Inspection on 13/03/06 for Shockerwick House

This inspection was carried out on 13th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Shockerwick House 15/01/07

Shockerwick House 23/08/05

Shockerwick House 06/01/05

Shockerwick House 16/07/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Shockerwick House Lower Shockerwick Bath Bath & N E Somerset BA1 7LL Lead Inspector Jill Cornelius Announced Inspection 13th March 2006 10:00 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 Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 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. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Shockerwick House Address Lower Shockerwick Bath Bath & N E Somerset BA1 7LL 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) 01225 743636 01225 744335 holbuttc@bupa.com www.bupa.co.uk BUPA Care Homes (CFCHomes) Limited Mrs Catherine Holbutt Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38), Physical disability (5) of places Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 38 persons aged 50 years and over May accommodate up to 5 Persons aged 18 years or over with Physical Disabilities Staffing Notice dated 30/08/2001 applies Manager must be a RN on parts 1 or 12 of the NMC register Date of last inspection 23rd August 2005 Brief Description of the Service: Shockerwick House Nursing Home is registered for 38 residents requiring nursing and personal care. The home is situated in a suburban position and can be accessed by car or bus. Transport is needed for access to local shops and social venues. The home is a converted older property, providing single and double rooms on three floors and communal space in 4 areas. There is a lift to all areas. There is wheeled access to the garden areas around the home. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection conducted as part of the annual inspection process. The inspection lasted two days. During the inspection the inspector spent time in discussions with manager, deputy manager, staff and examined a number of records, including six residents care plans, and records relating to the day-to day running and management of the home. The inspector spent time observing the residents in the home throughout the course of the visit and spoke with five at length and three visitors. Members of staff were observed on duty and two were consulted individually. What the service does well: Staff were observed as being respectful, warm in manner, good humoured and sensitive towards the residents’ at Shockerwick House. A high standard of personal and nursing care is provided and staff work hard to meet the needs and wishes of the residents. The residents and relatives spoken with during the inspection continue to express satisfaction about the home. The manager and deputy have a good rapport with individuals and were knowledgeable about the care needs of the individuals living in the home. The home has a stable care team and supporting workforce. The activities provide regular, varied and stimulating programme. The homes environment and its surroundings meet the needs and provide great pleasure and enjoyment to them. Meals were well presented and residents requiring help with feeding were well supported. Again at this inspection aspects inspected gave positive outcomes for residents at Shockerwick House. Mrs. Holbutt and the team are therefore to be commended for continuing to provide residents with a service which is well regarded and which has high standards of care. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5 Prospective resident’s needs are assessed prior to admission to determine the suitability of placement to ensure that their needs can be met. EVIDENCE: The Inspector looked at three pre-admission assessments, which were completed fully and were informative. The prospective resident, family and carers are fully involved in the pre-assessment and all information is used to determine the suitability of the placement. Where possible the manager had obtained comprehensive assessments and care plans from other professionals involved, for example social workers and hospital staff. Prospective residents’ are encouraged to visit the home either for the day or perhaps for lunch dependent on their wishes. A brochure containing a service user guide and statement of purpose is also made available to prospective residents’ and their families. One resident confirmed that she/he had received relevant information prior to admission and had made a visit to the home before making a decision to where to live. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Individualised planned care is detailed in each resident’s file, along with risk assessments. These have been reviewed consistently. The health and personal needs are identified including the residents social needs are full in content. There are satisfactory systems in place for the receipt, administration and disposal of medication in the home. Residents can be confident about the protection these systems provide. Staff have a good awareness of individual needs and treat resident’s in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. The home has a very clear policy and procedure for the care and comfort of the dying, which includes resident’s personal preferences. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 10 EVIDENCE: Six resident’s care plans were inspected to monitor how the resident’s are being supported to meet their needs. Care plans addressed resident’s physical and health needs. Care plans were also completed with regard to social, psychological, emotional, and cultural needs. The plans had all been reviewed monthly and had been updated to reflect the change in care needs. Health care needs were well evidenced in the Care Files and included, wound care, nutritional, and pressure area risk assessments. The information viewed had been regularly reviewed. There was recorded evidence of resident’s or their representative involvement in the review. This is to be commended. Records of the General Practitioner visits/contacts with resident’s and outcomes were available. The home had access to various pressure relieving equipment and this was documented in the plan of care. Specialist referrals and visits from other professionals were evidenced in care files including Audiologists, Chiropodists, Opticians and Dentists. Risk assessments had been developed to identify potential risks including manual handling and the use of bed rails. However, one individual in the home had a door alarm. Although there was evidence that this had been discussed with the individual and their representative a written consent had not been sought. The manager had rectified this by the second day of inspection; the Inspector viewed evidence. Temperature recordings for the drugs fridge are monitored and recorded daily. This evidenced safe limits. At the time of inspection no residents were undertaking self-medication. If this was the case there is a policy to ensure safe practice is observed. The home has a very clear policy and procedure for the receipt, storage and administration of medication. The inspector carried out a random audit of the medication held in the home, and no errors were found. It was evident from consultation and observation that the manager and the deputy manager had built a good rapport with individuals and were knowledgeable about the care needs of the individuals living in the home. Resident’s stated that staff, were responsive to their care needs. The atmosphere in the home on the two days of inspection was relaxed. Staff, the manager and residents were observed to have good relationships. Staff responded to residents in a sensitive and professional manner. Staff were witnessed knocking on resident’s doors before entering confirming respect for the residents individual privacy and dignity at all times. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 11 The home has a very clear policy and procedure for the care and comfort of the dying, which includes resident’s personal preferences. There was some evidence in documents viewed containing two “end of life” plans. Staff have supportive links with hospice and other professional staff, there is access to the local ministers who attend the home at any time. Hospitality would be offered to relatives if need be where service users are being nursed in the terminal stages of illness. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 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 the following standard(s): Residents experience a stimulating and varied life at the home with visitors encouraged, various informal and formal activities made available, days out and good meals. EVIDENCE: As at previous inspections the feedback from residents suggests the home remains a friendly, happy and comfortable place to live. The residents again were complimentary about the care staff and throughout the inspection I witnessed staff speaking to people with respect and dignity. Rising and retiring choices are documented during the assessment and referred to in the care plans. These are indicated by the resident’s daily and accommodated in balance with assessed needs. The residents spoken with also confirmed this, as did documented evidence in the care plans. A programme of in-house activities is maintained. Awareness of what is available is promoted by posters/notices around the home, by verbal reinforcement from staff and by a schedule of activities being placed in each resident’s room. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 13 Shockerwick also produces a newsletter. Residents enjoy the newsletter, and felt included in the homes life. Two residents said that this “was a good talking point for them to discuss with their visitor”. Shockerwick House has a full time co-ordinator who organises the varied activity schedule. Time is spent with the residents gathering information on their likes / dislikes, feedback and suggestions for activities / events. There is a planned event most days which includes visitors / entertainers to the home as well as organised trips from the home. Residents spoken with were very complimentary of the activities and said they participated in and enjoyed most events. It was noted by the inspector that a number of residents were keen to make sure they were in place for the start of the afternoon’s activity on the day of inspection. This was greatly enjoyed and many residents and staff joined in with singing and dancing. The grounds and gardens are extensive at Shockerwick House and the residents take advantage of the new scented garden and terraces enjoying the views when weather permits. A number of residents the inspector met said that the food provided in “their home” was “very good” and that it was always “served in a relaxed, unhurried manner”. Care and household staffing the dinning rooms were observed providing sensitive, respectful and patient support and encouragement to residents during mid-morning drinks and the lunchtime meal. An individual request for an alternative was responded to promptly and courteously. The inspector saw the meals prepared and well presented on individual trays for some residents to have in their rooms. Each course was served separately making sure that they remained hot. Individual choices for the evening meal were well noted. Residents receive Nutritional Risk Assessments and reviewed regularly. The menus are assessed for their nutritional content. The kitchen was not inspected on this occasion. