Care Home: Bournedale House

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What the care home does well There is a good level of satisfaction amongst the people who live and work at Bournedale House. People who live there are satisfied that their needs are met and are happy with the support they receive. Staff are happy with the training and support they are provided with. Good systems are in place to ensure the smooth running of the home. The care is monitored constantly and people living at the home are routinely consulted about the care they receive. What has improved since the last inspection? People who live at the home are very positive about the care they receive. Staffing rota`s have been reviewed to ensure they best meet the individuals specific needs. Staff training and supervision has been prioritised by the manager to ensure good practice is maintained. Care planning and risk assessing systems are much improved and provide comprehensive guidance for the staff to ensure that they have the information they need to meet the needs of the people living at the home. All the requirements and recommendations arising from the last inspection have been met satisfactorily. What the care home could do better: Daily entry recording by staff needs to be improved to provide a full picture of the individual. The activity programme needs expanding to ensure all people living at the home are catered for. Hot water temperatures should be slightly higher to ensure people living at the home have a comfortable bathing experience. All windows above ground floor should be checked weekly to ensure window restrictors are in place and are working properly to prevent accidents occurring. Key inspection report Care homes for older people Name: Address: Bournedale House 441 Hagley Road Edgbaston Birmingham West Midlands B17 8BL     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: Sara Gibson     Date: 1 9 0 5 2 0 1 0 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 25 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Bournedale House 441 Hagley Road Edgbaston Birmingham West Midlands B17 8BL 01214204580 01214204580 bournedalehouse@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr David Pangbourne Name of registered manager (if applicable) Ms Karen Smith Type of registration: Number of places registered: care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 11 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 11 Dementia (DE) 11 Date of last inspection Brief description of the care home Bournedale House is located approximately 3 miles from Birmingham city centre, and within walking distance of Bearwood shopping centre. Facilities such as churches, public houses, restaurants, library and parks are close to the home. Care Homes for Older People Page 4 of 25 Over 65 0 11 11 0 2 7 0 5 2 0 0 9 Brief description of the care home Bournedale House is a large Victorian property providing accommodation to 11 older adults. Care is provided on the ground and first floors, a chair lift provides access to the first floor facilities. On the ground floor there is a main lounge, dining area and kitchen, with toilet and shower facilities within easy reach. The lounge is to the rear of the property, is spacious and provides nice views of the rear garden. There is a shared double room to the ground front of the property that provides accommodation for two people who require ground floor facilities. This room has privacy screens. The first floor facilities consist of single bedrooms with ample storage, some with original Victorian fireplaces. The bathroom and shower room are large enough to allow for staff assistance if required. There are grab rails located in toilets and around the home to aid people living in the home. The service user guide for the home includes information on the range of fees charged. Care Homes for Older People Page 5 of 25 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 2 star. This means the people who use this service experience good quality outcomes. This inspection was unannounced and carried out over one day. All the key standards identified by the Care Quality Commission were assessed to evaluate the experiences of care and support received by the people living at Bournedale House. Information about the service provided were sought and collated in a number of ways. Prior to the inspection an Annual Quality Assurance Assessment (AQAA) was sent to the home for completion. The AQAA is a self-assessment that is filled in once a year by all providers. It informs us how the providers are meeting outcomes for people living at the home and is an opportunity for providers to share with us areas they believe they are doing well. We used comments and information in the AQAA to plan our inspection. Care Homes for Older People Page 6 of 25 During the course of the inspection we used a variety of methods to make a judgement about how the people living at the home are supported. We talked to the manager who was able to answer questions and provide us with documentation. We also talked to the staff team on duty and the people living at the home. We assessed the care provided to two people using care documentation. We sampled a variety of other documentation related to the management of the home such as training, recruitment, staff supervision, accidents and complaints. All this information helped to determine a judgement about the quality of care the home provides. Care Homes for Older People Page 7 of 25 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 25 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 25 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 are confident that the home can support them. This is because there is an accurate needs assessment, which they have been involved in. This tells the home all about them and the support they need. This is carried out before they are offered a place at the home. Evidence: The home understands the importance of having sufficient information when choosing a care home. They have developed clear information to help prospective individuals choose a home that will meet their needs and preferences. The information is contained in the homes statement of purpose which clearly sets out the homes aims and objectives, and is supported by a