Care Home: Bunkers Hill Care Home

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What the care home does well What has improved since the last inspection? Since the last inspection the manager and staff have improved the level of care and support provided to the people who live at the home. Care plans and risk assessments contain better information about people`s needs and preferences. They clearly tell staff what they need to do to make sure they receive the support they require in a safe way. Most residents have a detailed social care plan, which tells staff what they would like to do and how this will be facilitated. The management of complaints and the way in which safeguarding vulnerable adults concerns, as well as any other incidents that affect the wellbeing of the residents have been reported to the correct people promptly. More permanent staff has been recruited, which has helped to stabilise the staff team. This has led to a big reduction in the number of agency staff being used at the home, which people say has improved the consistency of the service provided. Staff have received essential training in subjects such as manual handling and safeguarding adults, as well as specialist topics, such as dementia and challenging behaviour. New staff told us that they had received a good induction to the home and an improved induction has been introduced for an agency staff. Residents and elatives said that they were happy with the way the home was managed they told us: `very good` and `in the past the home had gone downhill, but it has improved, it is so much better, the stress and strain has gone`, `brilliant staff`, `staffing levels are okay and there are lots of new staff` and `they do a good job`. A copy of the Service Users Guide has been put in every bedroom so that people have access to information about the home and how it operates. What the care home could do better: Care plans need to be amended regularly so that they reflect changes in peoples needs straight away, this will make sure that staff fully understand the level of support needed. Other areas that would benefit from some attention included the following. Recommendations made by the Environmental Health Officer should be addressed as soon as possible to ensure that the health and safety of residents is not affected. It was suggested that the handover sheet used to pass information to staff on the next shift contain more detailed information. The manager should also review the timescale for staff producing a full care plan when a new resident is admitted. CARE HOMES FOR OLDER PEOPLE Bunkers Hill Care Home Ross Close off Carlton Boulevard Lincoln LN2 4WQ Lead Inspector Dawn Podmore Unannounced Inspection 25th March 2008 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 Bunkers Hill Care Home DS0000061947.V358562.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. Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bunkers Hill Care Home Address Ross Close off Carlton Boulevard Lincoln LN2 4WQ 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) 01522 575139 01522 535100 bunkershill@unitedhealth.co.uk None United Health Plc Mrs Caron Lesley Davis Care Home 78 Category(ies) of Dementia (35), Dementia - over 65 years of age registration, with number (35), Old age, not falling within any other of places category (29), Physical disability (14), Physical disability over 65 years of age (9) Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide nursing and personal care for service users of both sexes whose primary needs fall within the following categories:Unit 1 (ground floor) - 15 beds DE over of 55 years of age (to include up to 15 beds DE(E)) Unit 2 (first floor) - 20 beds DE over 55 years of age (to include up to 20 beds DE(E)) Unit 3 (ground floor) - 19 beds DE over 55 years of age Unit 4 (first floor) - 24 beds OP to include 10 OP and 5 PD over 50 years of age. The remaining 9 beds to be registered for PD 18-65 years of age (and to include up to 9 PD/PD(E) 65 years of age and over. People admitted to these PD and PD(E) beds to be accommodated for not more than 12 weeks. The maximum number of service users to be accommodated is 78. Date of last inspection 24th October 2007 Brief Description of the Service: Bunkers Hill Care Home is a purpose built, two storey premises situated on the eastern side of the city of Lincoln. Car parking facilities are available at the front and rear of the building and it is within walking distances of public transport and local shops. The home is located in the centre of a new estate. It has a secure garden at the rear, which includes a patio area; this provides an attractive, safe area for residents to sit in. Accommodation is provided in 4 separate units in 78 single bedrooms, all of which have ensuite facilities. A lift gives access to the first floor. At the time of the inspection the manager confirmed that the weekly fees ranged from £394 - £440 depending on the residents assessed needs. This does not take into account any monies paid in relation to nursing care assessments, which would be deducted from the total cost. Additional charges are made for services such as chiropody, escorts to appointments and hairdressing. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report is available in the reception area. Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection was announced and took any previous information held by C.S.C.I. about the home into account. The main method of inspection used was called case tracking. This involved selecting a proportion of residents and tracking the care they receive through the checking of records, discussions with them and the staff who care for them and observation of care practices. A partial tour of the home was also conducted which included looking at some bedrooms, toilets and communal areas. Documentation was sampled and the care records of four residents were examined. The Commission are trying to improve the way that we engage with people who use services so that we gain a real understanding of their views and experiences of social care services. During this inspection we used a method of working where two ‘experts by experience’ visited the home as part of the inspection to help us get a picture of what it is like to live in this service. The term ‘Experts by Experience’ used in this report describes people whose knowledge about social care services comes directly from using them. The experts met and talked to residents, visitors and staff over a 4 hour period visiting all 4 units. They spoke with 12 residents and relatives, as well as some staff, and the things people said to them, and their observations, are included in the body of this report. Ten other people also shared their views with the inspector about the care they received and the facilities provided. Prior to the visit the providers had returned their Annual Quality Assurance Assessment (AQAA) and this will also be mentioned throughout this report. Ten ‘have your say about’ questionnaires had been returned from residents and relatives and comments from these will also be used throughout this report. On the day of the visit 71 people were living at the home. What the service does well: People are assessed before they move into the home to make sure that their needs can be met. Residents are cared for in a well-maintained, homely environment. Staff were observed interacting with residents in a respectful and responsive manner. Residents and visitors commented about the improvements made at the home. They said, ‘I feel that there has been an Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 6 improvement over the last six months and staff are much more aware of their rota and work requirements’, ‘I always find staff helpful’ and ‘the staff are very efficient and I am very impressed by their care’. People are offered a varied menu that takes into consideration their likes and dislikes. People told us, ‘meals are always well presented with a choice’, ‘I have never eaten so well, there is always plenty’ and ‘some meals are extra special – delicious’. There is an activities programme that offers stimulation and entertainment to suit individual preferences. Comments from residents and visitors included, ‘they play bingo and have reminiscence days, which I enjoy sometimes’, ‘I am not much of a ‘group’ person so do not usually take part (in activities)’ and ’they try to include/encourage residents to join in activities’. The home has detailed policies and procedures to inform residents and instruct and guide staff. What has improved since the last inspection? Since the last inspection the manager and staff have improved the level of care and support provided to the people who live at the home. Care plans and risk assessments contain better information about people’s needs and preferences. They clearly tell staff what they need to do to make sure they receive the support they require in a safe way. Most residents have a detailed social care plan, which tells staff what they would like to do and how this will be facilitated. The management of complaints and the way in which safeguarding vulnerable adults concerns, as well as any other incidents that affect the wellbeing of the residents have been reported to the correct people promptly. More permanent staff has been recruited, which has helped to stabilise the staff team. This has led to a big reduction in the number of agency staff being used at the home, which people say has improved the consistency of the service provided. Staff have received essential training in subjects such as manual handling and safeguarding adults, as well as specialist topics, such as dementia and challenging behaviour. New staff told us that they had received a good induction to the home and an improved induction has been introduced for an agency staff. Residents and elatives said that they were happy with the way the home was managed they told us: ‘very good’ and ‘in the past the home had gone downhill, but it has improved, it is so much better, the stress and strain has gone’, ‘brilliant staff’, ‘staffing levels are okay and there are lots of new staff’ and ‘they do a good job’. A copy of the Service Users Guide has been put in every bedroom so that people have access to information about the home and how it operates. Bunkers Hill Care Home DS0000061947.V358562.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. Bunkers Hill Care Home DS0000061947.V358562.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 Bunkers Hill Care Home DS0000061947.V358562.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 & 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People coming into the home have access to a range of information to help them make a decision about moving into the home. The home’s admission procedure includes an initial assessment, which helps to make sure that it can meet the needs of people admitted to the home. EVIDENCE: The home has a Statement of Purpose and a Service Users Guide, which contain information about the aims and objectives of the home, as well as how it intends to operate. Although one person told us that they had not received a copy of the Service Users Guide, copies were seen in plastic wallets in each bedroom visited on the day. A review of all information available prior to this visit, including the content of the A.Q.A.A and records seen at the inspection in October 2007, showed that the home does not admit residents without a care needs assessment being undertaken. Two relatives spoken with during this visit confirmed that their Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 10 relative had been visited prior to admission and that an assessment of their needs had taken place. This home does not provide intermediate care Bunkers Hill Care Home DS0000061947.V358562.