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 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 the following standard(s): 16,17,18 Arrangements remain in place for responding to concerns. These are satisfactory so that residents and their relatives and friends can feel that any complaints will be taken seriously. Residents’ legal rights are protected. Staff knowledge and understanding of Adult Protection issues provides a safe environment to protect residents from abuse. EVIDENCE: There is a complaints procedure with a formatted document for recording complaints available. This was viewed and found to be correct with outcomes of complaints completed. Residents’, visitors and staff comments showed that people feel comfortable discussing any concerns with senior staff or management. Residents are able to participate in the political process, and are enabled to exercise their rights by voting during elections. The majority of residents tend to use their postal vote. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 15 The Home follows the Bath and North East Somerset Council guidance addressing the protection of vulnerable adults. The appropriate Policy and Procedures are in place for Adult Protection and Whistle Blowing, staff receive training on Adult Protection during their induction and qualified staff are aware of the procedures to follow. This reinforces the staffs’ awareness and promotes safe practices with the residents’ at Shockerwick House. Opportunity was taken to put a scenario with two members of staff. They were able to respond appropriately. Staff spoken with confirmed the benefit of this training. Training continues to be provided to heighten their awareness of the issues of abuse and on the Whistle Blowing Policy / principles. This policy was held in the policies and procedures file in the office. Evidence seen in staff training records showed the staff attended training on issues around abuse. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 -26 Shockerwick remains a clean, well-equipped and safe standard of accommodation provided for the residents. Homeliness in communal areas and personalisation of individual rooms are both well promoted. EVIDENCE: Residents’ bedrooms remain looking homely and were personalised with residents’ personal possessions and furniture. However, it came to the attention of the inspector that one bedroom door had been alarmed to assist staff to establish this resident was leaving their room and can be offered assistance where appropriate. It was noted that this is a form of mild restraint and that there was no agreement in place from the residents or their relatives. It was noted that there was a risk assessment in place about using the alarm. By the end of the inspection period this had been rectified and an agreement was in place signed by a relative, as the resident was unable to give consent. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 17 Alterations to the first floor bathroom/shower room was being undertaken during the inspection. Residents are looking forward to use this additional facility. All areas of the home smelled pleasant and were cleaned to a high standard; this had been noted on previous visits. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29,30 Staff at the home provide are well trained, supported and are employed in sufficient numbers to meet the residents needs. Residents are supported and protected by the homes recruitment policy. EVIDENCE: The recruitment process was examined and all staff records examined showed that the home follows a recruitment procedure. Records contained all the relevant information. A random sample of the training records for a range of staff was observed. These evidenced a broad range of skills available amongst the staff team and an on-going commitment to staff training and development. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,36,37,38 Resident’s continue to benefit from the ethos, leadership and management approach of the home. The health and safety of residents, staff, and visitors is protected, however, a risk assessment regarding the dipping in the floorboards on the first floor landing needs to be undertaken. EVIDENCE: Mrs. Holbutt has been in post for 18 months. It was evident that Mrs. Holbutt has continued to attend clinical update training appropriately. Residents, their visitors and staff made positive comments about the management. Giving examples of good communication, staff being clear about what is expected from them and practice being consistent between shifts. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 20 Some of the health and safety records in the home were examined. Documentation showed that all-relevant checks were maintained correctly and at required intervals including all fire alarms and equipment, emergency lighting. Risk assessments for the first floor landing, ‘dipping floor’, had been planned by the manager, during the inspection. The carpets require to be lifted for this to take place. Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 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 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 3 3 3 Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? NONE 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. 1 Refer to Standard OP38 Good Practice Recommendations Undertake risk assessment for the ‘dipping’ flooring on the first floor landing. Follow any action required Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 Page 23 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 Shockerwick House DS0000020223.V282460.R01.S.doc Version 5.1 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. 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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