Inspection on 20/09/06 for Beacon Court

This inspection was carried out on 20th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Beacon Court 29/08/07

Beacon Court 06/12/05

Beacon Court 27/04/05

Beacon Court 05/10/04

Beacon Court 14/04/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Beacon Court 4 Church Road Dartmouth Devon TQ6 9HQ Lead Inspector Judy Cooper Key Unannounced Inspection 9:50 20 September 2006 th 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 Beacon Court DS0000051573.V305491.R02.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. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beacon Court Address 4 Church Road Dartmouth Devon TQ6 9HQ 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) 01803 832672 01803 832672 Thurlestone Court Limited Nigel John Harvey Care Home 34 Category(ies) of Dementia - over 65 years of age (34), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (34), Old age, not falling within any other category (34), Physical disability (34), Physical disability over 65 years of age (34) Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. PD from age 50 years Date of last inspection 6th December 2005 Brief Description of the Service: Beacon Court is a large detached house situated on a hill in a quiet residential area, and on a bus route going into Dartmouth centre. Residents’ bedrooms are on four floors with sixteen registered single and three registered double rooms, most of them having an en suite facility. Many rooms have views over the town. Three of the floors are accessed via a shaft passenger lift and there is a stair lift to the lower ground floor (bottom floor). Two rooms on the first floor require the resident to be able to negotiate two steps to access the rooms. There are two lounges, a dining room, part of which easily converts to form a quiet craft area and a conservatory with a sun terrace, which has far reaching views over Dartmouth and the surrounding area. There is a garden area at the rear of the property and a car parking area at the front. The home has good, level access from the car park. The home cares for older people, including those who are confused. The home can also offer care for residents, from the age of fifty years plus who are physically disabled. The weekly fees range from £350 to £500.00. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place on Wednesday 27th September between 9.30a.m and 5.15 p.m. Opportunity was taken to look at the general overall care given to all residents. The care provided for four residents was also followed in specific detail, from the time they were admitted to the home, which involved checking that all elements of their identified care needs were being met appropriately. A tour the premises, examination of some records and policies, discussions with the home’s registered manager, residents and staff, as well as a representative from the Court Group senior management team also formed part of this inspection, whilst staff on duty were observed, in the course of undertaking their daily duties. Other information about the home, including the receipt of several completed questionnaires from residents, relatives, and other interested parties, has provided further feedback as to how the home performs, and all of this collated information has been used in the writing of this report. All required core standards were inspected during the course of this inspection. What the service does well: Beacon Court continues to provide a comfortable, secure, well maintained environment, where residents’ individuality and residents’ rights, such as dignity, respect and privacy are upheld. A particular strength of the home is the relaxed, warm and friendly atmosphere within the home, which allows residents to feel able to choose their own particular lifestyle, which can alter from day to day (due to the nature of some of the clients) but to which staff respond to well and endeavour to accommodate. Visitors are welcomed and encouraged and links maintained with the local community. The relatively stable staff team remains well trained and able to meet the needs of the residents. Some members of staff, including several night staff, have worked for a number of years at the home and are therefore well known and trusted by the residents. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 6 Residents remain able to choose how they spend their time with some very individual lifestyles supported and maintained according to residents’ wishes. The home’s registered manager continues to have excellent communications with the residents and staff, which helps encourage good, open communications generally throughout the home. The management of the Court Group offer strong, regular support to the manager, visiting the home at least once a week and being available as required. This home has maintained good standards of care with all requirements continuing to be met and only four recommendations made following this inspection. What has improved since the last inspection? All Residents’ bedrooms have been fitted with door locks to further enhance and maintain residents’ rights to privacy. The hot water temperatures within the home are now all regulated to a safe temperature, which protects residents from the risk of scalding. The home’s laundry systems have been upgraded with the provision of superior washing machines and driers. This has helped the staff manage residents’ laundry more efficiently and maintained infection control more thoroughly. The home has introduced training feedback forms to audit any training provided to staff to ensure that staff attending feel that they have benefited from the training and are then able to use their increased awareness to the benefit of the residents. The manager has commenced