CARE HOMES FOR OLDER PEOPLE
Bushells House Mill Lane Goosnargh Preston Lancashire PR3 2BJ Lead Inspector
Ms Susan Dale Announced Inspection 4th October 2005 10:00 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 Bushells House DS0000009819.V252168.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 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 DS0000009819.V252168.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Bushells House Address Mill Lane Goosnargh Preston Lancashire PR3 2BJ 01772 865225 01772 865503 office@bushellhouse.freeserve.co.uk 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) 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 DS0000009819.V252168.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The Registered Person shall at all times employ a suitably qualified Manager. 22nd April 2005 Date of last inspection Brief Description of the Service: Bushells House is situated in the rural village of Goosnargh and provides personal care to a maximum of 31 service users of both sexes. The home is large, luxurious and set in a beautiful garden. There are several communal rooms including the library, upstairs lounge and dining room. All the individual rooms are for single occupancy and are large and very well appointed; many have en suite facilities. Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was announced and during the inspection the inspector was able to speak to a number of service users, care staff and the registered manager. Comment cards were sent prior to the inspection to service users, relatives/friends and General Practitioners/District Nurses. A response was received from 2 service users, 5 relatives/friends, 1 General Practitioner and 3 Social Care practitioners, all the replies were positive. The inspection took place over 4 hours and commenced at 10.00 a.m. What the service does well:
All the service users expressed their appreciation for the care and attention they received from the staff. All of them valued the leadership of the registered manager and the oversight she provided in ensuring their comfort in every aspect. The majority of service users have chosen to reside within the home and pay privately; they confirmed that they have not regretted the decision to leave their own homes. Social work practitioners who are involved with any placements at the home made the following comments: “The placements I have been involved in, all the residents and their families have been very pleased and satisfied with the care received.” and “Staff always approachable and helpful, very discreet and act appropriately.” A comment was received from a relative: “ My Aunt is 95 years old and has been at Bushells House for 14 years. In my opinion there is nowhere that she would be happier or better cared for.” Another comment by a relative: “The registered manager and her staff go way beyond the call of duty. They show love and genuine affection to all in their care.” Communication between the staff is good with staff meetings and regular individual supervision. Training is a high priority with 50 of staff obtaining an NVQ 2 qualification. Trips and activities are arranged according to the wishes of the service users and they are encouraged to participate in the local community with events such as the Goosnargh Flower Show. Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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 DS0000009819.V252168.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 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 the following standard(s): 1, 2, 4 & 5 Written information is available about Bushells House and prospective service users are able to sample the service provided before making a decision about moving in on a permanent basis. All service users are provided with a written contract/terms and conditions. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide that provides information about the home and the services. The documentation is regularly reviewed and kept up to date. Information about a four week trial visit is contained within the Statement of Purpose and a very flexible approach is taken over ensuring that prospective service users are familiar with the home prior to any decision to stay there on a permanent basis. Several service users spoken to were local people and confirmed that they had known Bushells House all their lives and were very happy to be residing in such a lovely home. The home has a suitable contract/terms and conditions of residency and each service user has their own signed copy.
Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 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 the following standard(s): 9 The home has appropriate policies and procedures with regard to the provision and storage of medication. EVIDENCE: The medication policies and procedures were examined and found to be suitable. Several service users are self-medicating and the details are recorded at the initial assessment. A lockable facility is available within the service users’ private accommodation for the storage of any medication. The supply of medication has been changed to a local chemist and the service they provide, according to the manager is excellent. Staff have received medication training from different sources including Boots and the Lancashire Training Organisation. A comment was received from a General Practitioner who confirmed that the service users medication was appropriately managed by the home. Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 Page 10 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): 13 & 14 Service users are encouraged to be as independent as possible and to maintain contact with friends, family and the local community. EVIDENCE: Service users who were spoken to confirmed that they are encouraged to be as independent as possible. Some of the service users are able to walk around the village or visit the local pub. One service user was able to drive and went out as he wished. Family and friends are encouraged to visit and participate in any activities taking place within the home. Several of the service users attend the local church. A News Letter has been devised in the summer and contributions have been asked for from service users their relatives, friends, staff and trustees of the home. The latest newsletter celebrates recent events, birthdays, memories and holidays. Trips out have taken place to Lytham and rural Lancashire and there are plans to visit the illuminations. Other events include a sing-a long, the gardening club and a Christmas Fair. Volunteers from local schools attend the home and they have also contributed to the newsletter. Service users have also contributed and participated in the Goosnargh Flower Show. Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 Page 11 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 & 17 There is a suitable complaints procedure and service users or their relatives/friends are very confident that any concerns they have will be listened to and investigated. Legal rights are protected by the procedures operating within the home. EVIDENCE: The home does have an appropriate complaints procedure and staff and service users confirmed that they are aware of the procedure. There have been no complaints made to the home or the Commission for Social Care Inspection. Service users spoken to confirmed that they are able to participate in their right to vote and did so either by post or a personal visit. Information about the advocacy service is available Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 Page 12 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): 20, 21, 22, 23, 24, 25 & 26 The home and its grounds provide safe, clean and comfortable surroundings with sufficient facilities for the needs of the service users. EVIDENCE: There is ample communal space including a large library and dining room and a large lounge on the 1st floor. Ramps are provided for access to the garden, which has a large summerhouse well used by the current service users. Lighting is domestic in character and sufficiently bright for all activities. The home has ample washing and bathing facilities. There are 3 communal bathrooms and a shower room and several toilets on every floor as well as close to the lounge and dining areas. Twelve of the bedrooms have en-suite facilities. Service users have access to all parts of the home via a lift as well as ramps. There are assisted toilets and all bathrooms are fitted with a hoist; a portable hoist is also available. Doorway widths can accommodate wheel chair users and there are ample storage areas for equipment/wheelchairs. Many of the individual rooms are very large and have individual entrance halls. The number of bedrooms with en-suite facilities has recently been extended.
Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 Page 13 The service user’s private accommodation is luxuriously furnished and meets the assessed needs of service users. Doors can be locked and are accessible to staff in an emergency. A new nurse call system has been installed that is linked to a computer with three levels of call depending on the level of the emergency. Lockable storage space for medication, money or valuables is available. All the rooms have natural ventilation. The water temperature is stored at the correct temperature of 60 degrees to prevent the risk of Legionella. The radiators have been covered in order to provide safe surface temperatures. There are four domestic assistants employed by the home and at the time of the inspection the home was very clean, service users expressed their satisfaction with the way their individual rooms were maintained as well as communal areas. Since the last inspection, four rooms have been decorated and re-furbished. The home has a separate sluice with hand washing facilities and a suitable policy/procedure for infection control. Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 Page 14 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): 30 Training is a high priority and all staff are provided with appropriate training. EVIDENCE: There are 21 care staff 10 staff have achieved NVQ level 2 with a further 2 staff due to complete NVQ 2 by April 2006. Two relief senior staff are in the process of completing NVQ level 3. Staff confirmed that they had been provided with training, including induction training that assisted them in the care of service users. The training included Fire Safety, Moving and Handling, First Aid, MRSA awareness, and Protection from Abuse. Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 Page 15 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, 34, 35, 36 & 37 The service users interests are central in the planning, recording and financial procedures. Staff are supported and appropriately supervised. EVIDENCE: Questionnaires are sent out to service users and their relatives every twelve months; the respondents are allowed to be anonymous. Members from the board of trustees visit the home once a month and talk to service users covering three specific areas, Hotel Service (food/domestic); Care Service and Core Values; the results are publicised and left in the library and on the notice board. Service user meetings are held every 3 months; minutes are taken and before they are displayed in the library the letters are enlarged by the manager for service users to be more user friendly. The home has a Business and Financial Plan plus appropriate Insurance for both the Building and Public/Employers Liability. All financial issues are
Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 Page 16 discussed and have to be approved by the Board of Trustees. The majority of service users are able to manage their own finances or with the help of their family. By agreement money is kept safe within the office For a few service users and a record is kept of all transactions. Staff confirmed that they have individual supervision; the registered manager supervises senior staff and the chef and cook; senior staff supervise the care staff. Supervision covers all areas of practice as well as the philosophy of care within the home. Personal records are accessible to service users, all the records seen were accurate and up to date. Bushells House DS0000009819.V252168.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 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 3 3 X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x X 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 3 3 3 3 x Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? No 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. 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. Refer to Standard Good Practice Recommendations Bushells House DS0000009819.V252168.R01.S.doc Version 5.0 Page 19 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
© 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 DS0000009819.V252168.R01.S.doc Version 5.0 Page 20 - 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!
