Inspection on 13/07/05 for Four Seasons

This inspection was carried out on 13th July 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

Four Seasons 05/04/07

Four Seasons 16/03/06

Four Seasons 08/02/05

Four Seasons 08/02/05

Four Seasons 08/02/05

Four Seasons 08/02/05

Four Seasons 16/06/04

Four Seasons 16/06/04

Four Seasons 16/06/04

Four Seasons 16/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE FOUR SEASONS (Summer Unit) Breightmet Fold Lane Bolton Lancs BL2 5NB Lead Inspector Mike Murphy Announced 13 July 2005 th 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. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Four Seasons Address Breightmet Fold Lane Bolton Lancs BL2 5NB 01204 392005 01204 393005 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) Southern Cross Healthcare Limited Mrs Jacqueline Mellor CRH N - Care Home with Nursing 121 Category(ies) of OP Older People - 55 registration, with number DE(E) Dementia over 65 years - 54 of places TI(E) Terminal Illness over 65 tears - 4 PD Physical Disability under 65 years - 8 FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 121 services users, to include: up to 55 service users in the category OP (Older People) over 65 years of age; up to 54 service users in the category DE(E) (Dementia over 65 years of age), with 1 named service user (JR) in the category of DE (Dementia under 65 years of age); up to 4 service users in the category TI (E) (Terminal Illness over 65 years); up to 8 service users in the category PD (Physical Disability under 65 years of age), within these, 2 places for named service users (BS and JC) A maximum of 29 service users in the above categories can receive nursing care. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 8th February 2005 Brief Description of the Service: Four Seasons is a 121-bedded care home providing a service to mainly older people, which include general nursing, dementia and residential care. The Home is also registered to provide care for eight younger people with a physical disability.The Home is situated on a bus route about 2 miles from Bolton Town Centre.The premises are purpose built on two levels with two lifts to the first floor.All bedrooms have en-suite facilities. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report specifically refers to the inspection of the Summer Unit at Four Seasons care home. The Summer Unit provides care and accommodation for up to 28 residents who require general nursing care. For an overall view of the home this report should be read in conjunction with those produced for the other 3 Units at the home. Some Standards were inspected as they apply to the home generally e.g. Choice of home and management standards and others as they apply to individual units within the home e.g. staffing, environmental and health and personal care standards. This announced inspection was the home’s first of two annual inspections for the inspection year 2005 to 2006. The inspection took place over nine hours. The inspection included discussion with residents and their relatives, a tour of the premises, inspection of care and other records maintained at the home, discussion with management and staff, and consideration of responses in returned questionnaires sent to residents, their supporters and others who visit the home such as social workers, doctors and nurses prior to the inspection. What the service does well: What has improved since the last inspection? A programme of redecoration was in progress at the time of this inspection. This is clearly improving the environment for residents and staff. It was evident that greater emphasis has been placed on enabling the residents of Autumn unit to access the various leisure activities within the home where possible. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 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. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 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 FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 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) 1,2,3, & 4. Standard 6 does not apply to this home. Prospective residents and their supporters are enabled to make informed choices about the home and Summer unit. EVIDENCE: The home provided a statement of purpose and service users guide that was readily accessible to all potential and existing residents and their supporters. Inspection of these documents revealed that they provided appropriate information in respect of the services provided by the home. These documents were readily accessible to residents and their supporters. Those spoken to found the information easy to understand and were of the view that they fairly reflected the service provided. Inspection of the contract of terms and conditions issued to residents by the home indicated that this document was appropriate and has been reviewed and appropriately amended. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 9 Inspection of care records on summer unit revealed that all prospective residents undergo a formal pre-admission assessment that is conducted by a senior member of staff from the home. Records of assessment revealed that all the relevant activities of daily life were assessed appropriately and any areas of need in these areas identified. Such an assessment ensures that the home identified precisely what prospective needs are and that the home will be able to provide the care that individual needs. Discussion with residents and their relatives, management and staff, and inspection of care records indicated that the care and accommodation provided were meeting residents assessed needs. