CARE HOMES FOR OLDER PEOPLE
The Bakewells 102 Junction Road Deane Bolton Lancashire BL3 4NE Lead Inspector
Judith Stanley Unannounced Inspection 8th December 2005 09:30 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 The Bakewells DS0000009282.V269913.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. The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Bakewells Address 102 Junction Road Deane Bolton Lancashire BL3 4NE 01204 655772 01204 655772 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) Mrs Helen Bailey Morgan Mr Andrew Philip Morgan Mrs Helen Bailey Morgan Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Within the maximum registered number (25), the home can provide care and accommodation to up to 25 Older People (OP) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 3rd May 2005 Date of last inspection Brief Description of the Service: The Bakewells care home provides personal care and support for up to 25 older people both male and female over the age of 65 years. The home is located in a residential area, approximately 2 miles from the centre of Bolton. The home is accessible by public transport and is close to local amenities. Resident’s accommodation is on the ground and first floor and comprises 21 single bedrooms, 10 of which are en-suite, and 2 double rooms. A passenger lift serves the first floor. Three lounges and 2 dining rooms afford residents an opportunity to mix together or quietly relax. All bedrooms have hand basins and vanity units as standard. There are call assistance facilities in all rooms and smoke detectors. Residents are encouraged to personalise their own rooms with items of furniture and belongings to make the room their own. Car parking is available within the grounds to the front and side of the Home. The gardens to the front and rear of the Home are well presented and all areas of the home, both internal and external, are maintained to a high standard. The home offers two - day care places; however, this service is not regulated by the Commission for Social Care Inspection it has been a long standing agreement with this home and there is adequate space and staffing to accommodate this facility. The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over a 3 – ½ period during the course of one morning and was unannounced. Part of the inspection was spent in the office looking at a selection of records the home holds on each resident (care plans) and other documentation the home needs to keep to run it’s business and part of the time was spent in conversation with the residents and staff and a tour of the premises. What the service does well:
The Bakewells is a good care home where staff work hard to provide the type of care residents need or expect. Residents are given choices in all aspects of their daily lives, and are encouraged to remain active and independent. Help is readily available where it is needed, and access to health services is arranged, as it becomes necessary. Staff are attentive and cheerful. Communication with supporters of residents (families, friends, social workers, health workers, etc) is good. As part of the inspection comment cards were sent to the home in advance, to be distributed to residents, relatives and other people who visit the home on a regular basis, for example GPs and district nurses. A district nurse visiting the home at the time of the inspection, commented that the home was “excellent and well run” she was also complementary about the staff and their dedication in caring for the residents. Another visiting nurse had descried the atmosphere in the home as excellent and that there was always a sense of caring form all the staff including ancillary staff. Other comments from returned comment cards were positive one stating,“ the staff are friendly and obviously have the welfare of the residents in mind as they do their work. The atmosphere is good and the appearance of the home is always clean and well cared for”. Another relative described the owners and staff as a “credit to their profession”. One resident living at the home said, “the standard of care in this home is extremely good, I really don’t see that it could be better. I am happy to be here.” Residents themselves very much enjoyed the variety, quantity and quality of the meals provided for them as well as the activities, social events an outings that staff arrange. The home is currently offering a day care place to one person, who attends the home every day. This arrangement is made in agreement with the person, their family and the home. There is adequate space within the Bakewells and enough staff to accommodate this person who is hoping to move into the home on a permanent basis when a place becomes available. The Bakewells DS0000009282.V269913.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. The Bakewells DS0000009282.V269913.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 The Bakewells DS0000009282.V269913.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): EVIDENCE: All of the above standards were inspected at the last inspection and no issues found. The key standards will be inspected at the next inspection. The Bakewells DS0000009282.V269913.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 and 10 The records showed that the health, personal and social care needs of residents had been identified, and were monitored and reviewed. Residents could be confident they would be treated with respect, and that their rights to privacy and dignity would be promoted. EVIDENCE: Three residents files were looked at to see if full consideration has been made for each resident’s health, personal, and social care needs. Care plans were found to be up to date and reviewed on a weekly basis by senior staff and monthly by the manager. Each record outlined the individual person’s background, work history, family, hobbies and interests, and likes and dislikes. This information helps staff to understand a little about the person to whom they are providing care and also provides topics for conversation.
