Inspection on 01/02/06 for Beacon Farm Care Centre

This inspection was carried out on 1st February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Beacon Farm Care Centre 22/08/08

Beacon Farm Care Centre 27/02/08

Beacon Farm Care Centre 16/04/07

Beacon Farm Care Centre 26/06/06

Beacon Farm Care Centre 27/07/05

Beacon Farm Care Centre 13/12/04

Beacon Farm Care Centre 17/06/04

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

CARE HOMES FOR OLDER PEOPLE Beacon Farm Care Centre Beacon Lane Cramlington Northumberland NE23 8AZ Lead Inspector Suzanne McKean Unannounced Inspection 1st February 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 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 Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beacon Farm Care Centre Address Beacon Lane Cramlington Northumberland NE23 8AZ 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) 01670 - 715000 01670 - 590567 beacon.farm@fshc.co.uk Cotswold Spa Retirement Hotels Limited (wholly owned subsidiary of Four Seasons Healthcare Ltd) Mr Mark Gregory Jellett Care Home 55 Category(ies) of Dementia - over 65 years of age (55) registration, with number of places Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 11 residents receive Personal Care 43 residents receive Nursing Care The home is able to provide 2 places to named residents under the age of 65, should either of these residents leave the home the CSCI must be notified 27th July 2005 Date of last inspection Brief Description of the Service: Beacon Farm Care Centre is a converted building of brick and tiled roof construction. It is built around a courtyard type garden area to the front with the bedrooms set around the outside of the three sided square. The area to the front is set with lawn and planting and is secure for safe resdient use. The home is situated on the outskirts of Cramlington with pleasant views over surrounding countryside. It is accessed via a country type lane / road and is within easy reach of local shops, public transport and other useful amenities including a popular garden centre. The home is registered to provide Mental Health Nursing and social care to an older client group, within the category of Dementia (memory problems). Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over two visits totalling eight hours by two inspectors Suzanne McKean and Aileen Beatty. It is the second inspection the home has had in this year. All core standards were examined over the inspections therefore both reports should be looked at to get the full picture. Twelve residents and three staff were spoken to, others chatted to briefly. Two relatives were spoken to directly. Four care plans, training records and records for medication were examined. Staff files, training records and health and safety documentation were looked at. Eight requirements and one recommendation were made at the last inspection. Two of requirements remain outstanding although significant work has been done to meet those. What the service does well: What has improved since the last inspection? What they could do better: The Manager has submitted her application to be the registered manager and this is progressing well however it must be completed. The redecoration Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 6 programme is almost complete and although some of the furniture has been replaced there is some still to do. The manager must ensure that the staff are adequately trained including at least 50 having NVQ level 2 and also that all care staff receive up to date moving and handling training. Social assessments and care plans must be undertaken in more detail for all residents and further work must be done to give residents choices in their lifestyles and day to day activities. 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 Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Standard 3 was examined at the last inspection and was met. The home does not offer intermediate care. EVIDENCE: Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 9 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 service users are having their needs met by the staff in the home, and the staff are aware of how to achieve this. The care plans have been improved to ensure that they can now be used to plan and evaluate the care as well as showing the care being provided. The further improvements should be undertaken as planned. The residents receive their prescribed medication in line with safe working practices. The medicines in the home are well managed and safely disposed of as necessary. EVIDENCE: The company have in place a comprehensive toolkit of care plan documentation and this was being used. The care plans cover health and social and personal care and a number of assessment tools are in use. These are now up to date and are reviewed monthly, they are dated and signed by the author. The changing health care and mental health care of residents are reviewed and up dated and they set out details of care for the complex needs of the residents. There are still improvements that can be made to the care plans, but they are now in line with the National Minimum Standards. In particular it Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 10 is recommended that care plans relating to care of people with dementia are made more easy for care staff to understand as they use technical terms not all staff will be familiar with. Personal care was given in privacy, and staff used residents preferred name during the inspection. The staff generally have an understanding of residents individual needs and were observed to deal with some potential difficult behaviour issues in a professional sensitive manner. The home has policies and procedures in place to ensure the safe administration of medicines. The treatment room was clean and well organised. There was no over stocking of medication and minimum controlled drugs in use. A random check of the Medicine Administration Records and the Controlled Drugs found no discrepancies. The home has sight of the prescriptions and record all medicines received and disposed of with dates and signatures of staff and the pharmacist. Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 11 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 A range of activities are available to meet the cultural, social, religious and recreational needs and residents are helped to exercise choice and control over their lives but this could be assisted further. Service users maintain contact with family and friends and the local community if desired. Standard 15 was examined at the last inspection and was met. EVIDENCE: There is currently no activity co-ordinator in post but a member of care staff is taking the lead in organising activities at present. A sensory room has been created which is very pleasant and contains specialist equipment. It is a relaxing room with soft lighting and items of interest to stimulate mind and body. It is recommended that some of the equipment be used in portable form, as some residents may be reluctant to use the room, in which case the room could be taken to them. The manager described a number of ways they plan to meet the varying needs of residents. There is already evidence of use of some rooms as quiet areas and others for more social activities. Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 12 The local church visits once a month although the denomination of this church may not suit all people. It is recommended that individual residents are supported to meet their religious needs outside the home if possible. The home has a good relationship with a local school and they have been visited by children from Beavers, Cubs and Scouts, which it was reported was very well received by residents. Some relatives also bring dogs in and some people enjoy this. People are offered choices but the manager agreed that people with dementia often need additional practical help and support to continue to make choices for as long as possible. For example, the home are going to develop picture menu cards to enable people with communication problems to indicate a preference non-verbally. A garden is available and the manager has some good ideas about how to develop areas for residents to use as a garden they can help to maintain such as raised flowerbeds. It is recommended that this idea is pursued. Care records examined found that a number of social assessments were blank. These must be completed for all service users. Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 13 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 home ensures that the residents and relatives are made aware of the complaints policy and that it is available in a variety of places. There is a system for managing and dealing with complaints, which makes it possible for them to be investigated and action taken to address any issues identified. The residents are protected by ensuring that the staff are given Protection of Vulnerable Adults training and the mechanisms for whistle blowing and reporting concerns to the Manager. EVIDENCE: The records of the complaints made to the home were examined, there has been one complaint recorded and this was investigated by the Commission for Social Care Inspection. The requirements identified as a result of this have been met and referred to communication with relatives, the improved arrangement of reviews with social services and the more detailed recording of care delivered especially the use of lap straps and seat positioners (which could be viewed as restraint). The records were detailed including the response to the complainant and the action taken in response to the issues raised. The record of meetings, which have been undertaken with relatives and staff, were examined and although the attendance was not high in the relatives meetings they showed the homes intention to maintain communication pathways. Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 14 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, 20 25 & 26 Standards 21 & 23 were examined at the last inspection and were met. The home is now safe has improved significantly since the last inspection. The redecoration and the replacement of furniture are well underway and are being managed well by Mrs Brown, the Manager. EVIDENCE: The entrance to the home is now pleasant and welcoming, the carpets have been changed and the redecoration has resulted in the area now being light and clean. There are bathrooms, shower facilities and toilets near to all communal areas and residents bedrooms. The large lounge next to the dining room was being redecorated at the time of the inspection and was not being used making it necessary for the residents to use alternative lounges. This was being managed well and the small lounge in particular had residents in which were settled and there was a pleasant atmosphere for them to sit. Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 15 Some of the carpets in the communal areas were heavily stained and require replacement. The staff confirmed that they are cleaned on a regular basis however the carpets are now some years old and are worn making them difficult to clean. The corridor areas have now been redecorated and have had the carpets replaced, this has improved the way the entrance of the home is presented. The residents have been encouraged and supported to bring personal items with them resulting in individualised rooms reflecting personal taste and previous lifestyles. Several of the carpets in the bedrooms are worn and dirty and some rooms do have an odour problem, they are also requiring redecoration and upgrading, all of which has been scheduled and is awaiting completion according to the plan. There is a large area to the front of the building, which is used by residents in the pleasant weather and garden furniture is provided for this. The Manager also has long term plans to improve other outdoor areas to offer a more varying outside space. Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 16 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 home is staffed with numbers of staff in line with the proposal made to the Commission of Social Care Inspection and there are qualified nurses on duty in sufficient numbers to meet the needs of the residents. The staff in the home are recruited in line with the companies policies and procedures and are being provided with a good range of both statutory and clinical training. However the moving and handling is now overdue and must be undertaken. The staff are encouraged to take National Vocational Qualifications and there are approximately 15 of the staff who have either level 2 or 3 in care. A number of staff have been signed up for the training and are awaiting it beginning. EVIDENCE: The staffing rotas showed that the Deputy Manager/Owner is staffing at levels in line with the proposed levels as submitted to the CSCI in February 2005. The acting manager has some hours in addition to the staffing numbers although she undertakes shifts within the rota as necessary. It was noted that when sickness and staff holidays occur home staff usually covers these occasions although use of agency staff can be arranged with permission of the Regional Manager. Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 17 The staff receive training in line with the company policy and statutory requirements for fire training, first aid, food handling and hygiene and a plan is in place to address this on an ongoing basis. The moving and handling training has fallen behind and the plan to address this is in place with training sessions planned, this must be followed to ensure that staff are up to date. Any additional training opportunities are allocated depending upon the individual staff member’s role, previous experience and qualifications. The staff recruitment and selection records all contained a completed application form, two written references, a completed CRB check and contained the evidence of the equal opportunities policy being followed. All staff commence employment on a trial basis and undertake an induction period depending upon their previous experience and qualifications. Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 38 Standard 35 was met at the last inspection. The manager Mrs Judith Brown has submitted her application for registration as manager with the C.S.C.I. She has shown a commitment to making improvements and is continuing to work toward these. The Manager has in place systems to make sure that the home is managed effectively taking into account the needs and wishes of the residents. The improvement in the health and safety practices are being continued and only the updating of the moving and handling training remains outstanding (see staffing standards). EVIDENCE: Mrs Brown and the senior staff of the home are continually monitoring the views and wishes of the residents by speaking to them on a daily basis. The Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 19 manager is continuing to arrange resident and relevant meetings although these not always well attended. The record of the last one arranged suggested that the contents of the meeting are varied and for those who do attend can offer them the chance not only to discuss any changes occurring. The company has policies and procedures in place to ensure that the home is managed effectively taking into account the needs and wishes of the residents and there is evidence that the Manager is working in line with these. Records were examined of the staff meetings, which take place regularly, and the contents of these suggest that there is a broad spectrum of relevant issues discussed. Regular reviews are arranged either by the Social Services departments or by the home and these offer the opportunity to have seek the resident and relative views, the home is now ensuring that where these are to be done a senior member of the care team is available to ensure that they are up to date with the resident current needs. Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X 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 2 13 3 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X X X 2 Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation 16 (2) (m) (n) 16 (2) (m) (n) 16 (3) 23 (2) (d) Requirement All residents must have in place a detailed social assessment and then a plan of care to meet their needs. The manager must develop ways of giving residents more choice in their day-to-day life experiences. The redecoration programme must be continued and completed as planned. This must include the corridor areas and the bedrooms. Outstanding Replacement of furniture must be undertaken as necessary. To include service users bedroom chairs communal area chairs and bedroom furniture as necessary. Outstanding A minimum of 50 of care staff must have NVQ level 2 training. The Manager must continue her application to be the Registered Manager. Moving and handling training must be provided in line with the guidance. Timescale for action 01/07/06 2. OP14 01/07/06 3. OP19 01/06/06 4. OP20 16 (2) (c) 01/06/06 5. 6. 7. OP28 OP31 OP38OP30 18 9 13 (5) 01/01/07 01/07/07 01/06/06 Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP12 Good Practice Recommendations The planned improvements should be made to the care plans including particular attention to the use technical terms that not all staff will be familiar with. It is recommended that the garden area be developed as discussed to offer additional stimulation for the residents. Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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. Extracts may not be used or reproduced without the express permission of CSCI Beacon Farm Care Centre DS0000000546.V275957.R01.S.doc Version 5.1 Page 24 - 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. 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