Care Home: Bank House Residential Home

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What the care home does well The home is in a quiet and peaceful country setting. A visitor commented that a reason for choosing the home was that it had a good reputation in the area. People are cared for in a clean and comfortable environment. All people spoken with made positive comments about the care they received; one said it had looked after her well and another said that she enjoyed sitting in a quiet lounge and watching the birds in the large gardens. The staff group is well trained and knowledgeable about the people living at the home and how they prefer to be cared for. The manager and senior staff work well as a team and there is a very stable staff group, enabling good knowledge of the needs of people. People are encouraged to make choices about their daily lifestyles and individual likes and dislikes are catered for. Comments from people who live at the home and their families were positive and included praise for the staff and the manager. What has improved since the last inspection? Regular reviews of assessments. Increase in trained staff and a staff member responsible for staff training and supervision. New windows to some rooms, redecoration and carpeting of the dining area and several bedrooms. The lamination of all relevant policies for display purposes. Reviews and updates to all risk assessments, further training on such issues as the Mental capacity Act and care planning, person centred records for each resident and a list made of staff who are accountable for medication administration and who have been trained according to the policies and procedures of the home. Care plans are now in more detail and contain more information to enable staff to meet the needs of people. What the care home could do better: The corridor in one part of the building has suffered from a water leak and the paint is peeling off the walls. Some of the bedrooms have cracks in the ceilings and are in need of redecoration. The owner is aware of these issues and has already made a start on the redecoration programme. Key inspection report Care homes for older people Name: Address: Bank House Residential Home Bank House Gosberton Bank Gosberton Lincs PE11 4PB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Julie Western     Date: 3 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 22 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home Name of care home: Address: Bank House Residential Home Bank House Gosberton Bank Gosberton Lincs PE11 4PB 01775840297 01775840297 janemoore1@talk21.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Miss Jane Louise Moore care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability old age, not falling within any other category Additional conditions: The Home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:- Old age, not falling within any other category (OP) 26 Dementia - over 65 years of age (DE(E)) 1 Learning Disability - over 65 years of age (LD(E)) 3 The maximum number of service users to be accommodated is 30. Date of last inspection Brief description of the care home Bank House is a two-storey, private, family-run care home located in a rural setting approximately a half of a mile from the village of Gosberton and 6 miles from the town of Spalding. The Georgian building has been extended to provide personal care for up to thirty older persons of both sexes, including one older person with dementia and three older Care Homes for Older People Page 4 of 22 Over 65 1 3 26 0 0 0 Brief description of the care home persons having a learning disability. Accommodation consists of twenty-two single rooms, none of which is en-suite, and four shared rooms, on the ground and first floors. The first floor is accessible by stairs or a passenger lift. The home overlooks lawns and garden areas and has car parking spaces at the front of the home The homes philosophy, which is displayed around the building, is that residents are treated as individuals and that there is an ongoing development of best practice in clinical and social care. The fees for the home range from £348 to £431 with additional charges made for hairdressing, chiropody and newspapers. This and other information, such as the statement of purpose and a copy of the last inspection report is available from the office. Care Homes for Older People Page 5 of 22 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Care Quality Commission (CQC). The visit lasted approximately two and a half hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent Care Homes for Older People Page 6 of 22 out surveys to people before we visited the service. The main method of collecting information during this visit is called case tracking, which includes following the care of a sample of four people through their records and assessing their care. We spoke to four people who use the service and saw rooms of those people who said we could and to three staff members. The manager and deputy manager were present throughout the visit and the general outcomes of the visit were discussed with them. Care Homes for Older People Page 7 of 22 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 22 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 22 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. Evidence: We saw the statement of purpose which was clear and contained terms and conditions and contracts. The service user guide we saw was called the residents handbook and contained useful information for people. It was in large print. The manager said that she or a senior member of staff always visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records we saw confirmed this. We saw written admission records that were clear and gave staff all the information they needed to meet the needs of people. A resident we spoke with described how he had visited for the day before he was sure he wanted to move in permanently. A relative told us that this home had been chosen Care Homes for Older People Page 10 of 22 Evidence: because it was the best of the ones they saw. A staff member described the admission process and the importance of making new residents and their families welcomed. Care Homes for Older People Page 11 of 22 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are in enough detail to ensure that the care needs of people can be met. Evidence: Care plans we saw contained information about the health and personal care needs of people, including a night care plan and sleeping assessment, a person centred care plan, risk assessments and a mental capacity assessment. They were reviewed regularly and signed where possible by people or their relatives or advocates. We saw a medication policy that was clear and comprehensive. The pharmacist visited regularly, the last visit one week ago and no issues were identified, with the comment by the pharmacist being Overall an excellent standard. People received regular visits from district nurses, Macmillan nurses, CPNs and other agencies involved with their care. People we spoke with said they were happy with the care they received and comments included I have no worries that I will be well looked after and They are always happy and kind to me. We saw staff carrying out their duties with kindness and sensitivity towards people, especially when attending to their personal needs. Care Homes for Older People Page 12 of 22 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities are regular and are tailored to suit the individual needs of