Care Home: The Bungalow Retirement Home

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What the care home does well The Bungalow is a very homely and friendly place, where residents are treated with respect and regard for their dignity. Residents are cared for by well-managed, competent and caring staff, who work well together as a team. All residents spoken with said how much they liked the staff; one said `they are the best you could wish for` and a visitor said `there is a heartfelt warmth encompassing all`. What has improved since the last inspection? Care plans have been revised and the office has been re-arranged, with all policies and procedures now readily accessible. More training has been arranged and there are more staff on duty. The quality assurance system has improved. What the care home could do better: Care plans should be signed by residents or their families to demonstrate their involvement. The service user guide should be written in plain English and residents should be able to read and understand it it easily. Crockery should not be chipped or cracked and meals should be served on warm plates. CARE HOMES FOR OLDER PEOPLE The Bungalow Retirement Home 156 Park Road Spalding Lincs PE11 1QZ Lead Inspector Julie Western Unannounced Inspection 17th June 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 The Bungalow Retirement Home DS0000067042.V366657.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. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Bungalow Retirement Home Address 156 Park Road Spalding Lincs PE11 1QZ 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) 01775 724995 Apex Care Limited Manager post vacant Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home providing Personal Care - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following category: 2. Old Age, not falling within any other category - Code OP. The maximum number of people that can be accommodated at The Bungalow Retirement Home is: 28. 28th June 2006 Date of last inspection Brief Description of the Service: The Bungalow is a single storey building, approximately one mile from the centre of Spalding. The home was originally a small bungalow and has been extended over time. The home provides personal care for up to 28 people over the age of 65; at the time of the inspection 24 people were living there. All bedrooms are single and ten have en-suite facilities. The home has two lounges, two dining rooms and a conservatory linking the two sides of the building. There is a paved courtyard, accessible to residents, with seating areas and a water feature in front of the building. Further seating areas are available within the surrounding grounds and there is car parking to the front of the premises. The Bungalow Retirement Home DS0000067042.V366657.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 carried out over three hours and took into account any previous information held by CSCI including the home’s previous inspection reports, its service history, any pre-inspection questionnaires completed by the Manager including the Annual quality assurance assessment [AQAA] and any residents’ questionnaires sent to the home by the Commission prior to the inspection. The site inspection was unannounced and consisted of tracking a sample of residents’ care records and assessing the care given. Some policies and procedures were examined and some records concerning the safety of the home were also seen. Three residents, three care and ancillary staff and two visitors were spoken with. The Manager was present throughout the inspection. At the time of the inspection the home confirmed that the weekly fees were £397. Additional charges are made for services such as chiropody 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 manager’s office. What the service does well: What has improved since the last inspection? Care plans have been revised and the office has been re-arranged, with all policies and procedures now readily accessible. More training has been arranged and there are more staff on duty. The quality assurance system has improved. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 6 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. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information provided is freely available to residents and clearly sets out what is available for them. A comprehensive initial assessment ensures that the needs of residents can be met. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. EVIDENCE: The acting manager confirmed that she or a senior carer always visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records confirmed this. Written admission documentation was comprehensive and clear, giving staff the information they needed to meet the residents’ needs. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 9 The statement of purpose contained all of the information required in Schedule 1 of the National Minimum Standards. The service user guide contained all relevant information but was not in a format particularly suitable for the service users to read easily. A resident described how she had visited for the day before she was sure she wanted to move in permanently. A survey from returned by a relative read ‘It is a pleasure to visit my relative in the home. The staff are always welcoming and helpful’. A staff member described the admission process and the importance of making new residents and their families welcomed. The home does not provide intermediate care. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are in sufficient depth and detail to ensure that residents’ care needs can be met. EVIDENCE: The care plans looked at in depth, contained information about the residents’ health and personal care needs. They were reviewed regularly and contained clear risk assessments. Some care plans were not signed by the service user or by their relatives/advocates, to confirm that they had taken part in them. Social histories ensured that there was plenty of information to meet residents’ social needs. A visitor to the home said ‘it’s very friendly and the residents are well looked after’. There was a clear medication policy and the pharmacist visited regularly. Residents received regular visits from district nurses and other agencies involved with their care. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 11 The staff team were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Social activities are regular and are tailored to suit individual residents’ needs. Residents have a choice of meals from a balanced and varied menu; not enough attention is paid to ensuring that residents receive a good service from the kitchen. EVIDENCE: There is a programme of regular activities, including entertainers, armchair exercises, flower arranging, coffee mornings, church services, barbeques, and various board and card games. The acting manager said that residents were also accompanied on trips to the local shops and cafes. Details of forthcoming events were displayed in the entrance area. Residents spoken with all said they had a choice of whether or not to take part. One resident spoken with said she would rather stay in the home and relax. Residents were observed eating breakfast and the mid-day meal. All residents said they enjoyed the meals served; one said ‘It’s good and there’s always a choice’. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 13 One resident was served food on a chipped plate and another had a cold plate. These issues were rectified at the time and the manager said that the crockery would be sorted, damaged crockery would be thrown out and new crockery would be bought that afternoon. The menu was balanced and nutritious and offered alternative choices of meals. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s procedures for addressing complaints and for protection from abuse are clear. Residents and their families are confident that their comments and concerns will be listened to. EVIDENCE: The home has clear policies and procedures to ensure that any form of abuse is recognised and dealt with appropriately. Residents spoken with said they did not wish to complain but knew how to make a complaint. The home had a copy of the Local Authority adult protection procedures. The acting manager said that residents and their families were regularly asked for their views regarding the running of the home. Since the last inspection there had been three complaints regarding staff members; investigations were held by the social services safeguarding adults team and following these, 2 staff members had been dismissed. Staff spoken with confirmed that they had received training in safeguarding adults and knew the procedures for making complaints and the Whistleblowing Act. Recent staff training had included information about the Protection Of Vulnerable Adults list and training was booked for harassment and safeguarding adults. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a safe, comfortable and pleasant environment that is suitable for their needs. EVIDENCE: Overall, the standard of decoration internally was high and afforded residents a good degree of comfort. Outside, the patio areas were well maintained and offered pleasant places for residents to sit out in good weather. Staff members described how any repairs needing attention were carried out by the maintenance worker. He confirmed that he had a book listing outstanding repairs. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 16 A visitor confirmed that his relative had requested her room to be painted in a colour she liked and this was carried out. One resident said ‘It’s a lovely, sunny-feeling home’. Recent improvements included new curtains in the main lounge, new furniture and carpets and a newly decorated laundry room. There were safety notices around the building to prevent the spread of infection and COSHH regulations were observed throughout. The building was clean and fresh-smelling throughout. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent. EVIDENCE: The daily staff rota showed that in addition to the acting manager, there were 3 staff for 24 residents. The home also employed a cook and domestic staff. There were currently staff vacancies at present and agency staff were being used meanwhile to give appropriate staff cover. The acting manager said that six staff members had the National Vocational Qualification [a nationally recognised qualification] at Level 2. A staff member described how she had an interview, gave three references and underwent an induction and CRB/POVA checks. Staff records confirmed this. Staff training records demonstrated that statutory training has been undertaken and that staff received regular supervision. Training records showed that all staff members had received the mandatory training, the most recent training being health and safety and the next being fire safety. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the health, safety and welfare of the residents are promoted. The views of the residents are listened to and they are involved in decisions affecting them. EVIDENCE: There is currently an acting manager in post. Following a successful interview a new manager has recently been appointed and is due to commence duties on 20th June 2008. Staff members spoken with said the acting manager has been very approachable and accessible. The owners’ representative visits usually on a weekly basis to support the acting manager, who said that all monies are managed by him and no monies are kept for residents by the home, relatives being asked to do this. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 19 Health and safety policies are well documented and demonstrate a clear commitment to ensuring the wellbeing of residents. A recent risk assessment of the building was carried out with the fire officer present. There is a quality assurance system in place; this consists of sending questionnaires to residents and their families/advocates. On return, these are discussed with the manager and owners and any issues from the returned forms are addressed. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 21 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 OP15 Regulation 16[2][1] 13[4] Requirement The registered person must ensure that meals are prepared and served in a way that is not hazardous to their safety and is attractive and appealing. Timescale for action 20/06/08 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. 2. Refer to Standard OP1 OP7 Good Practice Recommendations The service users’ guide should be in plain English and in a format that is easy for older people to read and understand. Care plans should be signed, where possible by service users or their families, to demonstrate that they have been involved in them. The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 The Bungalow Retirement Home DS0000067042.V366657.R01.S.doc Version 5.2 Page 23 - 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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