Inspection on 26/07/07 for The Bungalow Residential Home

This inspection was carried out on 26th July 2007.

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

The Bungalow Residential Home 23/08/06

The Bungalow Residential Home 05/10/05

The Bungalow Residential Home 21/04/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Bungalow Residential Home 54 Mossfield Road Farnworth Bolton Lancashire BL4 0AB Lead Inspector Mike Murphy Unannounced Inspection 26th July 2007 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 Bungalow Residential Home DS0000062979.V337614.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. The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Residential Home Address 54 Mossfield Road Farnworth Bolton Lancashire BL4 0AB 01204 794172 F/P 01204 794172 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 Margaret Lowe Mrs Margaret Lowe Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home is registered for a maximum of 18 service users to include: Up to 18 service users in the category OP (Older people who do not fall in to any other category. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 23rd August 2006 2. Date of last inspection Brief Description of the Service: The Bungalow is a privately owned care home providing personal care and accommodation for up to 18 older people. The home is situated in the Farnworth area of Bolton and is within relatively easy reach of shops, pubs, bus routes and other amenities. A park is situated across the road from the home. The home is a single storey building, surrounded by attractive gardens. All bedrooms are single. The fees at the time of this inspection range from £355.00 to £377.00 per week. (Information supplied by the home during the inspection) The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 26th and 27th of July 2007. The inspection took place over ten hours. The inspection included discussion with residents, their relatives, a tour of the premises, inspection of care and other records maintained at the home and discussion with management and staff. The home was being appropriately managed and residents and their relatives expressed satisfaction with the care and support provided by the home. What the service does well: 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. The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 6 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 Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 7 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): 3. Standard 6 does not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. No prospective residents are admitted to the home without their care and support needs being assessed appropriately. EVIDENCE: Before residents are admitted to the home the manager carries out an assessment of the prospective resident’s needs in consultation with the resident, their relatives and relevant health (for example doctors) and social care professionals (for example social workers). The purpose of such an assessment is to assist the prospective resident (and their relatives) in their considerations of how appropriate a placement at the home would be and enable the person conducting the assessment to judge if the home will be able to meet the prospective resident’s needs appropriately. The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 8 Prospective residents are encouraged to make trial visits to the home prior to admission and all placements are formally reviewed around 6 weeks after admission. 3 (recently admitted) residents pre-admission assessments were inspected at this inspection. The records identified that pre-admission assessments had been carried out by the home and were supplemented by assessments conducted by Social Services. Whilst it is acknowledged the pre-admission assessment conducted by the home is formally recorded it is recommended that this become a separate document to clearly identify it as such. In the current arrangements the preadmission assessment is included in the general care records and is difficult to distinguish from them. The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care provided for residents appears to be suitable, very well organised, and meets the expectations of residents and their relatives. However some improvements need to be made in respect of care records. EVIDENCE: The care records of 4 residents were inspected on this occasion. These contained care plans that were initially based on the pre-admission assessments referred to in the ‘choice of home’ section of this report. Whilst most care plans identified the problems residents experience some need to include more detail of what staff need to do to care for and support residents. Residents and relatives spoken to felt they were consulted about the care being provided and how care was delivered. And also said that their views on such matters were listened to and acted upon appropriately. Risk assessments, that seek to protect resident’s health and safety were also recorded in respect of residents skin integrity (assessing the risk of pressure sores), mobility The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 10 (including the risk of potential falls and fractures, and nutrition (including weekly weight monitoring) and other relevant areas and these were evaluated periodically. It is however recommended that these should be formally evaluated at least monthly. It is also recommended that sitting scales should be obtained and used for weighing residents instead of the current standard bathroom scales to minimise the risk to residents and staff. The registered manager informed the inspector that processes for recording care plans and risk assessments were to be reviewed with the intention of improving the quality of these documents. All residents are registered with a local GP and it was evident that all were enabled to access opticians, chiropodists, dentists, district nurses and other specialist services as individual residents needed. Discussion with relatives on the day of inspection indicated that they are kept informed of all changes in their relative’s health. The practices for the receipt, recording, storage, handling, administration and disposal of resident’s medicines were appropriate and safe. Senior carers (who have received training) are responsible for managing and administering resident’s medicines. No residents were managing their own medication at the time of this inspection. Medication administration records were up to date and the supplying pharmacy complete