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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s personal care and health needs are being met by staff who understand their needs and deliver care in a respectful manner. Care plans provide sufficient details to meet people’s needs, however not all of them contain information that fully reflects recent changes in people’s care. People are able to manage their medications themselves if they can, but if they need help staff are trained to support them with it in a safe way. EVIDENCE: We looked at the care records for 4 people living at the home, these contained information relating to his or her care needs. The plans were easier to follow and contained detailed information about the resident concerned. Two plans for recently admitted residents contained an in-depth assessment of their needs and information about their social preferences. As some individual plans had not been fully completed staff were working from detailed initial assessments. This information included social profiles that identified people’s likes and dislikes, as well as their preferences. It was suggested to the management team that the timescale for the completion of Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 12 a full care plan for new residents be reviewed so that staff have access to comprehensive information as soon as possible. Two other files provided staff with very good information about the person’s needs and how they should meet them. However one plan needed updating regarding the resident’s current eating habits and the deterioration in their general condition. Daily notes and staff comments demonstrated that they were receiving the correct level of care and support, but the plan needed updating so that it reflected the changes in their condition. Wound care was covered in detail and included body maps, photographs and wound mapping records. Various assessments were contained in all the plans examined. These included subjects such as, manual handling, pressure risk, nutrition, falls, bedsides and other areas of potential risk. Regular monthly reviews of care plans had taken place and daily records were completed in good detail. Records and peoples comments showed that health needs were being met with appropriate recording of GP, district, optician and chiropody visits. One relative told the expert by experience ‘staff always keep me informed in relation to my mothers needs and health issues’. The home uses a handover sheet to aid communication from one shift to the next. Although general comments were recorded staff were not always recording important issues on the sheet, these were however recorded in daily progress notes and handed over verbally. It was suggested that this be reviewed so that the handover sheet works more effectively in passing on all essential information about key events in the day of each resident. The A.Q.A.A. and the content of the last inspection report demonstrated that the home has satisfactory policies and procedures concerning the receipt, storage, administration and disposal of medications. On this occasion medication records were checked for the people being case tracked, these were all satisfactory. Residents and relatives who spoke with the experts by experience said that they were happy with the level of care they received. They told them ‘they do a good job’ and ‘the staff are very good they always talk to my wife’. This was confirmed by the comments received in the surveys returned to us. People said, ‘I feel that I am very well looked after’, ‘everyone’s friendly, night and day’ and ‘sometimes wait for buzzer (to be answered) as sometimes they are busy, but they will always come and tell me’. Observations and staff comments demonstrated that staff had a good knowledge of the people they cared for. They were seen delivering care responsive to resident’s needs and preferences, as well as respecting their privacy and dignity. Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 13 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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home enables residents to maintain and develop social interests and relationships of their choice. Residents receive a nutritious, varied diet, which meets their individual preferences and health requirements. EVIDENCE: There are two activities coordinators employed at the home who share their time between all four units. The experts by experience spoke to both of them and observed the activities provided on the day of the visit. There is a structured programme of activities available for those who wish to participate. This includes: crafts, games, bingo, reminiscence therapy, and one to one sessions. People said that they had been on outings such as shopping, and photographs were displayed on the wall showing a trip to the coast and the Christmas activities. Residents said that they had made Easter cards and painted eggs and resident’s artwork was displayed on the units. Posters were on display that announced forthcoming events, such as musical entertainment, reminiscence groups, and religious services. Religious services are held monthly and peoples participation recorded. A monthly newsletter was also available in the reception area. Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 14 Resident’s files contained a social care profile, which provided staff with a good insight into what sort of things residents were interested in. The two new residents did not have a social care plan, but the social profile and initial assessment gave adequate detail about their preferences. Files also contained good records of what activities they had participated in and when they had preferred not to take part. People spoken with or those who completed surveys said that they were happy with the level of social stimulation supplied. A relative also commented that she had been asked to complete a booklet about her mother’s friends, interests and family details. Visitors told the experts by experience that staff made them welcome at the home and that they could visit at any time. Both experts by experience ate lunch with the residents on two of the units. They reported that the food was very good and people’s preferences and choices had been respected. One reported to the manager that napkins had not been provided, even though they were available; this led to two people soiling their clothes. She also noted that cruets were not available on all tables. Both said that the meals looked attractive and plentiful with a choice of 3 courses. They also said that staff unobtrusively helped people who required it and were responsive to their requirements. People who were spoken with or returned surveys told us that they were very satisfied with the food. One relative said that he frequently ate lunch with his wife and that it was always enjoyable. Other people said, ‘food is liquidised if required and is good’, ‘the food varies, but is never bad’. ‘the staff try to satisfy residents needs, the meals are good’, ‘they have improved of late’, ‘the meals vary, my personal opinion is only fair generally, and on the odd occasion better’, ‘I have never eaten so well, there is always plenty’ and ‘some meals are extra special – delicious’. Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 15 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are clear policies and procedures in place for handling complaints and allegations of abuse; this helps to safeguard the people living at the home. Staff have received training in these subjects to help them protect the people they support. EVIDENCE: The home has a complaint procedure, which is displayed in the home and included in the Service Users Guide. Details contained in the AQAA and records held at the home showed that they had received 10 complaints/safeguarding adults highlighted since the last inspection. Eight had been appropriately investigated and any issues addressed, and 2 were still being investigated. People spoken with confirmed that they knew how to make a complaint, but said that they had none. They were complementary about the staff, manager and care provided, the content of the surveys confirmed this. One person said, ‘I have never had to complain, the staff are a credit to the home’. The home has procedures concerning the protection of vulnerable adults. The manager has reported any safeguarding concerns promptly and correctly. Staff demonstrated a satisfactory knowledge of what to do if they suspected abuse could be occurring and the majority had received training, with further sessions booked. Bunkers Hill Care Home DS0000061947.V358562.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): Standards 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home live in a well maintained, clean, comfortable and homely environment, which offers a good standard of décor and furnishings. EVIDENCE: We took a partial tour of the home which included looking at the bedrooms of the residents being case tracked. Bedrooms had been personalised by the residents or their families with photographs, mementoes and small items of furniture. A relative told us ‘the care home is very accommodating in trying to make the rooms look ‘homely’ and helpful when you want to bring in your own furniture’ Both experts by experience said that they felt that the home was bright, clean, tidy and homely, with no unpleasant odours. One of them said that the corridors and rooms were spacious and would allow wheelchairs to be manoeuvred around easily. An extract from the report of the other expert Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 17 stated, ‘Bunkers Hill is a large, modern, well-appointed care home with light, attractive fittings and furnishings, clean, spacious bedrooms and an air of welcome, all parts of the home were pleasantly, though not overpoweringly, fragranced – there were no bad odours at all. Fish tanks have recently been purchased for the lounges and one resident said that she found it very relaxing watching the fish. Photos of staff were displayed in the reception area and a ‘who’s on this unit’ folder was available at the entrance to each unit to help people recognise the staff. People told us, ‘I feel like I am in my own home’, ‘they are always vacuuming’, and ‘immaculately clean bedrooms’. One relative had highlighted to the manager that other residents could wander into people’s bedrooms, but he said that she had arranged for latches to be fitted to offer easy access, but better security. Gardens and the car park were well maintained with a fenced garden and seating. New facilities included raised flowerbeds, planted with spring flowers, and a residents green house, which was being erected. The home has a no smoking policy which people are told about before they come to live at the home. Any residents that wish to smoke can do so outside. Separate domestic and laundry staff are employed by the home to maintain the cleanliness. Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 18 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels and skills are adequate to meet the needs of the people living at the home. Procedures for the recruitment of staff are robust and therefore offer protection for people living at the home. Staff have access to training and support to help them meet the needs of the people they care for. EVIDENCE: Staff rotas and allocation lists showed that adequate staffing levels were being maintained. They also provided detailed information about which staff were on duty on each unit each shift. Residents and relatives said that staffing levels had improved and were satisfactory to meet people’s needs. Staff spoken with and those who returned surveys confirmed this. The use of agency staff has reduced greatly since the last inspection and none were on duty at the time of the visit. At our last inspection recruitment was being carried out correctly with essential checks such as references and C.R.B. (Criminal Records Bureau) checks being undertaken. The AQAA says that this process is still in place and staff comments confirmed this. One said, ‘I wasn’t able to work till the company had received both of my references and my CRB’ New staff said that they had received a good induction to the home, which included essential training. One person said, ‘under the new manager training and the induction package has improved 100 ’. Records indicated that agency Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 19 staff had been given essential information on their first visit. The manager said that they now started work an hour early on their first shift so that they could receive an appropriate induction. Training and supervision records supplied as part of the AQAA demonstrated that the majority of staff had received essential and specialist training to meet people’s needs. Training