Inspection on 17/12/08 for Beach Lawns Care Home

This inspection was carried out on 17th December 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Beach Lawns Care Home 67 Beach Road Weston Super Mare North Somerset BS23 4BG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Andrew Pollard     Date: 1 7 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Beach Lawns Care Home 67 Beach Road Weston Super Mare North Somerset BS23 4BG 01934629578 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Demelza James Type of registration: Number of places registered: Sanctuary Care Ltd care home 86 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: A maximum of twenty two of these persons may receive nursing care. These persons must be accommodated in the `Sandford Unit`. The maximum number of service users who may be accommodated is 86. The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Beach Lawns is an 86 bed home offering care and support for people who requirew personal and or nursing care. 0 Over 65 86 Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The purpose of the visit was to establish if the home is meeting the National Minimum Standards and the requirements of the Care Standards Act 2000 and to review the quality of the care provision for the individuals living in the home. Time was spent with the manager and regional manager and other members of staff. Comments received from residents during the inspection were shared with the registered manager but maintaining individuals confidentiality and these have been incorporated within this inspection report. A tour of the premises was made. Various records were sampled these included care plans and maintenance records. Inspection feedback was given and the visit was concluded. The quality rating for this service is 2 stars. This means the people who use this service Care Homes for Older People Page 5 of 26 experience good quality outcomes. We came to this quality rating at the last key inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents and their families are given relevant information in written or verbal form about the home. Contracts and terms and conditions of services are provided to all. The assessment procedure is clear and a thorough assessment of prospective residents needs is carried out. Evidence: The service user guide, statement of purpose and welcome pack are made available to prospective residents or families, this provides useful information about the services available and includes the terms and conditions of residence. The statement of purpose has some minor updates including the change in the use of beds and the organisations management structure. The manager wishes to include reference to new legislation relating to Deprivation of Liberty and Mental Capacity legislation in future. Visits to the home prior to admission are encouraged either for the day or perhaps for lunch dependent on peoples wishes. Care Homes for Older People Page 9 of 26 Evidence: The manager demonstrated a clear understanding of the admission procedure for individuals referred the home. Ms James told the inspector about the admission process for recently admitted residents. The pre-admission assessments seen were comprehensive and detailed. For residents who are funded by the local authority the home had in place a social services care management assessments in order to make a decision on whether the home and the skills of the staff team are able to meet the individuals needs. A review takes place soon after placement at the home, at this meeting the residents and their representatives are present and make their views known about how the placement is going. Staff spoken with said that all of those living at the home are treated as individuals, all with different needs and likes. A number of residents and relatives spoke positively about the staff and their cheerful attitude when helping them. Care Homes for Older People Page 10 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans detail residents care needs and are clearly written and give clear directions to staff.The staff provide appropriate personal care to maintain residents health, well being and dignity.Proper arrangements are in place for residents to access primary health care services.The staff properly store, administer and record medication on behalf of residents. Evidence: Several individuals care records were reviewed at this inspection it was evident that the plans in place had been generated from the needs assessment. Information contained within care records included, an individual person profile containing information about the reason for admission, health care, support services involved, next of kin, family contact details and medical history. Risk assessments were in place with detailed information to ensure safe procedures, for example, manual handling, the correct use of bed rails and how to reduce the risk of falls. Each resident also had records of health professionals visits, daily records of individuals routines and care plan evaluations. information about meting residents health care and personal care needs Care Homes for Older People Page 11 of 26 Evidence: was clearly written and gave detailed directions to staff. A more person centred approach is recommended in the care plan and management of care, which the manager supports and is taking forward. It is intended that each resident has a brief biography written and a person centred assessments where their wishes, likes and dislikes are put at the centre of the care provided. It is intended that peoples social needs and including, psychological, emotional, and cultural needs will be more fully detailed to demonstrates that the home takes a holistic approach to the provision of care. Staff training related to person centredness is taking place. Care review meetings led by the named nurse, where possible with the involvement of the resident, family members and key worker. Social Services also carry out review visits for the residents they fund. The reviews allow opportunity to discuss and evaluate residents care plans and any issues or concerns people may have. End of life care plans are becoming established whereby residents are encouraged to think ahead about the care they would like to receive if their health deteriorates. Each resident is registered with a General Practitioner (GP) on admission to the home and an initial first visit then set up. The GP conducts a weekly visits to the home or on request and conducts medication reviews. A residents said that, They always get the doctor to me if I am not well. A GP comment card indicated satisfaction with the home and all the outcomes were positive. Policies and procedures for receiving, storing, administering and disposing of medications are in place and meet with current legislation. The receipt, administration, disposal and