service user guide that details what services the home can provide, the qulaifications and experience of staff, and what levels of service the prospective resident can expect. The documents are clear and easy to understand, and can be made available in other formats such as large Care Homes for Older People Page 10 of 25 Evidence: print if required. The service user guide lists the fees charged by the home and any extra charges that may be incurred. Prospective residents are given a copy of the guide to refer to as needed. Admissions to the home are not made until a full needs assessment has been carried out by the home or a full assessment is obtained by the referring authority. During the inspection we saw two pre-admission assessments competed by the home. Both were comprehensive and well documented, providing a full picture of the individual and their needs and preferences. Care Homes for Older People Page 11 of 25 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. Each person is treated as an individual and the home is responsive to their individual needs and preferences, and this is documented accordingly. Their right to privacy is respected and the support they receive from care staff is given in a way that maintains their dignity. Medication is administered safely at the prescribed time to promote peoples health. Evidence: Two care plans were seen during the inspection, and were detailed, informative and provided good guidance for staff to enable them to meet the needs of the individual. The documentation identifies the individual need, how staff should support the person to meet that need and the agreed outcomes. Areas covered included: Physical and mental abilities, health and hygiene needs, dietary preferences and religious, social and cultural needs. All the care plans and assessments seen had been reviewed with the individual person and changes made where necessary to ensure staff are able to support people with Care Homes for Older People Page 12 of 25 Evidence: their current needs. Risk assessments for manual handling, falls, pressure area care and behaviour management were seen in the care plans. Risk assessments were comprehensive and specific to the individual. Reviews are undertaken monthly or as changes occur to ensure people living at the home are safe, potential risks are minimised and staff have the current guidance to follow. Medication is administered by staff who have undergone medication administration training. This is done in a safe and appropriate manner. Medication administration records were looked at, and all were found to be competed correctly. Medications are stored safely and appropriately and no issues were identified in this area. People were supported by staff to choose clothing appropriate for the time of year which reflected individual, cultural, gender and personal preferences. Staff were observed assisting individuals in a sensitive manner giving choices where necessary. Care Homes for Older People Page 13 of 25 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. The home provides activities for those living at the home. The programme needs to be developed to ensure that it meets the needs of all the people living at the home. A wholesome and varied diet is offered and specialist diets are catered for to meet the needs of individuals. Evidence: Activities take place within the home on an almost daily basis. The activities provided at present are quite limited and require further development to ensure the needs of all those living in the home are provided for. When activities have taken place they should be documented to show what activity was undertaken and by whom to provide an accurate record. Residents and relatives meetings are held throughout the year, and minutes of previous meetings seen demonstrate that staff listen and respond to suggestions made. The family input at the home is good. Family and friends are encouraged to visit at any time. This allows close relationships to be maintained and gives people living at the home a sense of family life. Care Homes for Older People Page 14 of 25 Evidence: Comments received from relatives and residents were very positive. They included: Very pleased with the quality of the service Staff are always kind and patient Im happy here, its warm, cosy and all the staff and others in the home are friendly and kind I am satisfied and very grateful and appreciative of the service the home provides We have the opportunity to speak to the manager when we have something to say. Meals are well balanced, nutritious and choices are offered to those living at the home. For those individuals who need support during mealtimes, staff give discreet assistance. Mealtimes are flexible and relaxed, and staff are patient and helpful. Dining at the home is a pleasant experience for all concerned. Care Homes for Older People Page 15 of 25 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. People who wish to raise concerns or make a complaint are confident that these will be dealt with effectively and their views listened to. Staff have access to the policy regarding safeguarding adults and have received training to ensure they possess the knowledge and skills to respond appropriately to allegations of abuse. Evidence: No complaints have been received by the home in the last six months. The manager operates an open door approach and during the inspection we observed her interacting well with service users in a friendly and caring way. Relatives said they had no reason to complain and were very happy with the service provided. They said they would go to the manager if any issues arose and were confident that action would be taken. Safeguarding Adults policies are clear and detailed. Adult Protection and Whistle blowing policies are availble for staff to access at any time. Staff have received training in safeguarding adults including whistleblowing. Staff spoken to said We would report any concerns to the manager. The staff had a good understanding of adult protection and stated that the manager is very approachable and would be easy to talk to if they had any concerns. Accidents and incidents are well documented, describing in good detail what happened and any follow up needed. Care Homes for Older People Page 16 of 25 