an evaluation programme within the home. This involves the manager evaluating all aspects of the running of the home, for which management time has been allocated. From this evaluation the manager will draw up an action plan to address any issues that would be of benefit to the running of the home and consequently provide better care for the residents. The Court Group have introduced a “Group” newsletter which informs residents and staff of any interesting issues that are happening throughout the Group homes. This allows all to feel part of a larger organisation and allows for any social activities or items of information to be known throughout the Group. The manager is in the process of introducing a new in-depth induction programme for new care staff members. This is to ensure that all new staff are fully aware of their responsibilities and expectations of their role. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 7 The home is maintaining a fuller record of what activities are made available to residents, so that staff are aware of which residents have undertaken what activity and alternative choices made available as required. The home has made a communications board available for residents and staff which contains lots of interesting and relevant information, allowing both staff and residents easy access to any new plans, events, etc for the home. The manager has streamlined the key worker system within the home to allow key workers to be aware of their expected responsibilities and for residents, who are able to comprehend, to also benefit from knowing what tasks they can ask their designated key worker to do. 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. Beacon Court DS0000051573.V305491.R02.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 Beacon Court DS0000051573.V305491.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (The home does not provide intermediate care) The quality in this outcome area is good. The admission process continues to be well managed and residents and/or their next of kin/advocate are given clear information regarding the service prior to admission so that they can make an informed decision. EVIDENCE: Since the last inspection the home has admitted some new residents. Two of these residents’ admission processes were inspected in detail along with two residents’ admission processes who were admitted several years ago. The two residents, who have been admitted since the last inspection, were talked with, and the other two residents’ admission process was discussed with the manager and the home’s records inspected in relation to the admission process and the subsequent care provided. One of the newer residents stated that the care both he and his wife received was satisfactory and they had both been made welcome when they came to live at the home. They were also aware of what care was able to be provided. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 10 Following these discussions, and observing documentation in relation to the admission process, it was concluded that these two admissions had been undertaken in such a manner as to allow the residents and/or their next of kin/ advocate to be aware of what services the home could offer and, following on from a pre admission assessment undertaken by the manager, know that the home was able to subsequently meet their needs. The manager visits all prospective residents, whenever possible, prior to the admission and there was detailed evidence of in-depth pre admission assessments as well as liaisons with other professionals that had taken place at the point of admission. Randomly selected residents also indicated that they had received sufficient information about the home to allow them to know whether, or not, it was the correct home for them. The prospective residents and/or their families had been given access to necessary information, including the home’s statement of purpose. Relevant contracts were in place for all of the four residents, which also included up to date fees. The home does not provide an intermediate care service. Beacon Court DS0000051573.V305491.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The quality in this outcome area is good. All residents are looked after well in respect of their health and personal care needs. Residents’ privacy and dignity is upheld and their life style choices respected. EVIDENCE: The care plans were inspected in respect of the four residents whose care was inspected. These were thorough and covered all required care needs as well as social and psychological needs. Residents and /or their families/advocate, had mostly, due to the majority of the residents’ mental frailties, chosen the option of allowing the staff to undertake the reviews on their behalf and this was noted as documented. The residents’ health care needs were being fully met, including any specialist needs. Recently the home has had contacts with the community psychiatric nurse team, a visiting speech therapist and the local District Nurse team. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 12 The request for a visit form a speech therapist was in response to staff having some concerns over the best way to feed a very dependent resident. It was a credit to the home that the staff were aware enough to recognise they would benefit from specialist intervention and it was pleasing to note that the advice given was being put into practice. The staff member feeding the resident explained that once the food has been taken by the resident the empty spoon is then put to the resident’s lips as this encourages the resident to swallow the food already in the mouth more easily. It should also be noted that this same resident, who has been at the home for several years, is physically very frail and immobile. However, the care given has ensured that the resident has not sustained any pressure areas whilst physically so frail. Appropriate handling and lifting equipment is made available including a mobile hoist. The married couple whose care was looked at in detail was noted as receiving appropriate care. It was pleasing to note that, although both had significantly different care needs, both were satisfied with the care provided and staff were also noted as treating their particular situation with sensitivity and ensuring that the couple were enabled to be together in a supportive manner which allowed both parties to still be able to maintain their relationship in a positive and personal manner. Both the management and staff should be commended for this, as tact and sensitivity were very much in evidence to ensure this remained the situation. Medications were well managed, with the home’s medication cupboard and the home’s allocation of medication being undertaken in a professional and safe manner. There is a small medical fridge for the storage of eye drops etc. The home continues to use a nomad dosage system, which continues to provide a safe and suitable means of allocating medications within the home. The home’s medication records were seen to be up to date, and carried a photograph of each resident on each individual resident’s recording sheet. The home’s manager takes overall responsibility for the management of medication within the home and in his absence a senior carer only is designated to this role. Staff who are involved in medication allocation undertake a distance learning course in the “safe handling of medications” and there are regular updates from the “in-house” trainer. The home stores and administers controlled drugs correctly and records were examined in respect of this and noted to be in order. It was pleasing to note that there were details in the medicine cupboard in respect of helping any one with a swallowing difficulty, which was particularly pertinent as the home is currently caring for a resident with this need. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 13 All residents’ individuality and dignity was noted as being upheld with staff speaking sensitively and kindly to residents whilst helping those that required support to maintain daily living skills. Residents presented well, wearing clean clothes which were noted as changed as necessary, and although it was noted that two gentlemen had not been shaved by the late afternoon, when the manager queried it with the carer responsible she was very upset to think she had forgotten, but also explained that because there had been a problem with the bath and shower on the day of the inspection the morning routines had not been as they should be. One resident was noted as being undressed quite early on in the day (approximately 4.00 p.m.). Again this was raised with the manager who confirmed that sometimes the resident did prefer to go back to her room at this time and sometimes she was undressed, ready for bed, if a change of clothes was required. However on this occasion she had chosen to remain in the home’s communal lounge, after being changed. Discussion took place as to whether it had been necessary to put nightclothes on the resident at such an early hour of the day. The manager spoke with the carers and it was noted that the resident was once again wearing day clothes, a little time after. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The quality in this outcome area is good. Residents enjoy a peaceful life at the home, with visitors encouraged and welcomed. Choices are made available and upheld by the home’s staff. Links are encouraged and maintained with the local community. Residents are able to participate in various daily informal activities, and can take advantage of weekly outings (which are charged for at £4.00 per outing). The home provides nutritious and varied meals. EVIDENCE: It was noted that residents feel they can take advantage of the informality of the home’s routines and consequently choose how they spend their time. The atmosphere within the home is relaxed, warm and friendly and all the staff and management should be commended for this. During the inspection it was noted that several residents had chosen to socialise together and had formed friendships and were enjoying each other’s company. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 15 An example of how staff managed diversity to good effect was evidenced in the care provided for the married couple within the home. One of the partners requires quite a lot of physical care whilst the other partner has some mental frailty. The manager and staff were noted as managing both sets of needs well whilst respecting the fact that the couple also wanted to spend time together. One resident smokes and is allowed to do so in his own room, being a long standing resident. The management have placed the resident in a “safe” room away from the main part of the home, however a risk assessment should also be undertaken in relation to this activity and reviewed regularly to ensure that the resident, and others, continue to be safe. Visitors are welcomed and encouraged and the home’s visitor’s book evidenced many visits from different people at various times. There is often a weekly outing with the next one being provided three days after the inspection. There is a charge for these trips of £4.00. The daily activities are currently provided in an informal manner within the home according to residents’ desires with detailed records kept to ensure all staff are aware of who has attended what and whether the activity was successful. The staff, at the home, are mainly responsible for providing the activities with some outside entertainment