to hospital. The relative was so pleased that her mother had been able to return to the home after the fall and had every confidence in the abilities of the staff to care for her mother, stating that she could not praise the staff too highly. Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 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 &15 The home provides a luxurious, relaxed environment that meets the expectations of the service users by ensuring opportunities for social interaction and religious fulfilment. EVIDENCE: The majority of service users meet in the lounge/drawing room for morning coffee and afternoon tea. Service users spoken to during coffee expressed their appreciation of the facilities provided at the home. Recently a Gardening Club has commenced with the gardener bringing various plants and wild flowers for discussion and this appears to have well supported by the service users spoken to. Other activities are musical evenings usually on a theme such as Irish on St Patrick’s Day. Homemade biscuits are always provided morning and afternoon with coffee or tea. The dining room is luxurious and a choice of meals is provided with the menu changed every 4 weeks. According to the service users spoken to the meals are excellent and they can see the menu in advance. The majority of service users prefer to have breakfast in their own room and breakfast consists of fruit, porridge or cereal. Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 Page 12 A member of staff who assists with meals confirmed that training is provided such as Food Hygiene and that specialised diets are catered for. One of the service users spoke about how they are always being encouraged to look at new ways for social interaction and recently it had been decided that coffee after their meal as it would be in a restaurant would encourage conversation. Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 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) 18 Policies and procedures are in place to ensure that service users are protected from abuse. EVIDENCE: The home has a policy on Adult Abuse which has been changed to include the details contained in the Department of Health Guidance `No Secrets’. The home has a policy on dealing with aggression. All staff have been provided with in-house training on the subject of Adult Abuse. Staff spoken to confirmed that they had been provided with training and would know what to do if they had to report any abuse under the whistle blowing procedures. The registered manager is aware of the commencement of the Protection of Vulnerable Adults Register (POVA). Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 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 Every effort is made to maintain the environment in which the service users live. Both service users and staff are proud to be connected with the large and luxurious building and gardens and have respect for the heritage of Bushells House. EVIDENCE: A record of maintenance is kept by the home and the trustees of the home meet regularly to review and agree a programme of maintenance. The home is not purpose built and has a lift that provides access to all floors. The gardens are extensive and well maintained and accessible to the service users. In the summer service users are able to sit within a summerhouse and admire the view. The building complies with the requirements of the local fire service and environmental health department. Since the registered manager took over at Bushells House, she has continuously striven to improve the facilities and made several changes for the benefit of the service users and staff such as additional bedrooms and a training room for staff. Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 Page 15 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 Appropriate Staff are provided in sufficient numbers at all times to provide care to service users. The policies and procedures for the recruitment of staff ensure that suitable staff are employed to work within the home. NVQ training is continuing to ensure that staff have sufficient knowledge in the provision of care. EVIDENCE: Staffing rotas have been maintained although the registered manager has found it difficult to recruit staff because of the location of the home and the difficulties this presents for staff that have to commute. Every effort is being made by the manager of the home and the Board of Trustees to address the problem. The majority of staff who work within the home have been working at the home for a number of years and this continuity has been appreciated and been of benefit to the service users. Six staff have completed NVQ 2 and 3 staff are in the process of completing the qualification out of a total of 14 care staff. Staff files were examined; a member of staff recently recruited had been checked appropriately with references taken up and clearance obtained via the Criminal Records Bureau (CRB) and the Protection of Vulnerable Adults Register (POVA). Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 Page 16 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) 31,32 & 38 The home is well run and managed with staff working well as a team promoting the health and well being of the service users. EVIDENCE: Recently the home suffered the outbreak of an infection, which affected a number of service users. Both service users and staff commented on the excellent way the outbreak had been handled. Staff said that a positive outcome had been achieved via good teamwork at which they appreciated the way the manager had worked alongside them. Staff meetings are held on a regular basis as well as individual supervision. Staff confirmed that they are provided with training in health and safety including safe handling techniques; food hygiene; first aid and fire safety. Policies and procedures are in place with regard to infection control and regular maintenance is undertaken on heating systems and water temperatures. Risk Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 Page 17 assessments are carried out for any potential risk and a record is kept of any accidents or incidents. The registered manager is responsible for reporting under the RIDDOR Reporting Regulations. The registered manager is currently completing NVQ 4 in Care and Management. Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x 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 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 3 28 2 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 3 2 3 x x x x x 3 Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 Page 19 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. 2. Refer to Standard 28 31 Good Practice Recommendations Training of staff to NVQ level 2 should continue. l Confirmation should be sent to the CSCI once the manager has completed NVQ 4 in Care and Management. Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unit 1, Tustin Court Portway Preston PR2 2YQ 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 Bushells House F57 F09 S9819 Bushells House V217365 220405 Stage 4.doc Version 1.30 Page 21 - 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!