Inspection on 16/04/07 for Beacon Farm Care Centre

This inspection was carried out on 16th April 2007.

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 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 26/06/06

Beacon Farm Care Centre 01/02/06

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 Ian Armstrong Key Unannounced Inspection 16th April 2007 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.V335645.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 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) Judith Brown Care Home 55 Category(ies) of Dementia - over 65 years of age (55) registration, with number of places Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 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 3 places to named residents under the age of 65, should any of these residents leave the home the CSCI must be notified 26th June 2006 Date of last inspection Brief Description of the Service: Beacon Farm Care Centre is a purpose-built care home of traditional brick build and tiled roof construction. It is set in its own grounds with a secure garden area on the outskirts of Cramlington with pleasant views over surrounding countryside. Entry to the home is via a country type road. It 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. The fees charged by the home range between £376.00 and £460.00 plus the free nursing care component. But do not include the following; Hairdressing, chiropody and toiletries. Residents pay for these in addition to the basic fee. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the visit : We looked at: Information we have received since the last inspection on 26/06/07. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service, their relatives and staff. The Visit; An unannounced visit was made on 16/04/07. During the visit we; Talked with people who use the service, relatives, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around parts of the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. What the service does well: What has improved since the last inspection? Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 6 NVQ training for care staff has been improved. This provides staff in the home with better skills to meet the needs of the residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives are given the opportunity to visit the home prior to their admission and receive good information on which to base the decision to move into the home. Pre-admission assessments are being completed to a good standard. This information assists staff to form the basis for the development of the care plan. The home does not provide intermediate care. EVIDENCE: Four residents pre-admission assessment records were examined and all were completed to a good standard. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 9 Relatives spoken to during the inspection said the home had given them the opportunity to visit prior to admission. The home had given them copies of the service users guide and complaints policy. Relatives said they had good information given to them on which they could decide about whether to choose the home. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of care planning is poor and is not centred around the individuals needs. This means the residents may not receive the care that they need. Residents healthcare needs are not being fully addressed within the care plans. This may impact on residents health if these are not properly completed. Staff are respectful towards the residents who are called by their preferred titles. Medications could be managed better. The system for receipt of medicines is unsatisfactory. However administration, storage and disposal is good. Staff in the home need to ensure that medicines received are properly checked to ensure the safety and well being of the residents. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 11 EVIDENCE: Four residents care records were checked the standard of these was poor. Many of the assessments in the files were not completed. A number of care records are not dated and signed. All four residents were admitted as needing nursing care, no nursing observations were taken on admission and recorded. No care plans were recorded in two of the files for mental health or social care needs. Information in some assessments has not been incorporated into the care plans. No evidence was seen in the care records of in house reviews being carried out with relatives or representatives in attendance. No records were seen of relatives being consulted about the care plans. A relative spoken to said she had had seen her mothers records but that no review of her care needs had taken place. During the visit staff were observed to be respectful to the residents. Relatives said that staff were kind and respected individual residents when attending to their personal care needs. The gender of the staff member agreed by the residents to provide their personal care is identified in the care records. Evidence was seen in residents care records of visits by other healthcare professionals. These records were well documented. Services for dental, optical and chiropody were being well maintained The systems for medications were checked. Administration records charts were well completed and in line with prescribed frequency times. Two residents controlled medications were checked. These records were satisfactory and the stock balances were correct. The systems for the storage and disposal of medicines were good however the records for the receipt of medicines are not being properly maintained. Staff on duty are not signing and dating when medicines are being received and to confirm the medicines are correct. The homes suction machine is old and not working at the present time. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents social activities are limited, therefore they do not fully meet their cultural, social and recreational interests. Arrangements for residents to maintain contact with family and friends is good. This ensures relationships can continue. Residents do not have a complete, well balanced nutritious diet, that offers choice and is of good quality. Therefore their dietary needs are not being fully met. EVIDENCE: There is currently no activity coordinator in the home and no weekly activity programme is taking place. Over the two days of the inspection no activities were planned or occurred for the residents. Since the last inspection visit in June 2006 no resident’s trips out have occurred. Individual social care plans are not well written and mainly not followed. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 13 Relatives spoken to said their was little in the way of activity or recreation for the residents. The home has an open visiting policy and relatives said they can visit at any time. Staff said there was little time for activities due the priority of meeting residents personal care needs and due to the loss of the activities coordinator. A visiting entertainer singer did visit the home in the first week in April which relatives said the residents did enjoy. Earlier in the year a mobile cinema showed the film Riverboat. Again relatives said some residents enjoyed this experience. The home has recently applied to the Local Authority for a grant and has been successful. The money will be used to build a sensory garden to the rear of the home. Gardens and grounds to the home are well maintained by the homes handyman. There are nice seating areas which residents can enjoy when the weather allows their use. The lunchtime meal for the residents was observed. There were four staff to assist residents in both dining areas. Food arrived in hot trolleys and was hot and nicely presented. Staff helped those residents who needed assistance to eat and good interactions were observed between staff and residents. Residents were offered a hot or cold drink with their meal. However both dining areas at present are not homely in feel and display little evidence to indicate this is where meals are eaten. Dining tables had no tablecloths, centrepieces or tablemats. Some tables had no condiments. No daily menus are displayed in dining areas. Menus currently do not specify what is offered for breakfast each day. No choice of sweet for main meals each day is stated. When sandwiches are included in the menus their ingredients are not specified. Relatives spoken to said food provided by the home was good. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The complaints policy is generally good and clearly available for residents and relatives to access. The system generally allows them to be investigated and for any action to be taken when issues are identified. Good systems of staff training are in place to ensure the residents are protected from abuse. Staff are knowledgeable of the procedures to follow. EVIDENCE: Relatives spoken to said that they had been given copies of the complaints policy and that they were confident the manager would address any concerns they might have and take appropriate action to rectify problems. Staff spoken to were aware of the procedures to follow for the safeguarding of adults. They said they had been trained in these matters. Training records showed the majority of staff had been trained. However a recent complaint made to the home had not been particularly well investigated. The residents records when checked showed that an assessment of their wound care had been poorly completed and that “fluid intake and out put” records were also poor. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment of the home is generally good and maintained to satisfactory standard. It is safe and appropriate for the residents who live there. The home is clean and tidy with no obvious smells or odours. Staff are aware of the procedures to follow for the control of infection. EVIDENCE: A number of residents bedrooms were seen these were well decorated with lots of evidence of personal furniture and effects. A relative of one of the residents was spoken to she said staff kept bedrooms tidy and clean. A bathroom and some toilets seen were also clean and tidy. There was no obvious smells or odours present. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 16 Some lounge chairs in the main lounge are damaged and need to be replaced. The kitchen was visited and the cook spoken with. The kitchen area was very clean. Cleaning schedules are being properly maintained. The cook and kitchen assistants are trained in food hygiene and their certificates are displayed. Stocks of food were observed to be satisfactory. The laundry was visited the member of staff here was aware and followed control of infection procedures. COSHH information was not displayed in the laundry room. Grounds and garden areas seen were being well maintained. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Numbers of staff employed in the home are sufficient to ensure the needs of the current residents are met. Good recruitment and selection procedures are in place. This ensures that staff have the skills and qualifications to care for the residents without placing them at risk. All staff receive a comprehensive induction training. This ensures that staff are equipped with the skills to meet residents needs. EVIDENCE: Duty rosters were checked over a four week cycle and numbers of staff were being maintained in line with the assessed needs of the residents. Staff on duty on the day of the visit were as specified on the duty roster. Staff spoken to said that staffing levels were being maintained. A relative spoken to said that there had been staffing problems in the past but that these had long since been resolved and now staffing numbers are good. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 18 Staff training records are well recorded. Statutory training for fire and first aid are good however moving and handling training is an outstanding requirement from the last inspection and has still not been achieved. Approximately 50 of staff in the home are NVQ trained and further training is organised. Staff spoken to in the home said they were happy with the amount of training provided by the company. The homes overall staffing establishment was checked and all posts are filled with the exception of one care staff of 22 hours each week. The shortfall for this is covered by other staff employed in the home. Two staff recruitment and selection files were read both of these were completed to a good standard with all appropriate checks in place. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is suitably qualified to manage and ensures that the service is run in the best interests of the people living there. Residents personal monies management is adequate and the records are in place to allow audits of these monies to be effective. Residents and staff are protected by safe working procedures in the home in line with company policy. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager of the home is an experienced nurse in working with the homes client group. She maintains her professional portfolio as required by the nursing council. She has two months left of the RMA to complete the course. Two relatives spoken to said the manager is approachable and acts on any problems identified. Relatives and staff meeting minutes were read agendas were appropriate and evidence was recorded of actions taken of issues identified. However the frequency of these meetings has been irregular the last relative meeting being approximately a year ago. Regulation 26 visit reports by a senior manager of the company were read and are good and carried out monthly. Monthly health and safety meetings are held the minutes show good content and actions taken where necessary to resolve issues. During the inspection the fire alarms were activated in the home, staff responded in an efficient and prompt manner to the homes procedures. The alarm was activated by a toaster and burnt toast nevertheless staff actions were appropriate and correct. Discussions with staff identified that supervision for staff is not being carried out at the specified levels of frequency. Staff supervision files also confirmed this. Home safety certificates were checked and all were satisfactory and correct. Residents personal monies management system was checked there was evidence of regular transactions taking place. Money balances were correct and a clear audit trail could be followed. However some entries only had one staff signature recorded. Relatives spoken to said they had encountered no problems regarding residents monies. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 21 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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 15.1 Requirement Resident care plans must be written to address all of their individual needs. Relatives must be consulted about the care records. Reviews of care needs must be properly structured. All care records must be dated and signed. Outstanding. Pressure area care assessments must be correctly completed. Residents identified as having dietary and fluid intake problems must have these care needs properly met. Menus in the home must state what is being offered each day for breakfasts. Sandwich ingredients must be specified. Alternative sweets for main meals must be stated. Records for the receipt of medications must be adequately maintained. Medicines when received must be recorded signed and dated. A weekly activities programme for residents must be carried out. Supervision of staff must take place every two months. DS0000000546.V335645.R01.S.doc Timescale for action 30/06/07 2. 3. OP7 OP15 15.1 16.2(i) 30/06/07 30/06/07 4. OP9 13.2 17/04/07 5. 6. OP12 OP36 16.2(n) 18.2 21/04/07 30/06/07 Beacon Farm Care Centre Version 5.2 Page 23 7. OP16 22.3 7. OP19 16.2© Outstanding. All complaints to the home must be fully investigated with a full response of the findings given to the complainant. Chairs identified in one of the lounge areas must be replaced as they are damaged. 30/04/07 30/06/07 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 OP33 OP35 Good Practice Recommendations Relative and staff meetings need to occur on a more regular basis than that at present. Residents personal monies records need to have two signatories for all transactions. Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Remington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Beacon Farm Care Centre DS0000000546.V335645.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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