also brought in on occasions, the next being planned for the 25th of the month. There was also to be a clothes show shortly after this inspection and a notice was displayed advertising this. Appropriate craft materials and activities were noted as being available. On the morning of the inspection a local clergy visited the home to give Holy Communion, which several residents attended. The home has employed a new chef since the last inspection. Although he had had little experience in preparing food for the elderly prior to the appointment at the home it was pleasing to note he was keen to learn and enthusiastic about his role and stated that he was learning all the time and was now confident that he could provide for the residents’ likes and dislikes as well as ensuring that the nutritional needs of the elderly were taken into account. The meal on the day of the inspection was roast chicken with all the trimmings accompanied by three fresh vegetables, followed by fruit salad (tinned and fresh fruit mixed together) and cream. However, when asked what choice was available for residents who may not have wanted the main lunch meal, the chef was unaware of what the choice would have been, neither was this information displayed in the home. This was discussed with the management of the home who were able to evidence that choice is always available and often given, however these choices had been made by staff rather than with the residents. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 16 The management of the home will address this in the future to ensure resident choice is upheld. The management of the home are also currently in the process of concentrating on the nutritional needs of the elderly and are committed to providing well-balanced meals that provide all the required nutrients to help promote good physical health for elderly people. The management of the home should be commended for this. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 17 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality in this outcome area is good. Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: The home’s complaint policy remains communally displayed and is also contained within the home’s statement of purpose. Residents stated that felt they could easily approach the manager or any staff member should they have any cause to. During the regularly held residents’ meetings the manager always goes over the complaints procedure to reinforce the fact that residents are able to voice any concern they may have. Staff, spoken, to were aware of adult protection issues and regularly attend vulnerable adults training. The effectiveness of the adult protection training that is provided is monitored. Staff have to complete a small question sheet after their training to demonstrate that they can identify the various forms of abuse including: physical, sexual, psychological, financial and material, neglect and acts of omission, discriminatory or institutional. Other questions include staff identifying who has the potential to abuse and whose responsibility is it to protect service users from abuse. This level of training does ensure that staff are fully aware of any abuse issues and residents can therefore be assured of good protection within the home. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 18 Feedback comments received from residents’ relatives family/advocate suggest that not all were aware of the home’s complaint policy, although it was noted, as stated before, that this was both communally displayed and also contained within the home’s statement of purpose which was located in a central area of the home. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The quality in this outcome area is good. Beacon Court is very comfortable, clean, well maintained and provides a safe standard of accommodation for the residents. EVIDENCE: The tour of the home confirmed that the owner and manager maintain very good environmental standards within the home, which makes Beacon Court a pleasant place to live in. Routine general upgrading continues to take place as required. Unfortunately on the day of inspection both the home’s assisted bath and home’s disabled shower were out of action. This resulted in some residents not being able to have their planned bath/shower. However the problem was due to be rectified the next day and residents were noted as being informed about the problem in a sensitive manner that could be easily understood. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 20 The manager ensures that the home’s fire precautions are maintained in line with the requirements of the local fire department, whilst a member of the Court group staff is employed specifically to ensure this, and all other areas associated with the health and safety of the residents, are maintained in accordance with the requirements associated with each health and safety area. This role is extended to all homes within the Court Group. The home’s fire log book was inspected and found to be in order. There was also a log of the Court Group’s health and safety officer’s monthly visits to Beacon Court, detailing any remedial work that needed to be done to maintain the required environmental/ health and safety standards within the home. It was also noted that any chemicals used within the home were being stored appropriately, within a locked facility, to further protect residents. Routine health and safety notices were provided with one being noted by the home’s chair lift to the lower ground floor, which asked all residents using the appliance to make sure they used the safety strap provided to help minimise any risk of slipping form the chair lift as it moved. This is seen as good practice. Privacy locks to all residents’ bedroom doors