CARE HOMES FOR OLDER PEOPLE
Queensmount 18 Queens Park West Drive Bournemouth Dorset BH8 9DA Lead Inspector
Gloria Ashwell Key Unannounced Inspection 30th August 2007 12:30 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 Queensmount DS0000020454.V349108.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. Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Queensmount Address 18 Queens Park West Drive Bournemouth Dorset BH8 9DA 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) 01202 391144 01202 304346 willis@bupa.com www.bupa.com BUPA Care Homes (BNH) Ltd Mrs Sheila Willis Care Home 52 Category(ies) of Old age, not falling within any other category registration, with number (52) of places Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The home may accommodate a maximum of 43 service users who require nursing care. The home may accommodate a maximum of 3 younger adults who require nursing care (age 35 years and above). Five of the eight double sized rooms may be used as shared rooms at any one time. 20th December 2006 Date of last inspection Brief Description of the Service: Queensmount is a BUPA purpose built care home situated in a quiet residential area, overlooking a large park with a golf course. The nearest shops, post office and other local amenities such as churches are approximately three quarters of a mile from the home. A bus service is available a short walking distance from the home. Queensmount is registered to accommodate 52 residents (over 65 years of age) including up to 43 requiring nursing care. Within that number the home may accommodate a maximum of 3 adults age 35 years and above who require nursing care. There are 42 single bedrooms and 5 double bedrooms; all bedrooms have ensuite hygiene facilities comprising as a minimum a wash hand basin and toilet. Bedrooms are located throughout the 3 floors of the home; a passenger lift enables level access around the home. The 10 ground floor bedrooms are for the accommodation of service users who do not require nursing care. The home has a hairdressing salon, a shop selling small items (toiletries, confectionary, note paper etc.) and a licensed alcoholic drinks bar open during restaurant hours and additionally two evenings each week. The gardens and grounds are well tended with garden furniture available so that residents can sit outside in good weather. There is car parking space at the front of the house for use by visitors. Laundering of clothing and household linen is carried out at the home and arrangements are made for chiropodists, opticians and other health and social care professionals to visit individual residents. Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 5 The fee range quoted in the service user guide at the time of inspection was £750 to £950 per person per week. Up to date fee information may be obtained from the service. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk A report entitled Care Homes in the UK - A Market Study is available on web link http:/www.oft.gov.uk/NR/rdonlyres/5362CA9D-764D-4636-A4B1A65A7AFD347B/0/oft780.pdf Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was a statutory inspection required in accordance with the Care Standards Act 2000. The inspection was unannounced; the inspector toured the premises and spoke to residents and staff and registered manager Mrs Willis. The duration of the inspection was 4 hours. The inspector observed staff interaction with residents and the carrying out of routine tasks. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same resident were examined and the resident spoken with. What the service does well:
People considering moving into Queensmount receive a full assessment and are provided with the opportunity to visit and spend time at the home to make sure that it is able to meet their needs. Residents are offered a menu that provides a varied and well balanced diet that is served in pleasant surroundings. A menu to order breakfast, lunch and supper is provided for the following day. Further choice is also available if the items on the menu are not suitable. On the day of inspection the home was very clean, of comfortable temperature and adequately staffed. The home is well equipped, attractively decorated and suitably furnished. The standard of care is excellent and each resident has a documented plan of care. Staff are enthusiastic, competent and receive training. Residents are very satisfied with Queensmount. Comments received during the inspection included “As homes go you can’t beat this one…the atmosphere; it’s laid back, you’re not rushed to do anything”. To ensure the continued satisfaction of all residents and the maintenance of high standards Queensmount operates a thorough quality assurance system Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 7 including the provision of questionnaires to residents, and regular in-house audits on a variety of subjects including food provision and infection control. 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. The summary of this inspection report can be made available in other formats on request. Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 8 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 Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does not provide Intermediate Care so Standard 6 does not apply. Prospective residents (or their representatives) are provided with information about Queensmount and are encouraged to visit in advance of admission to establish their impressions of life at the home and the standard of available accommodation. Prior to admission, the needs of each proposed resident are assessed and the home then writes to prospective residents confirming the ability to properly care for them. Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 10 EVIDENCE: The service user guide is made available to all residents and prospective residents. It contains general information about the home and includes reference to the outcomes of the most recent user satisfaction questionnaire. The Statement of Purpose and service user guide are available in a standard format; the provider organisation intends to make available this information in alternative formats, appropriate to the needs and capacity of individual prospective residents or their representatives who might find the standard format difficult to read and fully understand. The records of a recently admitted resident included details of pre-admission assessment which had been carried out by the registered manager she visited the prospective resident at the private address. In advance of making the decision to enter the home the closest relative of the prospective resident visited Queensmount to view the premises and meet residents and staff. The inspector spoke to a recently admitted resident who confirmed satisfaction with the home and said “I like it here they’re really very nice…the meals are lovely, and such a good choice…I’d recommend it”. Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health and social care needs of residents are fully met by suitably trained staff; doctors and other professionals visit as necessary and the home employs nurses and care workers who properly respect and promote the privacy and dignity of the residents. EVIDENCE: Residents believe they are properly cared for; comments during the inspection included “They do care….and are so cheerful….everything is very good”. Care provision is in accordance with a written plan of care for each resident thereby ensuring that staff have sufficient information upon which to base their care practice. Residents are actively involved in planning their own care and sign records to confirm their agreement.
Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 12 Care records of 4 residents were examined and contained risk assessments forming the basis for care plans and daily records describing the care of each resident. To ensure correct identification of residents, records contain a recent photograph of each resident. Medicines prescribed by doctors are safely stored and carefully administered to residents by staff trained in this work, thereby protecting residents from medicine errors. Medication administration records were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts those wishing to do so can manage their own medicines in accord with a risk assessment process; some of the currently accommodated residents manage their own medicines. In the presence of staff residents appeared relaxed, confident and at ease; staff interactions with residents were of a friendly and considerate manner and the atmosphere throughout the home was calm and tranquil. Residents are treated with respect and their privacy and dignity is protected at all times. Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are assisted to maintain as much independence as possible. Social and leisure activities are suited to the preference and ability of each resident. Contact with the local community is encouraged and visits by residents’ friends and relatives are welcomed by the home. Meals are appetising and of good quantity and quality. Most residents take meals in the large dining room on the ground floor; others receive them in their bedrooms. EVIDENCE: The inspector spoke briefly to a number of residents and at greater length with nine including those who were ‘case tracked’; all expressed satisfaction with the home, including the range of activities, meal provision, staff and premises. One said “Everything about it is good…the staff are really good”.
Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 14 The home employs two Activities Organisers (between them working a total of 59 hours each week) who arrange visiting entertainers, one-to-one and small group social and recreational activities. There is a daily programme of activities. At the time of this inspection a visiting musician was entertaining a large group of residents in the main lounge; the residents appeared to be greatly enjoying the session. Visitors are welcome at any time and those spoken with during the inspection confirmed they are always made to feel welcome and placed at ease by the staff. There is a good choice of meals, selected in advance by each resident from a menu. Snacks and ‘light bites’ are available at all times and can be selected from a separate menu, displayed on each floor. To ensure provision of good nutrition to each resident the home uses a ‘nutritional assessment system’. Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The complaints procedure provides information on the procedure to follow to persons wishing to make complaint; all complaints are recorded and properly investigated. The home protects residents from harm and abuse. EVIDENCE: To ensure residents and their representatives have access to the complaints procedure it is included in the service user guide to the home and a copy is provided to each residents’ relative/representative. Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. Comments received during the inspection included “I’ve never had any, but I’d go to the manager”. The home keeps records of all complaints received and investigated. Since the last inspection no complaints against the home have been received or investigated.
Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 16 The home has developed and implemented written policies and procedures for the protection of residents from abuse or neglect and provides all staff with training in the understanding of abuse and their role in protecting residents from abuse in its many forms, including neglect. Care staff spoken with during the inspection said they think the standard of training available to them is very high and they are encouraged to undertake training in subjects that interest them. Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Queensmount is a well-appointed and comfortable home. On the day of inspection the home was clean, pleasant and hygienic and conversation with residents and staff confirmed that this is the usual standard of provision. EVIDENCE: Queensmount is a spacious home, with good sized bedrooms, bathrooms equipped for the use of persons requiring assistance and attractive communal rooms; on the ground floor is the dining room and main lounge – each of the
Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 18 upper floors has a lounge with small kitchenette containing facilities for snacks and beverages. The home is clean, tidy and comfortable throughout; there were no unpleasant odours. There is an ongoing programme of redecoration and refurbishment to ensure the high standards are maintained. Rooms are attractively decorated and appropriately furnished and the home has a peaceful atmosphere. It is clean, well ordered and properly maintained. There is a range of equipment designed to meet the needs of the residents including assisted bathing facilities and hoists to enable safe movement about the home. Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and the good condition of the premises. Recruitment practices ensure the protection of residents from potentially unsuitable staff. Staff receive appropriate training and are competent to carry out their jobs. EVIDENCE: Trained nurses lead the care teams and at all times the home is in the overall charge of an experienced nurse. Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs.
Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 20 Staff are enthusiastic about their work and feel they provide a good standard of care to residents and are properly supported by the management and training provision. The records of 2 recently employed staff members were examined and found to contain all essential information including two written references, an interview assessment, health details, evidence of identity and of induction training. At present most of the care staff currently employed by the home hold a National Vocational Qualification in care; the home thereby meets the standard for at least 50 of the care staff to hold an NVQ in care. The provider organisation has an enthusiastic approach to staff training; recent topics have included Protection of Vulnerable Adults, First Aid, moving and handling, infection control and fire safety training. The registered manager and two other members of staff have recently attended training on the recently enacted Mental Capacity Act and will share the relevant information with other staff, to ensure proper and up to date understanding. Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is properly managed and the opinions of residents are welcomed to ensure they remain satisfied with all aspects of the service. The premises and equipment are well maintained, staff are supervised and receive training, and there are established policies and procedures. These measures ensure that residents receive the care they need in a safe environment. Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 22 EVIDENCE: Mrs Sheila Willis is an experienced nurse and manager and demonstrated high degrees of competency in both aspects throughout the inspection. The home has ongoing systems for quality assurance; satisfaction surveys are periodically issued and occasional meetings for residents and their relatives takes place. The home is accredited for ‘Investors in People’ and has implemented the ‘Personal Best’ programme developed by the provider organisation. To ensure continuity of approach the home has an extensive selection of clear and appropriate policy and procedure documents, including those for care provision, management and the premises. The home does not manage the finances of residents; residents who are unable to undertake this responsibility personally have nominated relatives, friends or other representatives to do this on their behalf. Staff trained in First Aid and health care are on duty in the home at all times. Records are kept of all accidents including details of investigation and the home has implemented an accident policy and procedure to minimise the risk of accidents and recurrence. The premises are well maintained and there are regular checks/tests of all equipment. The inspector examined some records to verify this information including those for water testing and fire safety. The home has recently developed a fire safety risk assessment and emergency escape plan. There is a thorough and regularly reviewed written assessment of the ‘Health & Safety’ of the premises and working practices. Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 24 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 Queensmount DS0000020454.V349108.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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