Inspection on 20/09/06 for Bushmead Court

This inspection was carried out on 20th September 2006.

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

Bushmead Court 01/11/07

Bushmead Court 10/11/05

Bushmead Court 31/05/05

Bushmead Court 11/10/04

Bushmead Court 14/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Bushmead Court 58/60 Bushmead Avenue Bedford Bedfordshire MK40 3QW Lead Inspector Carol Mitchell Unannounced Inspection 20th September 2006 09:50 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 Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 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. Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bushmead Court Address 58/60 Bushmead Avenue Bedford Bedfordshire MK40 3QW 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) 01234 353884 Calsan Limited Care Home 27 Category(ies) of Dementia - over 65 years of age (27), Old age, registration, with number not falling within any other category (27), of places Physical disability over 65 years of age (27) Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th November 2005 Brief Description of the Service: Located in a quiet residential street, close to city centre and other local amenities, this grade II building provides environmentally pleasant accommodation for residents. The home generally caters for elderly frail people, but has developed the service so that residents with dementia are now cared for as well. There are twenty-three single and three double bedrooms on two floors, and twenty rooms have en-suite facilities. There are three bathrooms, and a shower room. High ceilings, domestic furniture with a few antique pieces creates an environment enjoyed by residents. The garden offers a combination of paved patio area and beautifully maintained grassed area with flowerbeds, and easy access from the large, new all weather conservatory. There is space for some parking at the home. The home makes CSCI inspection reports available to residents and families on request. Fees at this home are summarised as follows: (This information was obtained from the home in September 2006.) Lowest fee £495. Highest fee, £550. Items not covered by fees are hairdressing (for example £7 wash and set), private chiropody (£10), manicures (start at £7). Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took into account feedback obtained from the Commission’s pre-inspection questionnaires and the comment cards received from 8 service users. The inspection visit took place over 4 hours 20 minutes on the 20th September 2006. During the inspection visit, the inspector spoke with clients, staff, and manager, and looked at some records, including information from the home’s questionnaires. The inspector also looked around some parts of the building, and spoke to the owner on the phone. The inspector would like to take this opportunity to thank the clients and staff who helped with this inspection visit. What the service does well: This home is a homely place. It is kept clean and comfortable, and the manager and staff put the needs of people living there first. People are well looked after, and they are listened to. During conversations clients said, “They are very kind”; “They are friendly and take care of us”. People are not afraid to speak up. “If there is a problem I speak to the manager.” “I tell them if there’s anything I don’t like.” Relatives are made to feel welcome. “It is very welcoming”, several said in a questionnaire. The home encourages people to carry on with their own interests, and to be as independent as possible. A client said, “I love it here, I run the music club. I do things here; I like the bingo and dominoes. The food is excellent, and I read large print books from the library.” The manager is helped by the owner, and the staff are well supported and trained so that they can do their best for people living in the home. Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 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. Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 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 Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 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, 3 Quality in this area is adequate. This judgement has been made using available evidence including a visit to the service. The needs of people at the home are assessed, and terms and conditions are agreed. Therefore, when people are admitted, it is the right decision for them. EVIDENCE: Examples checked during the inspection showed that the assessments include admission dates. (In the past this was not always the case.) The contracts seen had been signed by the client or a family member. Service User guides (information for clients about the home) are available, although as yet no large print or special versions have been printed, and this would improve quality in this area. Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 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): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can be sure their health and personal needs will be met because care is planned in an organised way, the staff are kind and have been trained. EVIDENCE: Health care is given high priority at the home, which has a contract with a local family doctor to provide an hour’s medical input every week. (This is in addition to usual local doctor and district nurse services). Liaison with local doctors and district nurses was referred to within care planning documentation, and a physiotherapist arrived at the home at the end of the inspection visit. Other health needs are addressed, for example there is a visiting dental service. Some clients go out of the home for appointments. There are close links with a local Community Psychiatric Nurse who visits every two weeks or so, or on request, to help with the support of people with dementia. Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 Page 10 Care plans which reflected assessed needs were available for the clients checked during the inspection visit. Care plans could be improved by reducing broad statements within goals and actions, and including more specific detail instead. For example by giving advice about how much someone should drink, and how often, and by detailing blood sugar levels which trigger a call to the family doctor. Clients had signed some of the records seen, and risks had been assessed. The whole cupboard is now used for the storage of medicines alone, so the medicines are more organised. Medicines are provided in blister packs. Staff questioned had received training in the management of medicines. Proper procedures are in place, and at the time of the inspection visit, two clients were self-medicating. Staff questioned had been trained for their roles, and were able to describe individual needs of specific clients in a detailed and comprehensive way. Two new hoists have been purchased, and staff undertake moving and handling training. Staff observed dealing with clients were calm, caring, and attentive. Clients knew the staff, and were calm and settled in their presence. During the inspection a call bell was answered promptly, and staff were observed promoting privacy, dignity, and independence by for example supporting clients discreetly and in a variety of ways when the toilet was needed. There are three bathrooms in the home, one of which has a fitted hoist. There is also a shower room. A client said that she was happy with the way in which she is helped to bathe. Staff were aware of how individuals use aids such as hearing aids and walking frames. Clients spoken to highly praised the way they are cared for. The content read in the home’s questionnaires indicates high levels of satisfaction amongst clients and families regarding how people living at the home are looked after. Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are listened to, and their views about how they want to live are taken seriously. Therefore they are supported to continue with their chosen lifestyle as far as possible. EVIDENCE: Discussion with clients showed that people are encouraged to live in the home in ways comfortable for them. An employee in a coordinating role works every Monday, and whilst group activities are laid on (dominoes on the day of inspection visit), individuals are also encouraged to keep up their own individual interests. For example one client runs a classical music club at the home, and another is to start going to bridge club outside the home. A member of staff at the home is to soon undertake specialist-training relating to the organisation of activities within care homes with a view to improving this side of life at the home. A Karaoke machine is to be purchased soon, so that musical activities can be better supported. Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 Page 12 Large print library books are available. One client was enjoying doing a 500piece jigsaw puzzle at the time of the inspection visit, and she also described how she likes helping with the dusting of delicate personal items in her room. The client explained that she had been able to bring into the home her own furniture, and that this makes her and her visitors feel very relaxed. Clients are able to manage their finances independently if they want and are able to. Mostly relatives support clients in this however. At the time of inspection visit one client was managing her own finances. Previous issues with recording have been addressed by a system where client monies are no longer held at the home. Instead, clients make purchases, and invoices are issued. Lunch was presented beautifully, with linen and lace tablecloths, place settings and flowers. Clients said that they enjoy the meals, “the food is excellent”. Clients are given a choice if they do not enjoy the planned menu. Written feedback from clients who completed questionnaires requested the addition of scampi and chips to the menu, and this was done immediately. On the day of the inspection visit a cook and kitchen assistant were on duty. Within questionnaires relatives repeatedly praised the home for making them feel welcome and involved in the home. Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 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 the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Staff have been trained, and the owner and manager listen to people living at the home. Therefore clients can be sure they will be protected from harm. EVIDENCE: The manager and staff questioned had received training about the protection of vulnerable adults, and had completed questionnaires testing their knowledge in this area. A complaints procedure appears in the information for clients, and in the contracts. More importantly, clients described how they would raise issues, and identified who they would talk to if necessary. In questionnaires clients and relatives demonstrated knowledge and confidence in reporting any problems. A client recounted giving important feedback directly to the owner (who visits often and always speaks with clients), and advised that he had been taken seriously, and action was quickly taken by the owner. In conversation generally, clients showed confidence that they can speak up and that they will be heard. An advocacy service is available, and representatives from a local Advocacy group have recently visited the home to increase staff awareness of when to ask them for help. Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 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 the following standard(s): 19, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Great effort is made to make sure the atmosphere feels homely; the home is well decorated, and well maintained. Therefore people living at the home do live in a safe and well-maintained environment. EVIDENCE: Clients said that they love their surroundings at the home; “it is superb” one gentleman enthused. Since the last inspection visit a large and impressive all weather conservatory has been built, and new furniture purchased for it. The conservatory includes a toilet suitable for wheelchair use, and a call bell system. Feedback from questionnaires seen commented on the high standards of decoration and cleanliness at the home. Two housekeepers were on duty at Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 Page 15 the time of the inspection visit, both showing careful attention to detail during cleaning tasks, and justifiable pride in their work. Clients are encouraged to bring in their own furniture and possessions, and rooms seen were very homely, comfortable, and clean. The maintenance man was busy working in the well maintained and pretty garden/patio area to which there is easy access from the conservatory. Decoration is ongoing in the home. Also, a new washing machine and tumble dryer have been purchased since the last inspection visit. The manager trains staff on matters to do with infection control. Essential maintenance/refurbishment of the passenger lift is to be carried out during October 2006. The manager was in the process of distributing letters to clients and families at the time of the inspection visit. Discussions have already taken place with individuals who usually use the lift, and plans have been made to carry on activities in different ways. A temporary lounge will be created using the quiet room, and an extra staff member will be on duty. The home has stressed to the engineering company the need to do the work as quickly as possible. Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 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): 27, 28, 29, 30 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Enough trained and supervised staff work at the home, and care is taken before employing staff. Therefore the needs of people living in the home are met. EVIDENCE: At the time of the inspection visit in the home were 24 clients, 4 care staff (including the manager), 2 housekeepers, a kitchen assistant, the cook, and the maintenance man. The manager is able to call in extra staff when she sees a need, for example if the lift is out of order. Clients spoke highly about the staff caring for them, and one client explained that his views about staff are taken into account. Staff talked competently about the individual needs of clients in detail when questioned, and had received training in areas such as health and safety, and moving and handling. Staff training files are maintained. Nearly all staff have now achieved or are undertaking National Vocational Qualification training, and the staff and manager described the owner’s attitude to training very positively indeed. Formal supervision sessions take place, staff meetings are held, staff complete feedback questionnaires, and receive handovers regarding changes in the Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 Page 17 conditions of clients. Care staff whose first language is not English are receiving lessons, are popular among clients, and work closely with English speaking colleagues. Staff files confirmed that necessary checks are made prior to employment, and proper procedures are in place concerning the recruitment of staff. New staff receive induction training, and their work is supervised by experienced team members. Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 Page 18 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): 31, 32, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made sing available evidence including a visit to this service. The owner, manager and staff care about people living at the home, and the owner and manager know how important training for staff is. Therefore, clients can be sure that the home is run in their best interest. EVIDENCE: The owner is very involved in the running of the home, and visits at least twice every week. Clients confirmed that the owner chats to them during visits, and takes their views very seriously. The manager described the owner’s role in the coordination of mandatory training, including health and safety training. Clients also referred to seeing he manager very frequently, and spoke about Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 Page 19 her in glowing terms. The manager, who is receiving appropriate training, feels well supported by the owner. Client meetings have been started, and questionnaires to obtain feedback from clients, families and staff are distributed, and acted upon. Staff supervision and training are given high priority. Staff interviewed are well supported by the manager and owner, and work in an effective and happy team. The manager and owner have worked to improve the systems in place concerning clients’ money and property. The manager has been in post since July 2005, but at the time of the inspection visit had not applied to become registered with CSCI. (This is a legal requirement). An application supported by the owner must be made as soon as possible. On the day of the inspection visit the owner advised the manager that the application will indeed be supported, and the manager undertook to obtain the relevant forms and information from the CSCI website or local CSCI office at her earliest opportunity. Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 Page 20 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 3 3 x x n/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 3 Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 Page 21 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 Bushmead Court DS0000014995.V312297.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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