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. A homely and comfortable living environment has been achieved for the people who live there so they feel safe and well cared for. Evidence: Communal areas in the home were warm, well decorated, welcoming and homely. People living in the home spend most of their time in the lounge. They looked comfortable, well cared for and happy and were interacting with the staff. The home is decorated, furnished and fitted to a good standard. Maintenance issues and repairs are responded to promptly, and the general housekeeping is of a good standard. However, during the inspection it was noted that two of the bedrooms had a strong odour of urine emananting from the armchairs in the rooms. The chairs should be thoroughly cleaned or disposed of to ensure the environment is pleasant to live in. Window restrictors were missing or broken on some of the upstairs windows which could cause a potential hazard of falls from the open windows. The manager informed us that both the issue of the odour and the broken window restrictors would be addressed immediately by the manager and the provider of the service. The bedrooms seen during the inspection were spacious and comfortable, and in some cases had been personalised with the individuals own photographs and ornaments to reflect their personal tastes. Care Homes for Older People Page 17 of 25 Evidence: The garden areas were tidy and well maintained and easily accessible to people living at the home. Servicing of equipment in the home takes place on schedule, and all maintenance certificates seen were in order. Weekly checks of the fire alarm, call system and hot water temperatures take place and are documented. Hot water temperatures recorded were on the low side around 36 or 37 degrees, the manager was advised that temperatures should be running around the 40 degree mark but not to exceed 43 degrees to ensure people living at the home have an adequate supply of hot water. The maintenance file is quite cumbersome and contains a lot of old information, this should be archived and the current information can then be found more easily. Care Homes for Older People Page 18 of 25 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. Staffing levels are well maintained to ensure people living at the home receive competent and safe care from appropriately trained and robustly recruited staff. Evidence: Staffing levels at the home are well maintained to meet the needs of the people living at the home. From talking to staff and observing them during the day it was evident that staff morale was good, and the interaction with the people living at the home was excellent. Robust recruitment procedures safeguard the people being supported at the home. Two staff files were sampled and all the relevant checks had been carried out prior to the staff member starting work at the home. New staff undergo an induction and probationary period to assess their competence. The staff training and developement programme at the home is good. Training for staff in the last year has included: Safeguarding Adults, Manual Handling, Fire Safety, and Safe Administration of Medicines. All the care staff hold or are working towards an NVQ in Care. Ongoing training ensures that people living at the home are supported by a safe and competent staff team. Care Homes for Older People Page 19 of 25 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 manager is very competent and possesses the skills and knowledge to oversee the day-to-day management of the home, and ensures that residents needs and views are responded to. Arrangements in respect of health and safety are good and prevent the risk of injury occurring. Evidence: The manager of the service is capable, efficient and proactive, and has a number of years experience in care. Staff and resident/relative meetings are held throughout the year and minutes are documented. From reading the minutes it shows that people living at the home are very satisfied with their care. People living at the home have access to their personal monies. Finances are secure and a robust audit trail is maintained. Care Homes for Older People Page 20 of 25 Evidence: There is a well planned staff supervision programme in place. The sessions are well documented and staff have the chance to discuss care issues and air any concerns they may have, gain feedback from their mentor and identify any training needs they may have. This further safeguards the people living at the home by ensuring the staff have the skills, knowledge and support they need to meet peoples needs. General arrangements for health and safety are good. Maintenance checks are carried out on schedule to ensure equipment is safe to use and maintenance issues and repairs are responded to promptly. Care Homes for Older People Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 22 of 25 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 All windows above ground floor level should have window restrictors fitted. This will ensure that a potential hazard of falls from open windows is diminished. 28/05/2010 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 1 7 Nutrtion charts should state exactly how much of each food item has been eaten at each meal to keep an accurate record of dietary intake. Daily records completed by care staff should be more detailed and give a full picture of events of the day and any follow up actions taken. This will provide a complete and accurate record of the individual on any given day. A planned programme of activities is to be developed to ensure all the people living at the home can participate fully in social activities. The programme should be formalised and on display for all to see. Furnishings should be clean and odour free to prevent infection and to ensure a pleasant living atmosphere is provided for the people living at the home. Page 23 of 25 2 7 3 12 4 26 Care Homes for Older People 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 5 26 Hot water temperatures should run at a temperature of between 40 and 43 degrees to ensure an adequate supply of hot water is provided for the people living at the home. Care Homes for Older People Page 24 of 25 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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