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 10 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) 7,8,9,10. The health and personal care needs of residents on the summer unit continue to be assessed and addressed appropriately. The arrangements for the management of resident’s medicines were appropriate and staff interacted and assisted residents sensitively and appropriately during the inspection. EVIDENCE: The health care records of 5 residents who live on the summer unit were inspected on this occasion. These were found to contain care plans that were initially based on the pre-admission assessment that is referred to earlier in this report. Care plans addressed the health, personal and social care needs of residents and were formally evaluated at least monthly. Risk assessments, that seek to protect resident’s health and safety were also recorded in respect of residents skin integrity, mobility, and nutrition (including weight monitoring) and other relevant areas and were also evaluated at least monthly. The arrangements for resident’s medicines were secure and appropriately documented. These arrangements are operated by senior staff at the home all FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 11 of who have undergone training in the management and administration of medicines. Senior managers at the home audit how medication is managed within the summer unit on a regular basis with the aim of ensuring a high quality of provision. Discussion with residents indicated that staff at the home treat them with respect and seek to maintain resident’s dignity and privacy particularly when personal care is being provided. Examples of such comments are ‘ the girls are always polite and willing’, ‘they help me willingly’, ‘my privacy is respected’ and ‘I am well looked after here’. Residents also indicated in their comments, and this was supported in discussion with staff and inspection of care records, that residents are able to access health care services appropriately, this included access to opticians, dentists, and chiropodists. Clearly this assists residents in maximising their health and well being. All residents were registered with a local GP. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 12 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) 12,13,14,15. The routines of daily life were as flexible as possible in a communal living setting. This is important for residents being able to make choices for themselves and retain their independence. Residents living on Summer Unit were enabled to participate as much as possible in the wide range of social and recreational activities (including entertainment) that are organised within the home. Meals provided a balanced and varied diet. Both activities and meals are very important areas for residents as they are central components of how they describe their satisfaction or otherwise with a home. EVIDENCE: The home is extremely active in the provision of a wide range of leisure and social activities. Residents from summer unit are particularly actively involved in the varied group activities on offer at this home. Individual records are maintained which provides clear documentary evidence that these individuals also choose when not to participate. Those unable or do not wish to join in are offered quality one to one attention with one of the two activity co-ordinators specifically employed at this home. A programme of activities was prominently displayed in the home – this enables residents to be aware what is available and to choose what activities they wish to participate in. This programme of activities is supplemented by entertainers occasionally coming to the home, FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 13 and a range of outings, that provide appropriate opportunities for residents to experience life and leisure outside the home. Residents generally and on summer unit in particular spoke very positively in respect of the food provided, choice of meals and dining areas provided. Comments made included ‘ the food is very good’, ‘I can have something else to eat if I wish’. Menus were varied, balanced and provided extensive choice. Staff were observed to assist residents on Summer unit sensitively and appropriately with their evening meal on the day of inspection. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 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 standard(s) 16,18 Appropriate arrangements had been made to provide an environment where residents and their supporters feel comfortable with making a complaint if necessary, and to prevent residents becoming victims of abuse. These are important areas that are crucial to the protection of resident’s in a care home, many of whom are extremely vulnerable. EVIDENCE: Discussion with residents throughout the home and inspection of responses in pre-inspection questionnaires and the service users guide issued by the home indicated that there was a general awareness and information provided that enabled people to make a complaint if they desired. A detailed and accessible complaints procedure and record was in place and prominently displayed in the home, which included details of how complainants could contact the CSCI if desired. Resident’s spoken to felt comfortable and confident enough to raise a complaint if they felt it necessary to do so. Inspection of policies and procedures operated at the home, discussion with staff and inspection of staff training records indicated that staff were aware of the importance of protecting resident’s from potential abuse and how to communicate any concerns they may have in this area. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 23,25,26. Summer unit was clean, warm, appropriately and comfortably furnished and appeared to be well maintained at the time of inspection. The unit was in the advanced stages of redecoration at the time of inspection. Clearly a pleasant and comfortable environment are important areas in the quality of life provided for residents at the home.The home generally was well maintained and the pleasant garden areas were accessible to all residents. EVIDENCE: Inspection of the premises revealed that summer unit was clean, appropriately decorated and appropriately/comfortably furnished. However like spring unit, although it was a warm day at the time of inspection, the corridors were not well ventilated and the need for some sort of mechanical ventilation in these areas should be considered e.g. guarded electric fans/extractor fans. The 5 resident’s bedrooms inspected on this occasion benefited from en-suite WC and hand washbasin facilities and were appropriately equipped and FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 16 personalised. Suitable facilities were in place to meet resident’s laundry needs. The inspector was informed that hot water temperatures were controlled by thermostatic mixer valves that are designed to prevent scalding accidents. Appropriate aids and adaptations were in place throughout the unit that assist residents to maintain their safety and meet their physical needs. Individual aids and adaptations are provided following referral to the appropriate health care professional. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 17 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) 27,28,29,30 Summer unit provided adequate and appropriate staff to meet the assessed needs of resident’s. Staff undergo an appropriate recruitment process. It was evident staff received a wide range of appropriate training – including NVQ training. Clearly these are all important in ensuring resident’s needs are met and that they are protected through adequate screening and training of staff employed at the home. EVIDENCE: Inspection of staffing rotas provided by the home indicated that staffing provision on summer unit has recently been reviewed to ensure staffing provision is appropriate to meet the dependency levels and needs of residents on summer unit – many of whom have complex nursing needs - and not merely to comply with the current minimum requirements that apply to care homes for older people. Random inspection of 2 recently employed staff personnel files revealed that these contained an application form (including health declaration), 2 written references, a Criminal Records Bureau check (including a ‘POVA first’ check), proof of identity (including a photograph), and evidence of induction training. Inspection of training records demonstrated that staff at the home were provided with appropriate training in care and related issues – including NVQ training. Discussion with staff revealed that they felt they were able to access appropriate training and were encouraged and supported by the manager in doing so. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 18 FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 19 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) 31,32,33,35,37,38. The home continues to be appropriately managed at the time of this inspection. This is important as residents need to have confidence in and access to competent managers. EVIDENCE: The registered home manager is a very experienced registered nurse manager and has completed an NVQ4 in management. The registered manager is supported by a deputy manager. Discussions with service users within the home, their relatives, and staff employed at the home indicated that the registered manager has developed a management style that is open, supportive, positive and inclusive. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 20 The following certificates of inspection/service records were found to be satisfactory on this occasion; electrical systems/equipment, passenger lifts/lifting equipment, gas safety, accident records/monitoring, monitoring of hot water temperatures, general and specific health and safety risk assessments, and control of clinical waste disposal. A report in respect of fire safety at the home issued by Greater Manchester fire and rescue service on the 18th of July make a number of requirements that need to be addressed by the home. FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 21 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 3 3 3 3 3 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 3 3 x 3 3 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 Standard No 16 17 18 Score 3 x 3 3 3 3 x 3 x 3 3 FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 22 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 19 Regulation 23 Requirement Timescale for action 30th of September 2005 2. 38 23 That an action plan to improve ventilation to corridors within summer unit corridors is submitted to the CSCI That the requirements made in 31st of respect of the Greater August Manchester fire officers safety 2005 inspection report dated the 18th of July 2005 is complied with and this compliance is confirmed in writing to the CSCI 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. Refer to Standard Good Practice Recommendations FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich BL6 6HG 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 FOUR SEASONS (Summer Unit) F56 F06 S5678 Four Seasons (Summer) V230151 130705 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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