undertaken included manual handling, safeguarding adults from abuse, challenging behaviour, diabetes and dementia awareness. The AQQA showed that 16 care staff had completed an N.V.Q. (National Vocational Qualification) in care and 14 other were currently doing the course. Staff confirmed that they had attended various training, with more sessions planned, and said that they were happy working at the home. They told us, ‘communication has improved and staff get on well together’, ‘it’s better since the new manager started, a lot better, we have had more training, for example dementia, rather than just the basics’, ‘very good access to training’, ‘I have been on all the relevant training that helps me with my job’, ‘staffing levels have improved lately and more staff with experience have been employed’ and ‘it’s the only place I have wanted to go to work each day’. One person told us that they had been thinking of moving but changed their mind, they said ‘the atmosphere is better now’. People told us that they were happy with how care was delivered at the home. They said, ‘brilliant staff’, ‘staffing levels are okay and there are lots of new staff’, ‘they do a good job’, ‘the staff are very efficient and I am very impressed by their care’, ‘staff are generally very friendly and caring in their attitude towards residents and their families’, ‘now residents feel secure and relaxed because they see staff around’ and ‘the staff are fine, friendly and offer you a cup of tea’. One relative said that they felt that there was not enough staff on duty, but this was the only negative comment received. Observation of care practices at the home demonstrated that staff were caring for people in the correct way and they were seen responding quickly to buzzers. One of the experts by experience reported that staff were visible in communal areas and that they responded well to peoples needs. Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 20 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, 33, 35, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is good management, guidance and direction provided to staff to ensure that care is delivered in a consistent manner. The home is managed in the best interests of the residents. There are systems in place to ensure that the health safety and welfare needs of residents are met. EVIDENCE: Since August 2007 Mrs Hazel Whittaker has been the manager at the home. Mrs Whitaker is a qualified nurse with 14 years experience managing a care home. She has also completed the Registered Managers Award level 4 in management. During the inspection period Mrs Whitakers application to become the Registered Manager of the home was being processed. At the time of the last inspection visit a number of complaints and safeguarding adult’s incidents had been received, some of which were not Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 21 reported to Social Services and the Commission. Since that visit the number of complaints received by us has reduced greatly. The manager has moved her office because she said that it made her more available to people who may wish to speak to her. She has kept us informed about any issues concerning the residents and the home in general, for example when the fireboard needed repairing, and has taken appropriate actions to address them. Residents and relatives said that they were happy with the way the home was managed they told us: ‘very good’ and ‘in the past the home had gone downhill but it has improved, it is so much better, the stress and strain has gone’ Staff praised the manager and the way that she managed the home. Comments made included: ‘Hazel is very supportive’, ‘Hazel has made a big difference especially regarding the standard of care delivered’, ‘best home I have every worked in’, ‘good supportive management has made a difference’ and ‘Hazel is supportive and approachable’. The home has a quality assurance system so that they can gain the views of people who use the service and ensure that the systems in place are being followed. Surveys had been sent to residents, relatives and staff in February, but the outcomes were still being summarised. Those sampled showed contained mainly positive responses. At the last inspection there was a satisfactory system in place for resident’s monies to be held in safe keeping by the home. This includes keeping a running total of all transactions and obtaining receipts and two signatures. There are a range of health and safety policies and procedures available to guide and instruct staff. There is a programme in place to service and maintain equipment in the home on a regular basis. Information provided in the AQAA, demonstrated that regular checks on equipment such as hoists had taken place. Two gaps in the information provided were discussed with the manager and arrangements were in place by the end of the visit to address them. The Environmental Health Officer had inspected the home on 12/3/08 awarding a 3 star rating. He identified several areas that needed attention including, inadequate cold storage space, kitchen and storeroom walls needing repair and some chopping boards in the servery’s needing replacing. The manager said that she was already addressing the issues raised. Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 22 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 2 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 2 X 3 X 3 X 3 2 Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15(2) Requirement Care plans need to be updated regularly so that resident’s current assessed needs can be met and are known. Timescale for action 01/06/08 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 OP38 Good Practice Recommendations Recommendations made in the Environmental Health Officers report should be addressed to ensure the health and safety of residents is not affected. Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG 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 Bunkers Hill Care Home DS0000061947.V358562.R01.S.doc Version 5.2 Page 25 - 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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