have recently been fitted which ensures that a resident can maintain their right to privacy if desired and it was noted that a few residents had chosen to keep their doors locked. Each resident had had a room risk assessment undertaken to ensure that any areas of risk had been identified and remedial action taken to address it if deemed necessary. The home presented as very clean throughout. Since the last inspection the management have provided extra touches such as an air purifier in the hallway and an ozone generator which is used in the lounge or any resident’s room where changing the air might prove to be beneficial. There was a slight incontinence odour noted in only one room, which considering the home provides care for several residents who have continence problems, was considered to be very positive. The laundering needs of the residents are met appropriately with new improved laundry equipment ensuring that all residents’ laundry needs are undertaken as effectively as possible. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 21 Staff receive regular cross infection training as part of the Court Group’s statutory training programme. During the inspection it was noted that an order was placed for gloves and liquid soap, whilst staff were noted as using gloves and aprons as required. A notice by the front door welcomes visitors but does ask them to refrain from entering the home if they are not well to help prevent the spread of infection to vulnerable residents. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 22 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. The quality in this outcome area is good. The home’s recruitment policies are in order and protect residents. Staff at the home are appropriately trained and employed in adequate numbers so as to meet the residents’ needs. EVIDENCE: Residents who were able to conformed that staff are kind to them. Staff were also noted as being well presented, polite and respectful towards the residents. The staffing rota was inspected. On the day of inspection there were twenty-eight residents in the home. The manager works from 8.00a.m until 6.00pm.as well and his role can incorporate some element of “hands-on” care as necessary. The home has an additional three carers on in the morning (one of which is a senior carer) and again three in the afternoon. Between 5.00p.m and 7.00p.m a school age young person works in the home undertaking tea-time duties, and again at weekends (but provides no hands-on care). At weekends the manager is not on the rota to work, however a senior carer oversees the management of the home. Two of the home’s senior carers were on duty during the inspection and both are very experienced and have worked at the home for a number of years. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 23 During the weekends there is one staff member less as the manager is off duty. However should there be the need for it the manager can increase the staffing hours, after negotiation with the home’s owner. Although those residents, able to verbally feedback their feelings, (except one who felt “that staff were could be overstretched at times”) felt there was enough staff to care for them and the staff themselves felt that they had been given enough time to undertake their duties, a couple of feedback cards from residents’ relatives indicated that they felt there wasn’t always sufficient staff on duty at all times. However during the inspection it was noted that residents were seen to in a timely manner and their care needs met. A feedback comment received from a relative which also helped confirm this stated: “A very good home. Staff very good”. The home employs a weekday cook, with a relief working at weekends and a cleaner three times a week (which is due to be increased to five times a week shortly). Training is provided regularly. Recent training provided has included updated statutory training such as fire safety, moving and handling, health and safety, and food hygiene. Due to the home having recently experienced some staff changes the current ratio of trained staff is less than 50 , as some staff who moved on were qualified staff, however the owner and manager are aware of the need to meet this requirement and has already registered several of the new staff members for the NVQ levels 2/3 training in care, commencing imminently. On the day of inspection the manager received a telephone call to confirm the staff members had been allocated funding for this training. New members of staff are currently being taken through the induction programme and various in-house training packages with a new in-depth induction training programme currently being trialled at the moment in respect of one new member of staff. This was seen to be very thorough and easier for staff to understand than the previous one. A lot of work has gone into compiling this from the senior management team of the Court Group and they should be commended for producing such an accessible training resource. Staff on duty were able to confirm that they had received a lot of in house training since their appointments and were happy to take advantage of the further training opportunities being presented. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 24 This level of training helps ensure that staff are appropriately trained and consequently able to provide suitable care for the residents at the home. Staff records for three staff members, employed since the last inspection, were looked at in detail. The recruitment procedures within the home, including receipt of completed application forms, two written references and an enhanced CRB check had been undertaken. However to fully ensure that there are suitable staff working within the home and that residents are protected the manager should validate any previously written references supplied by new staff members. The home has employed an overseas worker with a second due to start soon. The carer who had just commenced was liked by staff and was noted as being very good with the residents. Her documentation, from overseas, was in order and the management were also applying for an English CRB disclosure. Until this is returned the worker will remain supervised. All staff receive regular supervision and annual appraisals to allow them to fully understand their role/performance within the home. Staff on duty were spoken with and it was pleasing to note that those spoken with felt comfortable and happy working at the home. A comment from a staff member stated: “Very happy here, have been here about ten years”. During the inspection it was noted that staff took pride in their role and tried to ensure that all residents had a good quality of life, irrespective of need or diversity i.e. it was noted that frailer residents were given choice and respect as a matter of course. There are regular staff meetings held with minutes kept. Information that may be useful to staff, including the Court Group’s corporate strategies are also made available to all staff, with the staff having their own notice board. This allows them to have an awareness of all issues surrounding their roles. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 25 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The quality in this outcome area is good. The home is managed efficiently and well, with the manager being easily available and approachable. The registered manager undertakes his role professionally and has an awareness of residents’ needs and the staffs’ abilities to meet them. The home provides a safe, secure environment where residents’ safety and well-being is maintained. EVIDENCE: The manager achieved his Registered Manager’s Award last year. He has been in post for over twelve months and is well acquainted with the day-to-day running of Beacon Court. He is well liked and respected both within the home by residents and staff, and works well with outside professionals. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 26 The manager spends some rostered time working with residents on a daily basis, but also performs the required management tasks to the required standard maintaining all required records to a good standard. Staff stated that they felt the manager was very approachable and one staff member stated that: ”he was the best thing to happen to Beacon Court”. He is aware of the staffs’ abilities and is sensitive to any weakness they may have, providing support and encouragement/training as required. All records inspected were up to date, concise and detailed. The residents or the residents’ families/advocates deal with any financial matter. The manager does not deal with residents’ monies other than to hold small amounts as requested by residents or their families. There were detailed records in respect of these and the Court group senior management team undertake a monthly review of all monies held. This ensures residents’ monies are secure. A member of the Court group senior management team undertakes a formal monthly in-depth review of the service and provides the manager with a written record of this visit as required under regulation twenty-six. The manager holds three monthly residents’ and staff meetings. The Court Group Senior Management team are in the process of further improving their quality auditing approach to ensure that residents’ views are taken into account at all times. An example of this is the recently introduced auditing of the admission process for the residents, where newly admitted residents are invited to feed back on how they felt their admission went. These processes ensure that the home continues to be run in the best interests of the residents and continues to meet their needs at all times. The home’s annual development plan was also available. The manager confirmed that health and safety issues continue to be well managed within the home and records inspected supported this. The home’s hot water supply is now regulated throughout the home to a safe temperature. All hot surfaces accessed by residents have been previously covered. Both these measures help maintain residents’ safety at all times. The home also achieved “Investors in People” status last year. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 27 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 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 28 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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations A risk assessment should be undertaken in relation to the resident who smokes in their room and reviewed regularly to ensure that the resident, and others, continues to be safe. Resident mealtime choices should be made available to both staff and residents to ensure that residents are aware that they do not have to have the main meal but can have a choice if required. All residents should have a call bell available. The manager should ensure that any written references submitted by any new member of staff are checked to assure their validity, which again ensures the protection of residents through the appointment of suitable staff. 2 OP15 3 4 OP22 OP29 Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 29 5 OP30 The owner/manger should continue to provide staff training to allow the staffing requirement of having fifty percent of trained staff (to NVQ level 2 in care) on duty. Beacon Court DS0000051573.V305491.R02.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 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. 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