Inspection on 29/06/05 for George Basterfield House

This inspection was carried out on 29th June 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

George Basterfield House 10/09/07

George Basterfield House 12/06/06

George Basterfield House 09/01/06

George Basterfield House 11/11/04

George Basterfield House 19/05/04

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

CARE HOMES FOR OLDER PEOPLE George Basterfield House Risedale Road Barrow in Furness Cumbria LA13 9BZ Lead Inspector Marian Whittam Unannounced 29 June 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. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service George Basterfield House Address Risedale Road Barrow in Furness Cumbria LA13 9BZ 01229 894549 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) Cumbria Care Julie Bernadette Armstrong Care Home 35 Category(ies) of OP - Old Age registration, with number DE(E) - Dementia, over 65 of places George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2. The home is registered for a maximum of 35 service users to include: - up to 35 service users in the category of OP (old age not falling within any other category) - up to 16 service users in the category of DE(E) (Dementia over 65 years of age) 3. The staffing levels in the home must meet the Residential Forum Care Staffing Formula for Older Adults. 4. When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. Date of last inspection 19 November 2004 Brief Description of the Service: George Basterfield House is a care home registered to provide care for 35 residents, including 16 with dementia. The home is in a residential area of Barrow in Furness, close to the local park, leisure centre, shops, post office, public houses and other amenities. The home is on a bus route and is about half a mile from the town centre. The home is on two floors and has a passenger lift for residents .All the bedrooms in the home are single occupancy and 3 have en suite facilities. The home is divided into individual units, Linden and Elmview are EMI units and Ashlea and Oakdale are for physically frail residents. Each unit has its own non smoking lounge, kitchen and dining area in addition to the large communal lounge on the ground floor and the ground floor lounge used by service users who wanted to smoke. The home has well kept and secure garden areas that residents may use. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was on 29th June 2005 over five and a half hours; the inspector looked at a number of records, care plans and medication records, looked around the home and spoke with 11 residents, 2 visitors, 4 staff members and a modern apprenticeship student on placement in the home. What the service does well: What has improved since the last inspection? Decoration was improving as part of the ongoing maintenance and improvement in identified parts of the home. Record keeping has improved and personnel, training and recruitment records were in better order than previously and the information was clear and well laid out. The home does have a small amount of administrative assistance now as well. Comments from staff and records of training show that access to training is continuing to improve. After a period of instability the staff group is becoming more settled and comments from staff suggested that morale was improving. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui 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. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui 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 George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui 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) 1,3,4 and 5 Residents had information about the home and services available to make an informed choice. A clear assessment and care planning system was in place to provide the information staff need to meet resident’s needs when they come in. EVIDENCE: Information was available about the home for prospective residents and their families in the statement of purpose and service users guide so they knew what services the home could provide for them. Individual care plans showed that new residents needs had been assessed before and following admission and their individual care plans developed from this. The home manager or senior staff did an individual assessment of needs in addition to social services plans to ensure that the home could meet needs before residents came to live there. Where appropriate other care agencies and professionals were involved in providing information and making assessments of the needs individual to be met. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 Page 9 Trial visits were available but no one spoken to had taken this up before coming in. Residents spoken to said that families and/or social services had arranged it for them. Although some of the residents said they had asked for this home. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 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 and 10 A satisfactory care planning system is in place to provide staff with the information they need to meet resident’s needs. The health needs of residents are being met and there is multi disciplinary working to meet assessed needs. Improvements are needed in medication practices in line with good practice guidelines to fully safeguard residents and staff. Personal support was being offered in a way that promoted resident’s dignity and independence. EVIDENCE: Individual care plans, based on initial assessments, setting out health and personal care needs and had been reviewed and updated. Healthcare needs were being identified at assessment and there were good working relationships with other healthcare agencies. Residents spoken with said that they felt they were well cared for and that they were treated with proper respect by staff, with their wishes respected. One resident said about the home “its great, heaven here” and another that the carers were “like friends”. Residents said that they saw health care professionals in their own rooms and saw their visitors when they wanted to George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 Page 11 and could come and go as they wanted, as long as staff knew. There were residents going out with friends and relatives that day and going out for a walk. There were medication policies and procedures in place to safeguard residents but some practices for recording administration, ensuring a continuous supply of medicines and cold storage were not satisfactory. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 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, and 15. The home provides limited social activities and staff supported residents in to maintain outside contacts. There was variety and choice in food and catered for special dietary needs, however the quality of the catering had gone down. EVIDENCE: The home provided some regular activities, recorded resident’s hobbies and interests and organised social and religious events. Residents said that they could come and go as they pleased and see who they wanted to. Relatives spoken with said that they were made welcome in the home and that staff were “friendly” and kept them informed about changes. A supervisor and a carer have responsibility for coordinating activities. Staff on the different units did individual and group activities as their workload allowed. One resident said how much she enjoyed going to the local park with staff taking her in a wheelchair but there were not always enough staff free to do this on a regular basis. Another resident said that there had not been any trips out “for ages” and that it would be nice to have a “change of scenery occasionally”. There was no evidence of any trips out having been organised since Christmas shopping. Activities and menus had been discussed at the last residents meeting (1.5.05) and residents suggestions for days out had yet to be fully acted upon. However George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 Page 13 there was evidence that at least one of the suggested activities was in the process of being organised. Residents spoken with made a range of comments about the food in the home; one said the food was “ quite good” and another that it was “average”. Some residents spoken with felt that the standard of catering had “gone down hill” and the meals were not as well prepared as in the past and sometimes they “didn’t enjoy some things so much”. These residents said that they thought it was because they “didn’t have a proper cook” and one said that it had “gone on long enough”. The food provided had been raised at the last residents meeting and this discussed. The manager had requested that one particular agency cook did not return to the home. However the home is still using agency cooks and there is no permanent cook in post. The home should recruit a permanent cook to promote a consistent standard of catering. Food seen on the day appeared satisfactory and residents did not make any complaint about the lunch to the inspector when asked. The menus provided showed a nutritious and varied diet and a choice. The home must consult with residents about their opinions on the food and act promptly upon any issues raised. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 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, 17 and 18 The home has a satisfactory complaints system in place. There were satisfactory procedures in place to protect vulnerable adults and for whistle blowing including multi agency guidance and these were easily available for staff in the home. EVIDENCE: The home has a complaints procedure and logged complaints for investigation and the procedure was available to residents. Residents spoken to said they thought that the manager or supervisor would deal with any complaints they made. No one spoken to said they had made a complaint using the procedure. Advocacy services were available to residents and the home had information on this if they wanted someone to act on their behalf. Staff spoken with had received training on adult protection and dealing with aggression to promote residents safety and well being. The home did not deal with any resident’s personal finances only small amounts of spending money. Staff spoken with were aware of Adult Protection processes, the procedures in place and had received training and information on this to safeguard residents from abuse. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 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, 21, 22, 23, 24, 25 and 26. The standard of decoration in the home was satisfactory overall with evidence of recent improvements and more planned. The home was tidy, homely and adequately maintained for residents and had the equipment they need to promote mobility and independence. EVIDENCE: Some bedrooms in the home and communal areas had been redecorated and new carpets had been provided, improving the environment and comfort for residents and the homely appearance. There was a long term rolling programme of improvement for the accommodation. Residents said they were pleased with the improvements that had been made in their home The dining and lounge areas on the units were seen being used for daily activities, reading the paper and watching television and residents said they enjoyed being able to mix socially on the units. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 Page 16 Resident’s bedrooms seen by the inspector had locks for privacy, satisfactory decoration and had suitable lighting and furnishings. Many rooms had residents own possessions and this made them more personal and homely. The home and the laundry facilities were clean and tidy and systems in place to minimise risks from Legionella and test water temperatures. There is a range of equipment and adaptations in the home to help residents make the most of their independence and to get about the home. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 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 and 30 After a period of instability and change in staffing levels there is now a better match of suitably trained staff offering more consistency of care to residents. The procedures for the recruitment of staff are satisfactory and offer protection to people living in the home. EVIDENCE: After some recent staff changes and shortages the rotas suggest the home now has a more stable and consistent staff group and were managing to maintain adequate minimum staff levels. The home had recruited some new staff following the departure of some and was trying to recruit more. The supervisors have had to work as carers at times to cover staff shortages, which can lead to staff not being properly supervised and supported whilst on duty. However due to a system of having a ‘floater’ a member of staff who worked where needed this was less frequent. Staff spoken with said that staffing was “better now” and “after a spell when a lot left” it was now more stable. Staff training records showed that training needs were being identified and provided for. Staff said that there were plenty of opportunities for training and they were encouraged to go. The number of staff with NVQ Level 2 in care has increased and more staff were enrolled on the next course. The home had satisfactory recruitment procedures in place and the inspector looked at the files. The home had followed procedure and undertaken the necessary checks for staff to promote the safety of residents. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 Page 18 The home had individual training records for staff and was making good progress on developing these. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 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, 36 and 37 The manager was well supported by senior staff and provides clear leadership to staff. The home reviews aspects of its performance through reviews, quality surveys and residents meetings. Resident’s views are sought but are not always acted on quickly. EVIDENCE: Regular staff meetings allowed staff feedback, along with internal reviews of policies and procedures. Staff said that supervision was taking place and this had been recorded. Residents said that they saw the manager most days and could raise issues with her or the supervisor. There were records and minutes of regular residents meetings taking place in the home and these were on the units for George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 Page 20 residents and visitors. The results of satisfaction surveys had been collated and were available on request. The home should display these so that everyone can see them. The standard of record keeping and organisation of information had improved since the last inspection making it clearer and easier to follow. The manager was in the process of completing the NVQ level 4 qualification. George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 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 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 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 2 3 3 x x 3 3 x George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 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. 2. 3. 4. Standard OP9 OP9 OP9 OP12 Regulation 13 (2) 13 (2) 13 (2) 16 (2) Requirement Medication needing cold storage must be kept in a separate secure and dedicated refrigerator Prescribed creams and lotions must be recorded on administration. The home must ensure a continuous supply of medicines. The home must provide opportunities for recreational activities that meet residents expectations and preferences. The home must consult with residents about the food provided and act promptly on the issues they raise. Timescale for action 30.7.05 30.7.05 30.7.05 15.8.05 5. OP15 16 (2) 7.8.05 6. 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 OP15 OP33 Good Practice Recommendations The home should recruit a permanent cook to promote a consistant standard of food. The results of satisfaction surveys should be displayed so everyone can see them. F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 Page 23 George Basterfield House George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP 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 George Basterfield House F58 F10 s35198 george basterfield v232527 280605 ui stage 4.doc Version 1.30 Page 25 - 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!