The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 10 The focus of care at The Bakewells centres on each individual. Respect for the independence, dignity, privacy, choice, and fulfilment of each resident is carried through on a daily basis. One resident spoken with said that when her visitors come to the home, she meets with them in her own room, where staff offer tea and biscuits to guests and make everyone welcome. Staff were observed carrying out their daily duties and were seen knocking on doors before entering and were heard speaking to residents in a friendly, respectful manner. The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 11 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): 15 The meals are good, are served in quantities suitable for residents, and offer a generous amount of choice and variety. EVIDENCE: Residents were very complementary about the meals that are provided for them. One resident said, “The food was very good and always looked as good as it tasted”. Residents confirmed that choices were available at all mealtimes, one commenting that the cook would make you what you whatever you wanted. Breakfast is served on a flexible basis to allow residents the choice to lie in if they wish. On the morning of the inspection breakfast consisted of prunes, grapefruit, cereals, full cooked breakfast if requested, toast and preserves, tea or coffee. Lunch is served at a set time and residents were being offered beef stew and dumplings, vegetable burgers or poached fish served with potatoes and seasonal vegetables, followed by bread and butter pudding, yoghurts or fresh fruit. A lighter, but substantial tea is served late afternoon and a choice of homemade soup, sandwiches, poached egg on toast, bacon and tomatoes followed by dessert was available. Suppers are available to residents if they wish and hot and colds drinks are available at anytime during the day and night. Any special diets including soft or pureed diets and diabetic diets could be catered for.
The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 12 Meals at The Bakewells are served in two dining rooms both of which offer a congenial setting for residents to enjoy their meals. The smaller dining room tends to be used by people who require assistance at meal times. This is offered in a discreet and sensitive manner. All dining tables were nicely set with matching crockery and tableware. Mealtimes at The Bakewells are seen as a time for social interaction and residents are not hurried and are given sufficient time to enjoy their meal. The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 13 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): EVIDENCE: All of the above standards were inspected at the last inspection and no issues found. The key standards will be inspected at the next inspection. The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 14 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, 24 and 26 The standard of the environment within The Bakewells is good, providing residents with a comfortable and homely place to live. Residents can personalise their bedrooms to make them suit their needs, if they choose to. Infection control procedures are good, making this a clean environment for residents. EVIDENCE: From a tour of the building, it was seen that the premises were being maintained to a good standard, both inside and out. There was evidence of redecoration and renewal of fabric and furnishings. The premises were clean and free from offensive odours throughout, and residents spoken with complemented the domestic staff on the level of cleanliness that was maintained. The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 15 Residents said their bedrooms were comfortable and that they had everything that they needed, including some personal items that they had brought from their own home. Those residents spoken with chose not to spend time in their rooms in the day, preferring to sit in one of the lounges or to join in with the activities. However, they said they could if they want. Those bedrooms seen were clean and tidy - according to the wish of the resident – with furniture and fittings that were maintained to a good standard. Systems were in place to control the spread of infection. Staff were knowledgeable about infection control procedures. Staff were observed using protective aprons and gloves for different tasks. The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 16 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): EVIDENCE: All the above standards were inspected at the last inspection and no issues found. The key standards will be inspected at the next inspection. The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 17 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 and 38 The manager is suitably qualified and experienced, and manages the home well. All staff had received relevant health and safety training to ensure the safety and welfare of the residents is protected. EVIDENCE: The manager brings the added skills and knowledge of a qualified nurse to the home that is invaluable in assisting with resident’s health and welfare. The manager has completed the NVQ level 4 Registered Managers Award and is currently studying towards a degree in nursing. The manager is a “hands on” manager who works along her staff providing good leadership, guidance and support. The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 18 Health and safety issues were good with regular maintenance checks of equipment being undertaken. All accidents and incidents were being correctly recorded and reported. It was evident from discussion with the manager and staff that all staff had received mandatory health and safety training. The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 19 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 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 x x x x 3 x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x x x x x x 3 The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 20 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 The Bakewells DS0000009282.V269913.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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