CARE HOMES FOR OLDER PEOPLE
Beacon Court 4 Church Road Dartmouth Devon TQ6 9HQ Lead Inspector
Judy Cooper Unannounced Inspection 6th December 2005 10:00 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.V257203.R01.S.doc Version 5.0 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.V257203.R01.S.doc Version 5.0 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.V257203.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. PD from age 50 years To complete the NVQ qualification in Care and Management and/or the Registered Manager`s Award by 2005 27th April 2005 Date of last inspection 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. Residents’ bedrooms are on four floors with sixteen registered single and three registered double rooms, most of them having an en suite facilitiy. 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. Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on a Tuesday morning/ early afternoon. Opportunity was taken to tour the premises, examine some records and policies and talk with the manager and a senior member of the Court Group management, who was present during the inspection, as well as some residents and staff. Staff on duty were also observed, whilst in the course of undertaking their daily duties. A visitor to the home and a visiting District Nurse were also asked for general feedback as to the care they felt residents receive at Beacon Court. The majority of the required core standards were inspected at the last inspection in April 2005. Those inspected on this occasion concentrated on resident welfare on a day to day basis as well as some general environmental standards. Two core standards, not inspected on the last occasion, were also inspected on this occasion. Information from these observations/discussions has been used in the writing of this report. 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. Visitors are welcomed and encouraged and links maintained with the local community. The 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. 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.
Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 7 All hot water, provided to residents’ facilities within the home, must continue to be regulated to a safe temperature, to ensure that residents are protected form the risk of sustaining a scald. The management of the home should undertake a risk assessment in respect of a first floor landing adjacent to room twelve, which has wide spaced spindles and could be a risk factor for some frailer residents should they fall against it. The management should record and identify any measures that may need to be taken to minimise any identified risk. 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.V257203.R01.S.doc Version 5.0 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.V257203.R01.S.doc Version 5.0 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 admission process remains appropriately managed with residents’ needs explored and known prior to admission to the home. EVIDENCE: By looking at the records for two residents, who have recently been admitted to the home, it was noted that a full and detailed admission procedure was undertaken which had ensured that Beacon Court was an appropriate home for the residents. One of the residents, for whom records were inspected, was able to fully confirm that she had been made to feel comfortable, both on admission and since, whilst it was noted that the other resident was well looked after at the home with their needs known and met by the staff on duty during the inspection. The home does not provide for intermediate care. Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 10 Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 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 Residents’ health and personal care needs are very well documented, known and met. Residents are treated with dignity and respect and their individuality and independence maintained. EVIDENCE: Two care plans were inspected which related to the two residents whose admission procedures were previously inspected. The care plans were again very concise and detailed and contained all relevant information appertaining to providing for the individual residents’ care, and included any medical needs of the resident, as well as any visits made by District Nurses, G.P’s or any other health professionals. The manager and staff liaise with other professionals as required and, during this inspection a District Nurse was asked for feedback and was able to say that the staff cared appropriately for the patients she had contact with at the home and that she felt confident that the staff did all they could to follow any clinical instructions she may give. All necessary handling and lifting equipment
Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 12 was noted as having been being provided as was seen being used appropriately. Staff are to be provided with in-depth medication training, commencing on an in-depth distance learning course with a recognised external provider. The responsible person has also made arrangements for the home’s drug cupboard to have individual compartments for each resident, which aids a staff with the allocation/administration of residents’ medication. Resident feedback was very positive about the care received, with residents saying that they felt well looked after and the staff treated them well and were very kind to them. The visitor spoken with during the inspection also stated that they found this to be the case and stated that they would give the home “a gold star for the care and facilities provided to the residents they visited”. Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 Residents continue to enjoy a varied, yet peaceful life at the home, with visitors encouraged and welcomed. Choices are made available to residents regarding day to day living and staff take time, and put in effort in, to ensure that all residents enjoy a good quality of life. EVIDENCE: Staff members continue to regularly undertake activities with residents. External entertainment opportunities are also provided as well as monthly mini bus trips. The home continues to operate an open visiting policy and the visitor’s book showed that the residents continue to have many visitors at varying times throughout the day and residents confirmed that their visitors were able to visit at a time that suited, and were made welcome within the home. One visitor spoken with also confirmed this to be the case, stating they were always welcomed in the home and that the manager and staff were always very helpful and kind. The routines within the home are flexible to ensure that residents can choose how they spend their time. Several residents had again chosen to spend their time in the homes’ communal lounges whilst others had chosen to spend their time in their rooms.
Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 14 Several residents stated that they were well looked after and were very happy living at the home. The home is currently without a permanent cook but, fortunately, several of the staff members are able to take on this role whilst recruitment goes ahead, having the skills to deliver good quality meals. Residents also confirmed that they continued to enjoy their meals and those residents spoken with stated that they had enjoyed the meal served during the inspection. Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion. EVIDENCE: Although none of these standards were inspected, it should be noted that the CSCI home has not received any complaints, since the last inspection undertaken in April this year and the manager has investigated and fully resolved two minor internal complaints that were received. The manager also keeps full records of any complaints and subsequent investigations. Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Beacon Court remains comfortable, clean, warm and well maintained. EVIDENCE: The tour of the building showed that the registered provider continues to maintain the upgrading programme to ensure the home provides a high standard of accommodation. The accommodation was again noted as being comfortable, well maintained, clean and welcoming. There is an infection control policy and staff have infection control training as part of the Court Group’s overall in house training package. The laundering needs of the residents are met appropriately with new improved laundry equipment to be provided in the imminent future, which will ensure that laundry is able to be undertaken as effectively as possible. The manager and staff do their utmost to ensure that any odour problem is eliminated as soon as it is detected, by using good internal cleaning
Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 17 products/equipment, which the registered provider makes available as required. Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 Staff at the home are well trained and presented well in both appearance and manner. Staff continue to be employed in sufficient numbers to meet the current resident groups’ needs. EVIDENCE: Staffing levels were seen to be in sufficient numbers to ensure that residents’ needs could be met during the day and night. Residents spoken to said that they felt well looked after and that staff were always available if needed. During the inspection it was noted that staff had sufficient time to spend with the residents, attending to their personal and social requirements. Training continues to be well planned and supports the staff in providing for the varied needs of the residents. Several staff, within the home, hold an NVQ training award (level 2/3) and their experience is again reflected in some of the positive comments received from residents, a visiting District Nurse and a visitor to the home, spoken with during the inspection. The two staff who had been appointed from overseas, are currently undertaking their NVQ level 2 in care award. Two other staff are undertaking the same award and a further member of staff is undertaking NVQ level 3 training. When these staff have completed this training, along with the existing trained care staff, the home will have over the 50 of required trained staff.
Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 19 Both of the overseas members of staff continue to be valued, and form part of a strong staff group at the home, which has seen little change over the past ten months and so therefore provides a degree of security for the residents in the home. Staff spoken to felt positive about their role and said that they felt well supported by the management. The responsible person stated that in the attainment of the “Investors in People” award that the home recently was successful in obtaining (January 2005), staff worked together to achieve this award and it helped them, as a group, focus on training issues and the need to be experienced and aware in their caring role. Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,38 The home is managed effectively and well. Although the home’s management is maintaining routine health and safety issues, hot water provided to residents’ facilities, needs to be regulated to a safe temperature to protect residents from the risk of scalding. EVIDENCE: Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 21 The manager has been in post for approximately two and a half years. Since his registration he has been successful in obtaining his N.V.Q level 4 in care and has recently completed his Registered Manager’s Award. The staff and residents again spoke highly of the managers’ ability to manage the home and of his kindness and approachability. A representative from the management of the Court Group undertakes a monthly, in depth, quality audit visit where all aspects of the running of the home continue to be examined and reported on, including consultations with the residents. This ensures that all practices within the home are regularly reviewed and that the care continues to be of a good standard and as residents would expect/want. During this inspection the representative was present in the home and able to discuss the general management of the home. Routine health and safety issues are well managed within the home with some requested records being made available and being seen to be up to date, which confirms that residents are cared for in a mostly safe and secure environment. Residents’ hot water, supplying their washbasins, has not yet regulated to a safe temperature, however there are plans in hand to address this, which will eliminate the risk of residents scalding themselves. Hot water is, however, regulated where there is full submersion bathing facilities. All hot surfaces, accessible to residents, have now been protected throughout the home. Since the last inspection the registered provider has provided window restrictors to all but two residents’ bedroom windows within the home, to ensure residents are protected from any harm associated with having wider openings. Following the inspection of the home, discussion took place regarding the undertaking of a risk assessment in respect of a first floor landing adjacent to room twelve, which has wide spaced spindles and could be a risk factor for some frailer residents should they fall against this. The management will now record and identify any measures that may need to be taken to minimise any such identified risk. Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 x x x x x 2 Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 OP25 Good Practice Recommendations The registered provider should continue to ensure that all water outlets, including hand basins within the home, are risk assessed and the hot water regulated to 43 degrees Centigrade as required. The management of the home should undertake a risk assessment in respect of a first floor landing adjacent to room twelve, which has wide spaced spindles and could be a risk factor for some frailer residents should they fall against this. The management should record and identify any measures that may need to be taken to minimise any such identified risk. 2 OP38 Beacon Court DS0000051573.V257203.R01.S.doc Version 5.0 Page 24 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
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