medication audits on a regular basis. It is however recommended that when staff make handwritten entries to medicine administration records that these be checked and signed by 2 members of staff to maximise safety. Discussion with residents, their relatives and staff revealed that residents were treated with respect and that their right to privacy was upheld. Comments made included; ‘the staff are kind and very caring’, ‘the staff have always been lovely and are very friendly’, ‘I can go to my room if I want some peace and quite’’. On the day of inspection staff were observed to interact very positively with residents and treat them with respect, protect their dignity and assist them appropriately throughout the day. Residents and visitors seemed to have a positive rapport with staff. The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are being supported by staff to participate in social activities and are able to retain the ability to make personal choices. There was a general satisfaction with meals provision at the home. EVIDENCE: Discussion with residents and relatives (and observations made on the day of inspection) indicate that the routines of daily life in the home are as flexible as possible in a communal setting. Residents stated that they are able to choose what time they get up and go to bed, what activities to engage in and feel that staff inform and consult them about the care and support they need. Clearly this is very important in enabling residents to retain as much control over their life as possible. The arrangements for providing social and leisure activities are satisfactory. Activities at the home are co-ordinated by one of the senior care staff and an activities committee. A varied programme of activities/pastimes (including crafts) and outings is provided. The home was preparing for its annual summer fair at the time of this inspection. The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 12 Residents wishing to maintain their religious links are enabled to do so. The home has an open visiting policy. There are no restrictions on the time people visit. Evidence of this was highlighted in the visitor’s book where entries showed residents friends and relatives visiting at different times during the day and evening. The only time restrictions would be imposed is when requested by residents. Relatives spoken to during the inspection said they were always made welcome at the home and were able to see their relatives in the privacy of their own room or in a quieter communal area. Residents spoken to expressed satisfaction with care provided and organisation of life at the home. Observation of care practice and information in care plans indicated residents are encouraged to make choices. For example in respect to where they spend their day. While some residents chose to sit in the lounge a number were observed to spend their time in their own rooms. Meals are cooked on site in the home’s kitchen – which has recently been refurbished. Menus are varied and balanced and provide choice. Meals are served in a designated dining room. This is an appropriately furnished room that provides a comfortable and pleasant area for residents to have their meals. Residents’ meal times are as reasonable and as flexible as they can be in a communal setting. Lunch was observed on the day of inspection. This was a hot and substantial meal and staff assisted and served residents their meals appropriately. Discussion with residents revealed a general satisfaction with the meals provided. The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives knew how to make a complaint if they felt it necessary. Written guidance and training arrangements ensure that staff members have knowledge of abuse and protection arrangements and safeguards were in place to protect the welfare of residents EVIDENCE: The complaints procedure was prominently displayed in the home and included details of how to contact the CSCI if it was felt necessary by the complainant. Relatives spoken to on the day of inspection said in the main concerns or worries brought to the manager’s attention are responded to quickly and don’t become formal complaints. The registered manager keeps a complaint record – there were 2 current complaints from relatives – one being investigated by the manager, the other by the manager and Social Services. Policies and practices aimed at protecting residents from abuse are in place. Also Bolton’s inter agency protection procedure is held on site. Staff spoken to confirmed that they had received adult protection training (this was also reflected in training records maintained by the home) and were aware of the whistle-blowing policy operated by the home. Training records indicated that approximately half the staff had received recent adult protection training at the time of this inspection. The registered manager stated that plans would be made for the remaining staff to receive such training in the near future. The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20,21,24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home appeared to be structurally well maintained and provides a comfortable and appropriate environment to accommodate, care for and support residents. EVIDENCE: A tour of the premises revealed that the home was very clean and free of malodour. The lounges and dining room provide appropriate, comfortable and warm communal areas for residents. The kitchen has been refurbished since the last inspection and the inspector was informed a new dining room carpet was to be laid the day following this inspection. WC and bath/shower rooms were appropriately equipped and adapted to meet the health and safety needs of residents. Six bedrooms were inspected on this occasion – these were clean, warm, suitably ventilated, personalised, The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 15 comfortable and appropriately furnished and equipped. A programme of maintenance and refurbishment has been developed and implemented. Residents are encouraged to bring personal items into the home and this creates a more personalised atmosphere in resident’s own rooms. Discussion with residents and their relatives revealed that the home is cleaned to high standards. Appropriate measures to prevent the spread of infection were in place – including adequate hand washing/cleaning facilities, laundry and sluicing arrangements, provision of disposable gloves and aprons for staff, adequate provision of house keeping staff and appropriate arrangements for the disposal of