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Care Home: Bowerswood Retirement Home

  • Longmoor Lane Nateby Garstang Lancashire PR3 0JD
  • Tel: 01995606120
  • Fax:

Bowerswood House is a large, old house, approached down a narrow lane, and set in its own gardens surrounded by countryside, giving lovely views through the large windows in the lounge. It has been adapted to suit the needs of older people, for example, a passenger lift has been installed, and grab rails fitted around the home. It is a two-storey house, with single, and a few double rooms, sited on the ground and first floors. All of the rooms are ensuite, with bathrooms being conveniently located. There is sufficient communal space with a large lounge, a dining room, and a spacious seating area inside the entrance to the home. There is ample car parking space, and Garstang is a short drive from the home. Staffing is provided over 24 hours, every day of the year. Information about the service the home provides is available in the form of a standard brochure, and also a detailed and clearly written guide which tries to cover everything a resident needs to know about daily life in the home. CSCI reports are readily available from the manager to anyone who asks to see them. As at 10th October 2007, the fee scale ranges from £374 to £420, with additional charges for chiropodist and hairdresser visits, and extra newspapers and toiletries requested. Further details regarding fees are available from the manager.

  • Latitude: 53.902000427246
    Longitude: -2.808000087738
  • Manager: Mrs Nicola Mary Theobald
  • Price p/w: £397
  • UK
  • Total Capacity: 24
  • Type: Care home only
  • Provider: Bowerswood House Retirement Home Limited
  • Ownership: Private
  • Care Home ID: 3229
Residents Needs:
Old age, not falling within any other category

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Bowerswood Retirement Home.

CARE HOMES FOR OLDER PEOPLE Bowerswood Retirement Home Longmoor Lane Nateby Garstang Lancashire PR3 0JD Lead Inspector Ms Jenny Hughes Unannounced Inspection 10th October 2007 09:45 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 Bowerswood Retirement Home DS0000063244.V346630.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. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bowerswood Retirement Home Address Longmoor Lane Nateby Garstang Lancashire PR3 0JD 01995 606120 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) Bowerswood House Retirement Home Limited Mrs Nicola Mary Theobald Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 24 service users in the category OP (older persons 65 and over). 26th April 2006 Date of last inspection Brief Description of the Service: Bowerswood House is a large, old house, approached down a narrow lane, and set in its own gardens surrounded by countryside, giving lovely views through the large windows in the lounge. It has been adapted to suit the needs of older people, for example, a passenger lift has been installed, and grab rails fitted around the home. It is a two-storey house, with single, and a few double rooms, sited on the ground and first floors. All of the rooms are ensuite, with bathrooms being conveniently located. There is sufficient communal space with a large lounge, a dining room, and a spacious seating area inside the entrance to the home. There is ample car parking space, and Garstang is a short drive from the home. Staffing is provided over 24 hours, every day of the year. Information about the service the home provides is available in the form of a standard brochure, and also a detailed and clearly written guide which tries to cover everything a resident needs to know about daily life in the home. CSCI reports are readily available from the manager to anyone who asks to see them. As at 10th October 2007, the fee scale ranges from £374 to £420, with additional charges for chiropodist and hairdresser visits, and extra newspapers and toiletries requested. Further details regarding fees are available from the manager. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of this home included a site visit, which was carried out over one day. The site visit was part of the key inspection of the agency. A key inspection takes place over a period of time, and involves gathering and analysing written information, as well as visiting the home. During the visit we spent time speaking to residents, staff, the deputy manager and owner/manager. We also spoke to some visitors. Every year the registered person is asked to provide us with written information about the quality of the service they provide, and to make an assessment of the quality of their service. It also asks about the manager’s own ideas for improving the service provided. We use this information, in part, to focus our assessment activity. Surveys were sent and received from residents and their relatives, and staff from the home. During the site visit, staff records and resident care records were viewed, alongside the policies and procedures of the home. We also carried out a tour of the home, looking at both private and communal areas. Everyone was friendly and cooperative during the visit. What the service does well: The large gardens around the home are well kept and attractive, and can be viewed from the large lounge windows, the dining room windows, and many of the bedrooms. Solid wooden furniture is available in an outside seating area for people to sit and enjoy the views across the fields. Visitors are made welcome when they call, which may be at any time. They are welcome to stay and enjoy a meal with their relative if they wish. The home is clean, tidy, and homely, and presently has an ongoing process of decoration, with new carpets in some areas, some new bedroom furniture, and new bathroom flooring. The management carry out clear pre-admission assessments to make sure the home can meet the needs of the person before they say it is the right place for Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 6 them. These are done by a visit from the management to where the person is living, to discuss their needs with them and their family. The care plan produced from the assessment is very person centred, detailing individual wishes and needs. “It provides a warm caring atmosphere and makes my mother feel ‘at home’ and valued as a member of the home”, commented a relative. Visitors spoken to told us that staff always kept them informed of their relatives’ condition. “The staff are friendly and helpful and keep in touch concerning any problems which might arise. For example I am always informed if the doctor or nurse has visited,” stated a relative. Meals are varied, using fresh produce, and all residents said that they enjoyed them. We saw all of the residents eating their lunches, either in the dining room, where a few were helped by staff if they needed, or in their own rooms. The cook said that an alternative would be offered if a resident did not want what was on the menu. “You do get a choice you know”, confirmed a resident. Entertainers visit the home to provide music and singing shows. There is a clear complaints procedure in place, and any concerns or complaints are investigated thoroughly by the manager. Some residents told us that “I’d tell one of the staff”, if they were not happy about something, and others said that they would tell their family who would “sort it out”. Staff are recruited following a strict procedure, making sure all checks are carried out before they start work. This ensures they are suitable to work with vulnerable adults. What has improved since the last inspection? A website has been set up for the home, giving brief details about the service it provides, and how to contact the manager. The home is being continually improved by decoration, including refreshing the paintwork, wallpapering, or replacing old carpets and furniture. The gardens have been developed with more flowerbeds for the residents to enjoy. A bathroom has been refurbished since the last visit. Increased staffing levels have allowed residents to be offered a more frequent and greater choice of bathing times, and other attention needs. The monitoring of any accidents has improved, and may prompt a ‘falls risk assessment’ for those residents who have been noted as regularly falling. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 7 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. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 8 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 Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 9 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): Standards 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information the home gives to people about the services available, and the way it gathers information about people who want to live there, means that proper choices can be made about the suitability of the home. EVIDENCE: Information about the home is available in the form of a brochure, and a more detailed Statement of Purpose and Service User Guide. These are provided to all residents, and other interested parties. The owners have also set up a website for anyone to view, which gives a picture and brief details of the home. They are also considering creating a DVD, which would give people a virtual tour of the home, to further help them decide whether it is the right place to stay. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 10 Surveys returned from residents said that they had enough information about the home before they went to live there, and a resident we spoke to said “I came for a visit first with my daughter and decided I liked it here”. Individual records are kept for each of the residents, and there is a set procedure for admitting someone to the home, with a pre-admission assessment form being seen on three selected files. The assessments are carried out by management staff, who visit the possible resident at home, to discuss their needs. We saw that these held signatures of the resident or a family member, confirming agreement. The assessments are used by management to check that staff can give suitable care to each person, and to enable the manager to decide whether the home is the right place for them to live. Longer-term care plans are devised from this assessment. Staff spoken to said they are initially told by senior staff what each person’s needs are, and brief information is held with the daily diary sheets, which they can always look at. The senior staff said the carers are encouraged to view the completed assessments, and the care plans, so they have a good picture of that person. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 11 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): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The individual health and personal care needs of the residents are identified by managers, and generally met by staff, although they don’t always show that they have a full understanding of all the support needs of the residents. EVIDENCE: Individual care plans were available on the randomly selected files, identifying the areas of need for each person, and with clear instructions for staff for what they must do to meet that need. The guidance was detailed and person centred, giving instruction such as ‘need for encouragement, praise when task carried out’, instruction which identified the need for motivation in daily life tasks. A question asked during the care planning is ‘how does he/she feel about things?” to ensure it is person centred. The care plan lists each person’s problems, what the person’s aims are, and details information for carers on how to perform the task. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 12 Information was available on the protection of pressure areas, and the care plan addressed all relevant areas, including mobility, the senses, and nutrition. Good practices took place, such as formally recording whether residents wanted a key to their room, whether they preferred male or female staff, and whether they would like night checks. These were all signed by the resident to confirm. A form to go with the resident on any hospital admission was ready prepared, detailing contacts, medical and physical condition, allergies, mobility, and medication taken, saving time in case of emergency. Brief notes of residents care needs were available with the twice-daily records which staff completed. We saw that the daily records detailed the residents’ well-being that day, and any events taking place. We spoke to some staff, and the manager needs to ensure all staff read the complete care plan