controlled drug records were up to date and in order. The management of unwanted medication for disposal was discussed and it was suggested that a more secure storage bin is requested from the waste disposal company that takes away drugs for destruction. Staff are properly trained in administration of medicines. The supplying Pharmacist carries out regular advisory visits related to the medication arrangements. There are procedures in place to allow residents to self medicate if they are able to or wish to. The home has a pharmaceutical storage fridge the temperature of this is checked regularly. Throughout the inspection all of the staff on duty were observed helping residents with their needs in a polite way. Staff knocked on residents bedroom doors and spoke to residents respectfully. Comments from residents were very complimentary of the staff and the care they provided. All the residents spoken with said, They were satisfied with the care being provided. They spoke highly of the staff saying they were, Friendly courteous and caring. Care Homes for Older People Page 12 of 26 Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A limited range of social and recreational activities is arranged that needs to be developed to enhance the quality of life for the residents. Resident’s families are involved and informed of issues related to their relatives and are able to maintain close contact with families and friends. The food is of a high standard and provides a balanced diet for residents. Evidence: The home has an open policy related to residents friends or family visiting the Home. The staff are developing more detailed residents biographies and social profiles, which could provide interesting facts and life history information about residents and will be beneficial in enhancing person centred care. The manager accepts that the social and leisure arrangements need improving and the home is advertising to recruit a full time activity organiser for the new year. Entertainment is provided periodically and a limited programme of activities was seen on the notice board. staff are making an effort to provide social events for residents and one person has been delegated the role until an appointment is made. Special Care Homes for Older People Page 14 of 26 Evidence: events are arranged throughout the year and residents and relatives invited to attend. A regular news letter is produced to keep people up to date with event in the home. The local parish priest conducts services and communion on a regular basis and makes pastoral visits on request. At present there are no residents from other faith or cultural backgrounds in the home. there are good relationships in place with relatives and families and they are encouraged to contribute views and ideas about the home. The rotational menu offers traditional good food and choice is available at each meal. The menus are reviewed in response to residents views expressed in meetings and surveys. Residents make their meal choices each morning. Fresh fruit and vegetables are available and bowls of fruit are on offer in the home. Lunch was served in the dining areas, the tables were attractively laid and the meals nicely served. Residents can eat in their rooms if they choose to. Conversations confirmed that residents were happy with the meals provided and indicated they always liked the meals. Comments included, The food is really good and The meals are well cooked. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are robust and comprehensive policies in place to protect residents investigate complaints or manage allegations of abuse. There are good arrangements in place for staff training and awareness of Protection Of Vulnerable Adults matters. Evidence: A copy of the complaints procedure is on display and is part of the information provided to people on admission. Conversations with residents and relatives indicated people knew how to complain. The complaints policy and procedure contains all the required information. There have been no formal complaints received since registration. A large number of thankyou letters were seen from residents relatives. All residents who completed a survey indicated that they knew who to talk if they were not happy and how to make a complaint. Comments included, Ive never had cause to complain. Residents also said they would speak to their key workers or the manager to discuss any concerns they may have. The home has written procedures for adult protection and whistle blowing. The Local Authority No Secrets document was available. The manager actively promotes staff training and education in adult protection issues on induction and by regular updates. at present the manager is trying to organise Local Authority adult Protection training for all staff. Care Homes for Older People Page 16 of 26 Evidence: A number of staff are undertaking the National Vocational Qualification in care award, and a component of the award addresses issues around the topic of safeguarding adults from abuse. A recent issue has arisen which has been properly managed and is being over seen by Social Services. The General Social Care Council code of practice is to be distributed to the care staff. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of furnishing and decor is good to the benefit of residents. The home provides a safe and well maintained environment for the residents. The bedrooms and communal rooms and facilities are suitable and well presented for their purpose and meet the residents needs. The standard of cleanliness is good. Evidence: Beach Lawns is a large detached building comprising of three connected buildings. The home has wide views of the seafront and Bristol Channel The home is a three-storey building, and residents there are lifts servicing the upper floors. It is decorated and furnished to a good standard. Ongoing redecoration and upgrading are taking place raising the standard of the accommodation in all areas including better facilities for staff. residents rooms were personalised and many had personal item and some of their own furniture with them. There are adaptations in place throughout the Home and specialist equipment including mobility aids, pressure relieving equipment and corridor and bathroom handrails. Bathrooms include adapted baths to assist residents who may have reduced mobility. Toilets are situated in readily accessible parts of the Home near to communal areas and bedrooms. The bathrooms and toilets were clean, and were well stocked with hand towels and soap to help minimise risk from cross infection in the Home. Care Homes for Older People Page 18 of 26 Evidence: infection control policies are in place. the laundry and sluicing facilities are satisfactory. All bedrooms have en-suite facilities. There are several dining areas and conservatories and comfortable lounge areas. The Home looked clean and tidy in all areas. Residents were observed sitting in the lounges, the conservatory and going into their rooms, they looked relaxed and comfortable in their environment. Residents comments confirmed that the home is and clean and one resident stated, They are always cleaning and another, The decoration is nice and I like my room and have lovely views. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment procedures and records are in good order. The home is staffed with appropriately trained and experienced staff for the number of residents. Good progress is being made training care staff for the benefit of residents. Evidence: Each resident has a named nurse and key worker to support them and maintain their care plans. Senior care staff manage day to day arrangements on Allendale and a new NVQ level 4 care has been appointed to take on the role. It was clear from discussions that staff have developed relationships with individuals and support them appropriately. Many favourable comments were received about staff at the home from both residents and visitors to the home, comments included Staff are very kind and All of the staff are caring and cheerful. There were sufficient numbers of staff on duty to meet the needs of the residents. The staff team is stable and it was stated by staff that morale is good. There have been a number of staff recruited recruited since since registration but there remains a high level of vacancies, there is consequentially a continued use of agency staff. The recruitment procedure based on equal opportunities, was robust and proper procedures followed and records kept. Care Homes for Older People Page 20 of 26 Evidence: The manager of the home is fully supernumerary and shares the on-call arrangements with the deputy manager. The deputy manager assists with administrative duties and has a number of supernumerary hours each week to deal with administration and management duties. An administrator and receptionist are employed to assist with the smooth running of the home. The induction programme is comprehensive and based on the Skills for Care standards. Each new member of staff is linked to a mentor whilst they complete their probationary period. After completion of the common foundation training care staff enrol on National Vocational Qualification (NVQ) programmes level 2 and 3. Over 50 of staff currently have attained at least an NVQ level 2. A training matrix has been developed to show that all mandatory training including fire safety, food hygiene, first aid, load handling, medication and adult protection were undertaken and course dates booked to maintain the skills. All staff will have an annual appraisal, which identifies learning needs, and the manager provides regular one to one supervision. In due course the supervision responsibilities will be delegated to lead nurses when the have completed appropriate preparation for the task. The registered nurse training records are to be brought up to date and maintained following appraisals. Residents agreed that staff were always available when they needed them and listened and acted upon what the residents had to say. Staff that were observed to be supporting and caring for the residents, they were patient and encouraged residents to make choices. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run taking into account the views and wishes of residents. There are good arrangements in place to maintain and service the equipment and facilities in the home. The Home protects the health and safety of residents and staff. Staff supervision and appraisal arrangements are good. Evidence: Ms James was able to demonstrate a good understanding of the requirements of the registered manager post and has high visibility in the home giving strong leadership and direction. A new deputy manager is now in post. There is continuing support and guidance from the regional manager who also carries out the Regulation 26 inspections each month. weekly perfomance reviewsa re also carried out by the manager. The home has a Health and Safety(H&S) policy, audits and relevant training takes place. Generic and individual risk assessments are in place and kept under review. Care Homes for Older People Page 22 of 26 Evidence: Manual handling risk assessments are completed and reviewed for all residents. two staff have been delegated special responsibility for H&S matters and are awaiting specific training for the role. Relevant inspections and maintenance has been carried out at the required intervals for the fire alarms and equipment, gas and electrical installation, hoists and lift. The kitchens have been inspected by the Environmental Health officer who is due to reinspect in the coming months, there are no works outstanding. There are ongoing works to resolve hot water supply difficulties and the installation of safety valves on hot water outlets. There are satisfactory arrangements in place to manage the risk of legionella in the home. The fire logbook records showed fire alarm tests, fire training and drills are carried out on a regular basis to protect the health and safety of residents and staff. Alarm activated fire door closers have been installed on bedroom doors. A fire Marshall is on duty each day. The home has comprehensive policies and procedures for the management of the home in place to support older people, including confidentiality, policy and equal opportunities. All policies are kept under review and are available in condensed form to staff in a handbook. The manager has develops a development and business plan for the home. A quality assurance audit has been carried out that records the views and wishes of residents and helps to inform the development programme for the future. The most recent resident surveys showed the majority of residents rating services between good and excellent. The organisation has started on the process of seeking the Investors in People award. supervision arrangements are in place for all staff and take place regularly. Regular residents and staff meeting are held at the home and provide an opportunity for open discussion, to raise concerns, ideas and suggestions and to plan for the future. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Enhance care plans to ensure they are holistic and more person centred and evidence the involvement of the resident and relative in their development and review. Fully introduce the end of life care plan documentation where possible. Obtain a more secure drug disposal bin with a fixed lid. Ensure that Registered Nurse training records are kept up to date and demonstrate continued clinical learning and updating. Ensure people delegated specific responsibility for Health and Safety matters receive relevant Health and Safety management training for the role. 2 3 9 30 4 38 Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!