waste. The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment, provision and training of staff employed at the home are being managed appropriately. This is important to ensure resident’ are being cared for adequately and appropriately by staff who able to deliver this support safely and competently. EVIDENCE: Inspection of staffing rotas indicated that staffing provision at the home complied with the current minimum requirements that apply to care homes for older people. Discussion with manager and staff at the home indicated that they were of the view that staffing levels were appropriate to meet the dependency levels and needs of resident’s. There is also adequate provision of housekeeping, catering and ancillary staff at the home. Inspection of 3 staff personnel files revealed that these contained an application form (including health declaration), 2 written references, a Criminal Records Bureau check (including a ‘POVA first’ check), proof of identity (however 1 file did not contain a recent photograph of the employee) and evidence of induction training. However the application form that is used needs to be changed to ensure all applicants provide a detailed work history – doing so helps (along with the other screening measures in place) to ensure that staff who care for vulnerable people are suitable to do so. This was discussed with the registered manager on the day of inspection. The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 17 There is a commitment to NVQ (with all care staff having at least an NVQ 2 in care, and 50 have obtained an NVQ 3 in care) training, moving and handling, fire safety, first aid, protection of vulnerable adults and other training provision for all staff at the home. A review of staff training is conducted as part of the regular individual staff appraisal/supervision conducted by the registered manager. The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 18 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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Bungalow was being appropriately managed in a way that enables residents, their relatives and staff to feel that they are being supported properly. EVIDENCE: The registered manager is experienced, has achieved the NVQ Level 4 in care and management and has completed the registered managers award. Discussion with residents, their relatives and staff indicate that the manager operates a management style that is open and accessible. The home was well organised with a clear management structure. Senior carers and a team of care staff support the manager. There is also administrative/maintenance, catering and domestic staff The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 19 The manager has developed a quality assurance system to measure residents and their relative’s satisfaction, with the level of care and accommodation provided. This is essential as such information will enable a quality improvement plan to be fully developed and implemented to further improve the quality of life for residents. The manager informed the inspector that she intends to further develop the quality assurance system to incorporate the views of visiting doctors, nurses, social workers and others who regularly come to the home. And to develop her own checks to ensure practices in the home are of as a high a standard as possible. Measures were in place to ensure that residents’ financial interests are safeguarded. Residents are encouraged to control their own money. However where they are unable (or choose not to) personal allowances are managed by the home. The arrangements for this were secure and appropriately documented. The health, safety and welfare of residents and others are promoted and protected. For example staff are provided with regular training and appropriate equipment to ensure resident’s moving and handling needs are met. An example of this would be for a resident who needs to be safely moved with the aid of a hoist. Fire safety training is regularly provided. Information provided by the home indicates that electrical safety inspections/servicing has been carried out. A gas safety check was schedule to be carried out the week following this inspection. The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 20 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 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 21 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. 1 Standard OP18 Regulation 13(6) Requirement In order to help protect resident’s the CSCI must be informed in writing in writing that arrangements have been made for all staff to receive up to date protection of vulnerable adults training In order to help protect resident’s the CSCI must be informed in writing in writing that all prospective employees submit a full employment history (as part of their application) together with a satisfactory written explanation for any gaps in employment. That you confirm in writing to the CSCI that a recent photograph is kept of all staff members as part of your recruitment process that seeks to protect residents That it is confirmed in writing to the CSCI that a current gas safety certificate has been obtained in respect of the home Timescale for action 30/09/07 2 OP29 19 (1)(b) Schedule 2 paragraph 6 30/09/07 3 OP29 19 (1)(b) Schedule 2 paragraph 1 13(4)c 30/09/07 4 OP38 30/09/07 The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP3 OP7 OP8 Good Practice Recommendations That the pre-admission assessment is recorded as a separate document in the care records. Whilst care plans identified the problems residents experience some need to include more detail of what staff need to do to care for and support residents. To help maximise the health and safety of residents risk assessments for moving and handling, nutrition and skin integrity should be formally evaluated at least monthly. Sitting scales should be obtained and used for weighing residents instead of the current standard bathroom scales to minimise the risk to residents and staff. When staff make written transcriptions to medicine administration records these be checked and signed by 2 members of staff. This will minimise the risk of a mistake being made and therefore help to protect residents and staff. OP8 OP9 The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 © 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 The Bungalow Residential Home DS0000062979.V337614.R01.S.doc Version 5.2 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. 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