Inspection on 20/11/05 for Lower Oldfield Park

This inspection was carried out on 20th November 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lower Oldfield Park 11/04/07

Lower Oldfield Park 24/10/06

Lower Oldfield Park 28/03/06

Lower Oldfield Park 30/03/05

Lower Oldfield Park 09/12/04

Lower Oldfield Park 23/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Lower Oldfield Park 82 Lower Oldfield Park Bath Bath & N E Somerset BA2 3HP Lead Inspector Melanie Edwards Unannounced Inspection 13th November 2005 09:45 Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 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 Lower Oldfield Park DS0000008168.V265367.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 Adults 18-65. 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. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lower Oldfield Park Address 82 Lower Oldfield Park Bath Bath & N E Somerset BA2 3HP 01225 448396 01225 448396 82lop@btconnect.com 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) Bath Mind Mr Norman Fair Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (6) Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 6 persons with mental disorder aged 20 years and over 30th March 2005 Date of last inspection Brief Description of the Service: 82 Lower Oldfield Park is owned by Bristol Churches Housing Association and operated by Bath Mind. Bath Mind is an independent voluntary organisation, which is affiliated to National Mind. Bath Mind operates a number of projects in the Bath area, of which 82 Lower Oldfield Park is one, for people experiencing mental ill health and their carers. 82 Lower Oldfield Park is a care home, providing care and support for up to six people with long-term mental health needs. The service users are supported 24 hours a day, seven days a week by the home manager, a deputy manager, a senior care officer and a team of care officers. The home itself is a three storey building, which is conveniently placed close to a bus route which takes you into the centre of Bath, and is close to local amenities such as the shops on Moorland Road, Bath. There are six bedrooms, two communal lounges, a kitchen/diner, four bathrooms and five toilets on all three levels. There is also a sleep-in bedroom for staff members on the lower ground floor. Bath Mind’s aim is to provide encouragement, support and assistance to service users, in order to increase and improve their quality of life, freedom and independence with a view to moving on to supported housing when appropriate. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Four residents were consulted, as well as two `support’ staff currently who were on duty. The staff were asked about their roles and responsibilities, training needs, and how they support residents and carry out their duties. A range of records relating to the day-to-day running and management of the home were inspected. A selection of resident’s care records was also reviewed. The home was viewed throughout. What the service does well: What has improved since the last inspection? What they could do better: Residents would benefit if there were care plans in place for each resident to demonstrate how staff are supporting residents with their needs. It would also be beneficial if risk assessments and care plans are regularly reviewed and updated to demonstrate needs were monitored. The health and safety of residents would be better protected if the following safety practices were adhered to:Firstly, up to date checks of the kitchen fridge should be maintained to ensure it operates within food safety guidance levels. Secondly, all foods that safety guidance advises are `high risk’ should be temperature probed before serving to ensure the food has reached above the minimum required temperature. Thirdly, staff preparing and cooking food should wear suitable protective covering when they are preparing and cooking food. It would also be beneficial for residents, staff and visitors if there were liquid soap or a similar hand washing material available at the sinks in bathrooms and toilets. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 6 The privacy of residents, staff, and visitors would be better maintained if the broken lock on the top floor bathroom door were repaired to ensure the room can be secured when in use. There was no heating in the entrance hall of the home making this area feel uncomfortably cold. Suitable action is needed to ensure the hall is comfortably warm for residents and staff and visitors. 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. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 Residents feel their assessed needs are fully met, however assessment documentation only partly supports that needs are assessed. EVIDENCE: To find out how residents’ mental health needs are assessed two residents assessment records were inspected. There was assessment information in place of each resident’s physical, social and psychological needs. However the assessments had not been regularly reviewed and updated; which is a process that will helps demonstrate staff monitor residents changing needs. There was evidence that demonstrated residents have been involved in the assessment process, and residents had signed care documentation in agreement with the care to be provided. All the residents were positive in their views of the staff and the care they provide. Examples of comments by different residents included, ‘I think it’s a first class home, they help us ever such a lot they help sort out if you have got any problems, I feel the home is run properly ’, `I think the staff are ok, it’s safe and relaxed ’ and, `they are all alright, the staff work hard, and `I’m quite pleased with the staff’. These comments reflected the positive views of all the residents about how they feel their needs are met. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 9 Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Residents feel their needs are met, and are well supported to take risks in their daily lives .However there are no up to date care plans to reflect how staff should support residents with their needs EVIDENCE: To find out about what care is provided two residents care plans were requested but were not available at the time of the inspection. The lack of availability of care plans is a matter of concern, as care plans are required to guide staff in the care to be provided. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 11 Two residents files were inspected and these contained assessment information, risk assessment information and care review meetings records. In discussion with the staff on duty they conveyed a sensitive approach as well as a good understanding of residents’ range of needs. Staff and residents were observed sitting in communal areas, and communicated with each other in a warm friendly manner. All of the residents who were consulted said they felt satisfied and well supported by staff in their daily lives. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 17 Residents are provided with a varied, well balanced diet, and are supported and encouraged to live a fulfilling life. EVIDENCE: Residents are encouraged and supported by staff to go on trips to areas of interest on a regular basis and residents clearly gain much satisfaction and enjoyment from these opportunities. One resident said they had been out for a bike ride with a member of staff recently, and two other residents said they like to go to the shops. One resident was observed going out to the shops during the inspection. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 13 There was information written in care records, which was also confirmed by the staff on duty, that demonstrated residents regularly go to different community activities, including the shops, the pub or different day care support groups. The menu record was inspected to see if residents are provided with a varied and well balanced diet. There was evidence that residents are offered choices of dishes and the menu choices were nutritionally well balanced, and varied. Residents kindly invited the inspector to join them for lunch, and this meal consisted of either pizza with salad, or cheese on toast .The cheese on toast was tasted, and was well cooked. Residents also explained that each day they take it in turns to cook the evening meal, at least one day a week, with the support of staff. They also said that this included the purchasing of food produce from the shops. Residents explained that this task was a therapeutic duty, to encourage their independence. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 20 Residents are supported to meet their needs in the way they prefer, and the systems in place for the handling, administration, storage and disposal of resident’s medication are safe. EVIDENCE: The procedures and systems in place for administration, storage and disposal of medication were reviewed to monitor if systems are safe. The medication administration charts of two residents were inspected. There was a photograph of the resident maintained with each record, to ensure medication is dispensed to the correct person. The medication administration charts were legible, up to date, and contained the signature of the dispensing member of staff. The reasons for any omissions had also been written on the charts. As has already been referred to in the report residents were all very positive about the home, and how their needs are met, further examples of comments made by residents included `The staff work hard to help us, they respect us and our independence’; ‘the home has a friendly atmosphere it’s a pleasure to live in and its all geared to our individual needs’. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 15 Both staff were observed supporting residents in a good humoured and sensitive manner, and residents evidently have built up warm and trusting relationships with them. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 There are procedures in place to help ensure residents’ complaints are investigated thoroughly. EVIDENCE: A copy of the complaints procedure is made available to all residents. The procedure includes the contact details for `MIND’ the registered charity who run the home and the Commission for Social Care Inspection, if someone wishes to make a complaint. The complaints record book was viewed to find out how complaints are responded to. There had been no new complaints recorded since before the last inspection, the record did include the details of how the complaints were to be dealt with. All the residents who were consulted said they felt very able to speak to any of the staff if they had any concerns or complaints. Both staff conveyed a good understanding of the importance of respecting resident’s rights and empowering them to make decisions in their own lives. This should help create a culture where residents feel `comfortable’ to complain. There are also regular residents meetings held and this is an opportunity for residents to express any concerns or complaints they may have. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 30 Residents live in a homely environment that generally meets their needs EVIDENCE: Lower Oldfield Park is a converted older style residential property, in a residential area close to local shops and amenities, and a bus route into the centre of Bath City, making the home accessible to community-based facilities. However the home would not be currently suitable for someone who cannot manage to walk up stairs, as there is no lift. The style of decoration throughout was homely and domestic. The home was clean and tidy, and residents looked relaxed comfortable and settled in their surroundings. The home looked generally satisfactorily maintained however there is currently no heating in the entrance hall, and on the day of the inspection this area felt uncomfortably cold. Also the lock on the top floor bathroom door was broken Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 18 and could not be used, and as such the room cannot currently be secured when in use. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 36 Residents are supported to meet their care needs by competent wellsupervised staff. EVIDENCE: The staff on duty said that they had attended a range of training in subjects relevant to the needs of residents. Staff conveyed that they are committed to increasing their knowledge and understanding of the needs of the residents in their care. In discussion with staff it was evident they have a good understanding and awareness of residents range of needs. Both staff also explained that part of their role is to ensure residents feel emotionally `safe’ and are supported to maintain and develop independence in their daily lives. Staff also said that there is a structured, regular system of staff supervision in place for all staff. This should help ensure safe practice and to ensure staff are supported and developed in their work. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 20 Based on the positive comments made by all of the residents who were consulted, staff evidently support residents sensitively. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 40, 41, 42 The health and safety of residents staff and visitors is partly protected and generally the Homes record keeping and policies and procedures help to safe guard residents. EVIDENCE: General health and safety practices and procedures were inspected and the following practices need to be revised to ensure safe systems are in place. Firstly up to date checks of the kitchen fridge should be maintained, to ensure it operates within food safety guidance levels. Secondly staff should monitor the temperature of `high risk’ foods before serving to ensure the food has reached above the minimum required temperature. Thirdly staff should wear suitable protective covering when they are preparing and cooking food. There was also no liquid soap or a similar hand washing material available at the sinks in bathrooms and toilets. The fire logbook record showed that the range of required fire safety checks were being carried out. There are regular health and safety checks carried out Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 22 of the environment to try and ensure that the building is satisfactorily maintained. There are policies and procedures in place to support and guide staff in their care practices, health and safety matters, employment issues, and the general running of the home. A sample of policies and procedures were inspected, including the `missing persons procedure’ and the policy for responding to verbal or physical aggression. The contents of both documents looked helpful and easy to follow: however a number of policies and procedures did not include a review date. This information would be helpful to demonstrate policies and procedures are being regularly reviewed and updated to ensure they are still current. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 2 3 X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 2 X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 X X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Lower Oldfield Park Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score X X X 3 3 2 X DS0000008168.V265367.R01.S.doc Version 5.0 Page 24 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 YA6 Regulation 15 Requirement All residents must have an up to date care plan in place demonstrating how needs are to be met. Residents’ risk assessments must be regularly reviewed and updated. The broken lock on the top floor bathroom door must be repaired. Hand washing products must be available in bathrooms and toilets. Suitable action must be taken to ensure the entrance hall of the Home is comfortably warm and fit for its purpose. Timescale for action 20/12/05 2 3 4 5 YA9 YA27 YA42 YA24 14(2) 12(4)(a) 13(3) 23(2)(p) 20/12/05 20/12/05 27/11/05 20/12/05 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 YA42 Good Practice Recommendations Staff should wear suitable protective covering when they are preparing and cooking food. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 25 2 3 YA40 YA42 The home’s policies and procedures should be formally reviewed and updated on a regular basis. `High risk’ foods should be temperature probed before serving to ensure the food has reached above the minimum required temperature. Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Lower Oldfield Park DS0000008168.V265367.R01.S.doc Version 5.0 Page 27 - 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. 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