the management has completed and is updating, to ensure they have a full picture of the person, rather than depending on the brief notes. Residents can choose to go where they wish in the home, and may see visitors in the lounges or dining rooms, or in their own room. Some residents prefer to stay in their own room, where staff were seen to knock and wait for an answer before entering. Some staff need to be more flexible towards the individual need, which has been identified. Sometimes practices did not reflect the dignity or respect of people that had been identified in care plans. For example a meal was placed in front of a person with poor sight with no comment, and her questions remained ignored for a while; a dismissive answer was given in passing to a mildly confused resident who needed reassurance to settle her. Staff showed genuine concern and catered well for the physical needs of the residents, but need to be aware of the importance of addressing the well-being of residents, and recognise when their actions are causing more confusion than comfort. Several of the carers have attended training in dementia care, and should link this to their work. One resident commented, “All staff are very helpful towards me”. “They allow my father to retain a sense of freedom and purpose in his day to day life. They maintain very good rapport with him”, commented a relative. “The staff are friendly and helpful and keep in touch concerning any problems which might arise. For example I am always informed if the doctor or nurse has visited,” commented another in a survey. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 13 One very dependent resident receives regular district nurse support, and we saw a clear and detailed care plan, with support systems, including a turning chart and water record. Monthly reviews are carried out on the needs of each person, and we saw any changes were always noted, with the care plan being updated if needed. We noted that not all people involved in administering medication had completed the training, although one had some in-house guidance, and another was bank staff and supervised by the manager. One was an experienced long-term staff member. All should undertake the training before administering. The manager said she or her deputy checked the medication records and administration about every two days, but there was no evidence of this, and we advised her to formally record that this had been done. A separate Controlled Drugs cupboard is used, and the records were complete and up to date, although some out of date medication kept there was to be returned. Returns to the pharmacy were clearly recorded and signed for. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 14 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): Standards 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ daily lives and social activities are generally catered for, but some people would benefit from more individual stimulation more suited to their capacities and preferences. EVIDENCE: We saw that the individual care plans include information on each person’s life history, their religious needs, and which hobbies and activities they prefer. The home provides activities, such as manicure sessions, birthday parties for residents, and cheese and wine evenings. A children’s dance group have visited giving a performance for the residents. Entertainers call at the home, providing music and singing. Adverts for these events were seen in the entrance hall, and residents commented “It’s good to watch and have a sing sometimes. You don’t have to join in though”. One resident said they preferred to stay in the quiet. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 15 Some activities are carried out on an ad hoc basis, when people feel like doing something. The manager said they played skittles, bingo, board games, and played videos with memories from the years of residents’ youth, for example 1939. A reminiscence book is also in the lounge for people to look at. We discussed with the manager that these activities did not reflect the abilities of most of the people in the home. For example, one carer tried to play skittles with a resident, but the resident soon lost interest and preferred to have a wander around the home. The Bingo game had been put out, but never opened. The reminiscence book lay unopened. There was on occasion no staff in the lounge area to offer stimulation to individuals. The manager needs to address the individual interests they have recorded in the detailed assessment and care plan, and identify relevant stimulation for each person. This should also then be recorded for referral by staff. One resident who was sat in the lounge said they just wanted to do something, but was unable to express what, and so would have benefited from some staff direction to help occupy them. Staff need to be aware of the need to develop the quality of life for people in the home. Some residents put coats on and sat outside with staff and relatives, and did enjoy having a cup of tea and a chat. “I like to have some fresh air sometimes”, commented a resident. Visitors call regularly, and we saw a full visitors book, with people calling throughout the day. “You’re always made welcome”, said a relative. The rooms we viewed all contained the personal possessions of the resident, usually pictures, ornaments, or small pieces of furniture. “I like all my things in here. You can bring what you want as long as it fits in alright”, commented a resident. We saw lists of personal possessions in most files, and the manager needs to make sure there is always a list of the possessions each resident brings into the home. Any sundries required by individuals are either paid for by the home, receipted and invoiced, or families leave pocket money that is kept in the safe, and people pay as needed. We saw the records of these transactions, which were up to date and correct. We advised the manager that any moneys passed to the home by families should be receipted, and we suggested a copy of the record of sundry transactions to be sent regularly to families. A sample meal was taken of fish or ham with vegetables, followed by sponge or fruit crumble and custard. The meal was well cooked and tasty. “It’s always nice food here”, commented a resident. The dining room overlooked the large garden, and created a calm, relaxing atmosphere to eat a meal in. Staff quietly served individuals, tactfully helping where needed. A three weekly menu was followed, with changes if residents asked, or for such as birthdays. We noted the weekly delivery of fresh groceries. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 16 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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident their concerns will be listened to and acted upon. Staff have an EVIDENCE: There is a complaints procedure in place, with a complaints book to record any complaints, which may come to the manager’s attention. Two complaints had been recorded, both regarding care linked to domestic issues. They had been investigated and addressed by the manager to the complainants’ satisfaction. The Commission for Social Care Inspection (CSCI) had received one complaint regarding care practices and training, which has been passed to the manager of the home to investigate. She is in the process of dealing with this, and on completion will send a report to the CSCI of her findings. We advised the manager to record minor concerns. This record can be a useful tool in identifying any problems that need addressing before they may become major complaints, by having a clear overview of the issues. This also helps monitor the standard of service provided. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 17 Staff spoken to knew about the Adult Protection procedure, and what to do if they had any concerns. They said they would always act if they thought a resident was at risk. Also if it was a member of staff causing concern they would inform the manager. The manager said that she was aware of the need to ensure all the staff were refreshed in the procedures to ensure residents were protected. Abuse awareness training is provided. Residents said they would tell any of the staff if they were not happy. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 18 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): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a well-maintained environment, which provides aids and equipment to meet the care needs of the residents. It is a very pleasant, safe, and homely place to live. EVIDENCE: The large garden around the home overlooks the surrounding countryside, and is well maintained and attractive, with seating where residents can enjoy the good weather. Manicured lawns and large flowerbeds can be seen from most windows. “We often sit outside, with coats on if it’s chilly, and have a cup of tea and a chat”, said a resident. “It’s nice to get a bit of fresh air” Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 19 Some relatives’ surveys commented that they felt the gardens were underused. The manager agreed this was the case this summer, mainly due to the poor weather, but plans were in place for a summerhouse to be erected, which would provide more options for residents to be outside, without depending on good weather. General decoration is ongoing, with several bedrooms being decorated, the dining room repainted, and a new carpet fitted in the large lounge. The home is staffed with domestic staff who follow a daily cleaning routine, and the rooms viewed were clean and fresh. Residents’ rooms all had several personal items in them, from small pieces of furniture to pictures and ornaments. “I’ve got lots of my bits and pieces in my room, it makes it feel more like mine”, said a resident. A couple of families had provided their relative with small heaters for their rooms, and the manager confirmed she had carried out a risk assessment to ensure the residents safety if they used these. All of the home was warm and comfortable during our visit. Grab rails, assisted bath, raised toilet seats and a lift all go towards helping the mobility of people around the home. The front door has been fitted with a keypad lock for security. The manager confirmed this would not restrict residents from going out if they wished, and risk assessments were carried out to identify those residents who needed to be accompanied for safety reasons. The keypad allows monitoring of visitors to the home, as staff need to open the door. A handyman is employed to deal with the day-to-day work that staff note in a maintenance book, such as new light bulbs, or minor fixes to fixtures and fittings that have broken. He also makes sure the garden is always neat and tidy. The small laundry area is away from the kitchen and dining area, and was clean and tidy. The manager discussed the issue of some misplaced laundry being returned to the wrong residents, and how she was trying to deal with it, by constantly guiding and instructing staff in the system used. The home advises families to name all clothing to help prevent it being misplaced. Staff spoken to were aware of the correct way to work to prevent and control infection. The kitchen was refurbished last year, and is fully equipped to provide meals in a safe environment. The manager needs to continue to ensure health and safety and food hygiene procedures are followed when food is being prepared, as, due to the position of the kitchen, staff sometimes use it as a route through the home. Further improvements are planned, including new bathroom flooring, and some bedroom furniture. A planned conservatory will increase communal space. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 20 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): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is properly staffed, which means that the residents are supported by sufficient numbers of trained staff. EVIDENCE: Staff files showed that the necessary recruitment checks had been carried out to ensure the protection of residents. References and Criminal Records Bureau checks were available, and notes of the interview were made. The manager needs to ensure these notes are clear for all applicants. The application form has been developed, and now includes a request for more relevant information from applicants, to help identify the most suitable people. Some staff started work, under supervision, following a POVA 1st check, while waiting for their CRB disclosure to be returned. The manager should keep clear records of the dates all checks are returned. All new staff have induction training, and are given a staff handbook, which gives guidance and information on their terms and conditions, and working practices in the home. The staff group are a mix of long term experienced and younger enthusiastic male and female carers. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 21 Basic training has been attended by staff, including moving and handling, first aid, food hygiene, and fire safety. In-house training is also provided, such as infection control, health and safety, diabetes awareness, and dementia care. The manager said that a better system is being developed to more clearly show the training staff have attended. Seven of the 17 care staff hold NVQ qualifications, (41 ), which includes two who hold NVQ Level 4. Three more staff are due to start the course. Rotas were seen, which show there is usually a high staffing level in the home, which the manager said she felt is necessary for the dependant people they look after. The manager discussed plans to develop and train selected staff to have specific responsibilities and more senior roles. Domestic and kitchen staff are an important part of the overall care team, and are involved in helping to guide residents, and generally chatting as they go about their work. Staff comments were, “I find the management very supportive”, “It’s a nice place to work. We all get on well”, “You know where to look to find out what help people need, and I would always ask anyway if I wasn’t sure”, and “Training is available. I want to do my NVQ now”. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 22 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): Standards 31, 32, 33, 35, and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an experienced manager and senior staff who work to improve services and provide a better quality of life for residents. EVIDENCE: The owner and manager is a Registered General Nurse, and has worked in residential care for about 15 years, nine of those in supervisory and management positions. Visiting relatives confirmed that they are always able to speak to the manager and staff about the care provided, and felt it was a friendly place to be. A survey stated “The staff are always friendly and we are kept well informed of Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 23 anything we need to know and have always found them very approachable. A good service”, although another survey commented that communication with relatives could improve. A survey was provided by home for service users in July 2007, and the responses seen were all positive. The manager said she tries to use these for feedback every six months. Residents meetings are held about every month, as are staff meetings, with minutes taken. We discussed the benefits of also having meetings for relatives and friends of the residents, with the minutes distributed to all, not just the people who have been able to attend. This would give evidence that the home does listen and tries to take on board all comments and suggestions. We suggested another way of ensuring information was shared, was to promote formal appointments with relatives, in addition to the already regular informal feedback given, to discuss the progress of their relative, and any issues needing discussion. We discussed the possibility of getting formal feedback from other professionals such as GP’s, district nurses and social workers, to see if they considered there was anywhere the service could be developed. A newsletter was available in the entrance hall, although not all the relatives spoken to were aware of this. We suggested sending this to relatives to let them know of the events in the home, and they may even wish to contribute to it. Staff have one to one supervision every month with management, and clear records are kept of this. These are targeted to each staff member’s individual needs, and identify training needs and confirm correct working practices. The management confirmed that they regularly audited records, such as medication, pocket money, daily notes, accidents, and complaints, and we advised that they clearly identified when and who did this. The manager is not responsible for handling any residents’ finances, and they either manage them themselves, or family help in this area. Clear records are kept of any personal allowances. Maintenance of equipment is regularly carried out, and we saw evidence of regular servicing, ensuring the safety of both residents and staff. The management team are very open to suggestions on ways to improve systems. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 24 Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 25 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 3 3 X 3 X X 3 Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 26 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 OP9 Regulation 13(2) Requirement The manager must ensure all staff administering medication have received accredited training. All individuals must be given opportunities for stimulation, which is linked to their assessed need, to help develop their quality of life. Timescale for action 30/11/07 2 OP12 16(2) 30/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP10 OP28 OP32 Good Practice Recommendations All staff should have a full understanding of residents’ needs, and should be flexible in providing the right support to individuals, respecting their dignity. There should be 50 of care staff holding an NVQ qualification The manager should continue to develop communication systems between residents, staff and families, to show that the management is transparent, and aims, where possible, to use feedback to develop the service. DS0000063244.V346630.R01.S.doc Version 5.2 Page 27 Bowerswood Retirement Home 4 OP33 Actions taken when auditing records should be confirmed with a signature and date record, as part of the quality assurance procedures. The manager should look at developing quality assurance procedures to show that she is regularly measuring whether the home is meeting its aims and objectives. Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Bowerswood Retirement Home DS0000063244.V346630.R01.S.doc Version 5.2 Page 29 - 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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