residents. People have a choice of meals from a balanced and varied menu. Evidence: Care plans we saw showed that individuals are assessed for their needs and wishes regarding lifestyle and daily activities. There is a life history which details the preferred activities of each person. We found that there is a dedicated activities room where people can play card and board games, make arts and crafts and have manicures. The home provides a variety of activities for residents including entertainers and trips to local pubs and shops. On the day of our visit there was a visit from the local church and carol singing in the main lounge. People we spoke with all said they had a choice of whether or not to take part. Some told us about recent events such as watching chicks hatch, a Christmas party and a carol service. Some said they preferred to sit in a quiet lounge instead. A list of 30 instant daily activities was displayed in the staff room for staff to carry out at any time. We saw the mid-day meal being eaten and people we spoke with all said they enjoyed the meals served. Comments included Marvellous and Its all very good and you can choose what you want. The menu for the week was displayed in the dining room and offered alternative choices of meals. The cook was knowledgeable about the Care Homes for Older People Page 13 of 22 Evidence: nutritional needs of service users and described cooking for people on various diets. Bank House recently received a food hygiene rating of excellent by the local health and safety officers. Care Homes for Older People Page 14 of 22 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures for addressing complaints and for protection from abuse are clear. People and their families are confident that their comments and concerns will be listened to. Evidence: People spoken with said they did not wish to complain but knew how to make a complaint. The home had an up to date copy of the Local Authority adult protection procedures and staff members said they had read it. The training programme showed that there was a rolling training course for staff on safeguarding adults. Staff members spoken with knew what to do in the event of a serious concern and confirmed that they had received appropriate training. A resident said that if they had a complaint the manager would see to it and visitors spoken with said that they were given information on how to make complaints. We saw that one complaint had been made to the safeguarding team since the last inspection. This concerned the care of one named person and following the investigation, recommendations were made regarding communications with families. Care Homes for Older People Page 15 of 22 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable and pleasant environment with both private and communal space that is generally suitable for their needs. Some corridors and rooms are in need of redecoration. Evidence: Residents have a lot of communal space, with four lounges and an activities room to choose from. Externally, the standard of decoration was high. Internally some corridors and rooms were in need of redecoration and the manager acknowledged that this was due to be carried out this year. Residents said they were comfortable in their surroundings and that they had been able to bring some of their own belongings to feel more at home. Recent improvements had included new windows to some rooms, redecoration and carpeting of the dining area and several bedrooms. The gardens were well maintained and offered pleasant places for people to sit out in good weather. Staff described how any maintenance issues were addressed quickly by the maintenance personnel. There were safety notices around the building and a medicated hand wash by the visitors signing in book to prevent the spread of infection and COSHH regulations were observed throughout. The building smelled clean and fresh throughout. Care Homes for Older People Page 16 of 22 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, which means that people receive a good standard of care and support. The systems within the home protect their health, safety and welfare needs. Evidence: The staff rota we saw showed that the manager, the deputy manager plus two carers were on duty. In addition there was a cook, a kitchen assistant and a domestic. The owners partner was responsible for maintenance and provided general support. We saw training records for staff and these showed that all but one member of staff has achieved the National Vocational Qualification [a nationally recognised qualification] at Level 2. One staff member has achieved Level 3. We spoke with staff members who described how they had an interview, gave three references and underwent CRB/POVA checks and had induction before starting work. Staff records we saw confirmed this. Training records we saw showed that the training required by law has been undertaken, with abuse prevention, care planning, the mental capacity act and deprivation of liberties in addition. The owner said that a senior staff member now has responsibility for supervision. Records we saw showed that staff members all receive regular supervision and staff meetings, which staff members confirmed. Care Homes for Older People Page 17 of 22 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the health, safety and welfare of people are promoted. Evidence: The manager has owned and managed Bank House since 1991.She is a trained nurse and has achieved the Registered Managers Award. The deputy manager is working towards the Registered Managers Award. People we spoke with all made very positive comments about the way the manager and deputy manager ran the home, finding them approachable and supportive. People we spoke with said the staff group were very kind and helpful and staff we spoke with said the staff group had been together for many years and worked well as a team. There is a sound quality assurance procedure, with separate questionnaires for people, their relatives/visitors and staff. The findings are discussed with the staff team and residents and acted upon. Health and safety policies were well documented and showed a clear commitment to ensuring the wellbeing of people. Records were well maintained. Care Homes for Older People Page 18 of 22 Evidence: We saw minutes of the last residents meeting and these showed that residents felt free to express their opinions and comments about the running of the home and that the management listened and acted on issues and ideas. A sample of residents financial records were examined and showed that finances for people are kept in a safe place and there is a clear system of accounting in place. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. The homes pre-inspection questionnaire has evidenced that maintenance and service histories of all aids and adaptations are carried out as required by law. Care Homes for Older People Page 19 of 22 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 19 23(2)(b)&(d) The care home must be kept 07/08/2009 in a good state of repair and kept reasonably decorated to ensure that residents live in comfortable surroundings. Care Homes for Older People Page 20 of 22 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 The premises must be kept in a good state of repair internally. To ensure that people live in a safe and comfortable environment. 31/03/2011 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 21 of 22 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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