Care Home: Bathampton Manor

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What the care home does well Bathampton Manor provides a warm, inviting and homely environment where every effort is made to provide care that is centred on the individual health and social care needs. There is a real sense confirmed by individuals I spoke with that there is a flexibility and choice in how individuals spend their time and importantly it is recognised how maintaining links with the community is an important part of living in the home. An example of this was one individual I spoke with who spoke of the importance for them to attend their local church and how "this is something I still feel able to do and it means a lot to me". The care planning practice of the home is good and provides detailed information about the individual`s care needs and importantly the reviewing practice helps in keeping this information up to date and taking account of the changing needs of individuals. Staff have a strong commitment to providing quality care and the home has a history of retaining staff which helps in providing a continuity of care and opportunity for staff to establish a strong sense of team working and real relationships with the residents of the home. What has improved since the last inspection? Two requirements were made at the last inspection one about recording of accidents in the home records looked at on this visit showed that recording is of the required standard. The other requirement related to Quality Assurance questionnaire the home is currently waiting the introduction of a new system to obtain the views of individuals about the service they receive. What the care home could do better: The home`s Statement of Purpose must show information that is specific to Bathampton Manor as set out in regulation and a requirement has been made about this. The home`s activities and staffing arrangements need to be looked at, staffing to make sure that the level of staffing remains satisfactory and set against the dependency needs of individuals in the home. The activities arrangements also relates to staffing in that there must be sufficient staffing capacity to enable a full and varied activities programme to take place and also enable staff to spend quality one to one time with residents. CARE HOMES FOR OLDER PEOPLE Bathampton Manor Mill Lane Bathampton Bath Bath & N E Somerset BA2 6TS Lead Inspector Jon Clarke Unannounced Inspection 1st November 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 Bathampton Manor DS0000008147.V352238.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. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bathampton Manor Address Mill Lane Bathampton Bath Bath & N E Somerset BA2 6TS 01225 466260 01225 466260 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) www.bcvs-homes.co.uk BCVS Homes Mrs Marilyn Evans Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 21 persons aged 65 years and over requiring personal care only. 23rd January 2007 Date of last inspection Brief Description of the Service: Bathampton Manor is one of three homes owned and managed by B.C.V.S. a Bath based charity. The home is a converted older property set in extensive grounds. It is some distance from Bath the nearest facilities being in Bathampton which has pubs, church and small shop. The home offers care and accommodation for up to 21 older people over three floors with stair lift or lift access to all floors. Eleven of the rooms offer en-suite facilities. There are two communal lounges and dining room with plans for a conservatory to be built during this year. The gardens and grounds are particularly attractive with level access and a number of seating areas. The philosophy of the home is to look after the residents in a caring and sympathetic way so that their privacy and dignity are respected and to encourage active independence where possible. A resident said of the home if you cant live in your own home its the next best thing. Fee £435-509 dependant on care needs and facilities such as en-suite allinclusive other then health services. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the home as part of an inspection the manager was present for part of this visit. I looked at a number of records including care plans, daily care records, accident reports, staffing records. There was also an opportunity to speak with a number of individuals who live and work in the home. A number of Have Your Say questionnaire were sent to the home before this inspection responses were received from 12/15 residents 12/15 relatives 7/15 staff and 1 health professional. As part of this inspection the manager completed a Annual Quality Assurance Assessment (AQAA) which set out the areas of practice based around the National Minimum Standards summarising what the home does well, the evidence for this, what they could do better and how they have improved in the last 12 months. The information from the AQAA and questionnaires has been used to help make a judgement about the quality of care provided in the home. What the service does well: What has improved since the last inspection? Two requirements were made at the last inspection one about recording of accidents in the home records looked at on this visit showed that recording is of the required standard. The other requirement related to Quality Assurance Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 6 questionnaire the home is currently waiting the introduction of a new system to obtain the views of individuals about the service they receive. 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. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 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 Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose provides the required information about the home, the facilities, staffing arrangements, admission procedure and aims and objectives of the home so that individuals can make an informed choice about the suitability of the home. However there lacks information specific to Bathampton Manor such as staffing arrangements. The home undertakes full and comprehensive assessment of prospective residents so that they are able to make an informed decision about the capacity of the home to meet health and social care needs. EVIDENCE: The home’s Statement of Purpose provides information about the service and facilities individuals can expect. Included are the aims of the service, admission arrangements and statements as to accommodation, daily life and routines. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 9 There is no information specific to the home about the manager, staffing and organisational structure of the home. A number of pre-admission assessments were looked at and provided good information about the health care needs of the individual. In one instance there was very good detailed information about the personal history and hobbies, interests however this was not consistent with other assessments seen. Where individuals have been assessed by the local authority social services a copy of the assessment is part of the admission assessment information. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care Planning and arrangements for meeting health care are generally good providing staff with the necessary information so that the health and social care needs of residents is met. Arrangements for managing resident’s medication make sure that resident’s health needs are protected. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld. EVIDENCE: A number of care plans were looked at and showed good practice in this area with full and detailed information about the health and social care needs of the individual. Risk assessments had been completed and reviewed regularly as had moving and handling assessments. Reviews of care needs had been completed and the contribution of key workers added to this reviewing and updating of care needs and circumstances of the individual. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 11 Individuals who live in the home have good access to community health services such as chiropody, dental and optician. The home has good relationships with the local GP and one responded to the Have Your Say questionnaire and was positive about the home’s approach and care provided in the home. There was evidence from records seen that the home responds well to any health concerns either through referral to the individual’s GP of with community nurses. Residents who responded to the questionnaire said that they “always” 7 and “usually” 5 receive the medical support they need. Medication was not looked at on this visit however the home had a pharmacist inspection visit on 15th June 2007 and the report stated that the home’ s practice and arrangements for managing medication was satisfactory. I spoke with a number of individuals who live in the home and all were very positive about the approach and support they received from staff. One spoke of how they found staff “extremely helpful and very friendly”. When asked about how staff treated them in relation to did they feel they were respected by staff they all again were positive about this “always” “can’t fault how they treat us”. During the visit I was able to observe staff with residents and they were always sensitive in their approach, supportive and caring in the way they spoke and assisted individuals. One comment from a relative said about the home “it cares for it’s residents and treats them with dignity”. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for meeting the social and recreational needs of residents are generally good and there are opportunities for residents to maintain links with family, friends and the local community. The arrangements for providing activities would benefit from being looked at to try and see if improvements could be made to provide more stimulation and activities which suit the individuals in the home. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals, which are balanced and meet the dietary needs of individuals in the home. EVIDENCE: There was a mixed response from individuals I spoke with about the activities provided in the home. One said that they would like “a little more activity” another said there was “enough for me”. Respondents to the questionnaire said there was “always” 4 “usually”6 “sometimes” 2 to the question Are there Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 13 activities arranged by the home that you can take part in? On the day of my visit there was an outside entertainer and this is arranged on a regular basis and one individual I spoke with said she “very much enjoyed” the entertainer that day. Other activities arranged included flexexercise, flower arranging, and quizzes. There are also occasional trips out. Staff also spoke of how they try to do individual activity though at times this is difficult because of workload demands or shortage of staff. A relative commented that they felt residents needed more stimulation and suggested talking books be arranged for the home?? Individuals said they felt the home was “welcoming” to their visitors and there “are no restrictions about friends coming to see me”. Comments from relatives included “a pleasure to visit” “the staff are positive, cheerful and welcoming to visitors” “very welcoming to family and friends” “always made to feel welcome and have no worries about how my relative is looked after”. All relatives who responded to the questionnaire said that the home “always” helps in keeping in touch with relatives and friends. Respondents to the questionnaire said that they “always” 6 “usually” 6 liked the meals in the home. Individuals I spoke with again were positive about the quality of meals and food provided “always good” “very good” “always a choice”. The menus offered a varied range of meals and those with specific diets such as diabetes are well catered for. The meal on the day of my visit was well presented and looked appetising. Staff were noted providing support and assistance where this was necessary and did so in a sensitive and caring manner. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear procedures in place and this enables individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. EVIDENCE: There have been no complaints made since the last inspection. The home’s complaint procedure is made available to all residents as part of the information individuals receive on coming into the home. All respondents to the questionnaire said they knew how to make a complaint. When asked about this individuals I spoke with said they “would not hesitate” in talking with a member of staff or the manager if they were unhappy about anything. One individual said they “could always talk to the staff here they listen and would do something”. Staff have undertaken Safeguarding Adults training and the home has a Vulnerable Adults policy. I asked individuals if they always felt safe in the home and also whether they ever felt staff spoke to them inappropriately all Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 15 said no “staff always talk to us how I would want to be spoken to and treated” and felt safe in the home. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe, welcoming, homely and hygienic environment for the residents and staff. EVIDENCE: Since the last inspection the main lounge of the home has been decorated making for a brighter and inviting area of the home. After some considerable time and fund raising effort a new conservatory is now being built. This will provide additional area for residents to use and being heated will be suited for year round use. Residents spoke of the home always being clean and well looked after. There are procedures in place and facilities for staff to maintain good hygiene practice and staff are provided with the necessary protective clothing when necessary. A relative said of the home “it provides an attractive environment and excellent standard of care” Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements in the home are generally satisfactory so that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. However the home needs to make sure that staffing is at a level so that the needs of residents are continuing to be met. The recruitment and selection of staff is undertaken to make sure that as far as possible the health and welfare of resident is protected. EVIDENCE: Staffing rotas were looked at for a period of three weeks they showed that on a number of occasions there were 2 care staff on duty rather then the norm of 3, 2 pm and 2 waking night staff. A number of staff who returned the Have Your Say questionnaire commented on staffing in the home; “we only have basic staffing level, holidays etc can be a problem” “need to have bank relief to help with cover for sickness, holidays etc “more bank staff to cover shifts when needed”. Residents who responded to the Have Your Say questionnaire said that staff are available when you need them “always” 3 “usually” 9. I was advised that 95 of staff have completed NVQ qualification level 2 or 3. Only two of the day staff have yet to complete this training. This is to be commended. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 18 Training records showed that staff have completed the required mandatory training such as moving and handling, fire safety, infection control. Where required staff complete medication training. There is now an identified member of staff who monitors and reviews training needs. All staff respondents to questionnaire said they were satisfied with training provided. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good opportunities for individuals who live in the home and others to express their views about the service they receive. The practices of the home help to make sure that the health, safety and welfare of residents and staff are protected. EVIDENCE: A number of individuals I spoke with commented on how approachable the manager of the home was and there was a feeling that she was someone who would listen and take action where necessary. This was confirmed by one individual who said they would “always go to her” “she is someone we can talk to”. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 20 The home is introducing a new quality assurance system and staff are waiting for training. This will be welcomed in that it will enable individuals and others to express their views about the quality of the service provided. Resident’s meeting are held regularly the last being in May and these do provide an opportunity for residents to make suggestions and comment about the care they receive. Records relating to fire training were looked at and showed fire training had taken place for staff 02/09/07, 10/10/07 and for night staff 02/10/07 and 02/7/07. The fire system was serviced on 25/09/07, weekly fire alarm test take place and monthly emergency lighting tests as required. Equipment such as hoists, lift, are regularly serviced. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 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 2 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 22 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 OP1 Regulation 4 (1) c Requirement Timescale for action 31/01/08 2 OP12 16 (n) The manager to make sure that the home’s Statement of Purpose includes information specific to the home. The manager to consult service 01/03/08 users about the programme of activities arranged by or on behalf of the home. 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 OP27 Good Practice Recommendations To review staffing arrangements in the home against the dependency, social and health care needs of the individuals in the home. Provide a report to the CSCI with the outcome of this review and any actions taken as a result. Bathampton Manor DS0000008147.V352238.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Bathampton Manor DS0000008147.V352238.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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