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Inspection on 31/05/05 for Beacon Hill Lodge Nursing Home

Also see our care home review for Beacon Hill Lodge Nursing Home for more information

This inspection was carried out on 31st May 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service creates a clean and homely environment in which to live. Nutritional needs are very well monitored by the care and kitchen staff. Particular attention has been paid to people who have difficulty in eating or maintaining weight.

What has improved since the last inspection?

Student nurses now have placements at the home. They are supernumerary.

What the care home could do better:

Incontinence care must be more clearly monitored. Staff files must hold all the information that is stated in schedule 2; some files did not have photographs of staff. The home must keep clear records of possessions handed over for safe keeping, in line with their own policy.

CARE HOMES FOR OLDER PEOPLE Beacon Hill Lodge 18 Beacon Hill The Downs Herne Bay Kent CT6 6BA Lead Inspector Tina Thomas Announced 31/05/05 & 01/06/05 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 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 Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Beacon Hill Lodge Address 18 Beacon Hill, The Downs, Herne Bay, Kent CT6 6BA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01227 375536 Unique Help Group Ltd Registered Care Home 30 Category(ies) of Care Home for Older People registration, with number of places Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 06/09/04 Brief Description of the Service: Beacon Hill Lodge is a detached Victorian building. It faces the Downs and the sea. The Home is registered for a total of thirty beds. The Home has twenty single rooms and five double rooms. Most rooms have en-suite facilities. Some rooms have sea views. The Home has a large lounge and separate dinning rooms. The Home has a passenger lift. All rooms have a TV point, nurse call alarm and telephone point. The Home has parking space for guests at the front of the Home. Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Unique Help Group has been recently purchased. The new Registered Individual is Mr K Rajakathan. Letters have been sent to relatives to inform them of the change. The Manager verbally informed people that live in the home of the changes. This was an announced inspection that was conducted over a two-day period. The inspection was conducted with the assistance of the Manager Carolina Simmonds and the new area manager Eileen laherty. On the day of inspection there were 25 people living in the home. What the service does well: What has improved since the last inspection? 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 Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 7 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 standard(s) 3,4,5 People have their needs assessed and can be sure they can be met. People have the opportunity to visit to assess the quality of facilities and suitability of the home. EVIDENCE: As previously mentioned in the summary Unique Help Group has been bought by a new owner. Insufficient time has elapsed for the new owner to prepare an updated Statement of Purpose or Service User Guide. The area Manager expressed that this would occur soon. Service Users only move into the home after having a comprehensive, holistic assessment, conducted by the Manager or on some occasions, another manager within the group. The assessment looks at health care, psychological and social needs. Someone who had recently moved to the home expressed that their relatives had chosen the home initially, because they believed it could meet the person’s needs. The relatives had visited the home first, and then taken the Service User Guide to the person selecting a home, before the person themselves visited the home to make a final decision. Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 8 The Home does not offer intermediate care Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 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 standard(s) 7,8,10 Service Users health, personal care needs, and social needs are set out in a care plans. Some areas need improving, to ensure health care needs are met. Service Users feel they are treated with respect and their right to privacy upheld. EVIDENCE: A selection of care plans were viewed. One Service Users care needs have changed and a variation has been applied for. One Service user has a pressure area, which they had when they went to the home. The care given for this was thoroughly recorded and monitored. Recording regarding incontinence care is insufficient. Requirement made regarding this matter. (Requirement A Part 1) People that live in the home said that the staff were very polite and called them by their preferred name. They said that staff always knock on the door. Nutritional screening is very good and is a joint effort between care staff and kitchen staff. The inspector viewed a letter from a dietician reflecting that for one service user the cook had made an excellent job of fortifying meals. Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12,13,14,15 Service Users social, cultural, religious and recreational needs are met. The visitor’s book shows that people who live in the home maintain contact with their family and friends. EVIDENCE: People who live in the home are helped to exercise choice and control over their lives. People who live in the home expressed that they could go to bed and get up when they wanted, wear what they wanted and eat what they wanted. Service users receive a wholesome and balanced diet. Food was of good quality and plentiful. Staff assisted people who needed help to eat, in a discreet and unhurried manner. The cook seeks information from the Food Commission weekly. The Home employs an activities coordinator for ten hours a week. On the day of inspection several service users and the activities coordinator were playing chess. Some people play scrabble or cards with the activity co-ordinator. The Home organises a bus trip every other week. Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 11 Some people belong to clubs that they belonged to before entering the home, and go to these independently. The Home has a visitor’s book, which indicates that visitors come and go at a variety of times. People at the home expressed that they could get up and go to bed when they wished. People at the Home expressed that they made choices regarding the clothes they wear, and the food they eat. The Home looks after the pocket money of 17 Service Users. The inspector observed that the system was sound. Two peoples records were randomly chosen and checked against the amount of money held. On both occasions the money suitably corresponded with the records. People that live in the home have regular meetings. These are recorded and action. On average about twelve people that live in the home attend these meetings. They discuss things such as the accommodation, staff, activities and catering. Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 12 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 standard(s) 16, 18 Sometimes Service Users and their relatives do not feel confident that their complaints will be listened to, taken seriously and acted upon. EVIDENCE: The Home has an adult protection issue that is currently being investigated. A past Service User’s relative brought it to the attention of the Commission. The Home has had two formal complaints since the last inspection, which have been well documented and investigated. All staff have had prevention of abuse training. All staff will be having updates in June 05. The Home has a whistle-blowing policy. Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 13 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 standard(s) 19,20,21,22,24,25,26 Service Users live in a well-maintained environment with access to indoor and outdoor communal facilities. The home has sufficient lavatories and washing facilities. Specialist equipment is in a place to maximise service users independence. Service users have comfortable bedrooms, which are personalised. The home is clean and pleasant. Staff despite having adequate training, engage in activities that could result in Service Users health and safety being compromised. EVIDENCE: Décor and furnishings in the home are of good quality, both in communal rooms and people’s own rooms. People that live in the home have personalised their own rooms, some have bought items of their own furniture. All bedrooms have locks and people can use their keys if they choose. The Home has a garden, with garden furniture so that people can enjoy the outside space. Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 14 Bathrooms were clean. Hot Water temperatures randomly selected from some baths and sinks were found to be within an acceptable range. Cleaning equipment was left unattended in the corridor, despite the cleaner having had COSHH (control of substances hazardous to health) training. This could potentially compromise the health and safety of people that live in the home. The Manager addressed the situation immediately. The Home has specialist equipment so as to maximise independence, examples would be hoists, and toilet raisers. The home was clean ad odour free. The home has a laundry in the grounds, which is used, by all homes within the group. Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28, 29,30 Service Users needs are met by the numbers and skill mix of staff. Staff are suitably trained. Recruitment policy and practices must be adhered to, so as to ensure service user safety. EVIDENCE: Information on staff, held by the home, was not sufficient to meet all parts of Schedule 2 of the Care Home Regulations. The Home must hold a recent photo of all staff. Staff files that were viewed did not have photographs. Requirement made regarding this matter. (Requirement 2 Part A). Files of trained staff did not hold information regarding the status of their current registration with the Nurses and Midwifery Council. The Manager considered that the staffing numbers were currently high. The staffing rota confirmed this. People that live in the home expressed that their needs were met in an unhurried manner. Staff confirmed this. All care staff have an induction, which is in line with TOPSS. Staff receive mandatory training, which is updated as frequently as required. The Home also has a selection of other training it offers staff The Home has fifteen carers, 5 are trained to N.V.Q Level 3, and 2 are trained to N.V.Q Level 2. All staff has Criminal Records Bureau checks prior to starting work. Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33, 34,35,36, 37,38 The management of this home is satisfactory overall. Most records are well managed ans service users’ financial interests are safeguarded. The health, safety and welfare of service users and staff are promoted and protected. Staff records, recording of possessions for safe keeping and one area of care planning must be improved. EVIDENCE: The manager is currently completing a Registered Managers Award qualification. She is also completing a master’s degree. Staff agreed that the Manager had an open approach. The manager is in the process of registering with the Commission. Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 17 The home has policies in place to protect the best interests of the people that live in the home. These have recently been updated. The home has policies regarding the safe keeping of service users money. Records were cross-referenced and found to be correct. One record regarding Service Users valuables was not dated, was not descriptive enough and was not in-line with the homes own policy. Requirement made regarding this matter (Requirement 3 Part A). Conversation with staff, and staff records confirmed that care staff received regular, formal supervision from the manager. The manager has conducted environmental risk assessments to ensure as far as is reasonably the health and safety of people that live in the home. The home has current and adequate insurance cover. Generally, records were well maintained for example, risk assessments, accident book and visitors book. As previously mentioned in the report staff files and one area of care planning must be improved. Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 3 3 x 3 2 3 3 2 Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 19 NO Are there any outstanding requirements from the last inspection? 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. 2. Standard 8 29 Regulation 12 Schedule 2 schedule 4.9 Requirement Incontinence care must be more closely monitored The home must hold information on staff working in the care home which is line with Schedule 2 clear records must be kept of possessions haded over for safe keeping. Timescale for action 01/07/05 01/07/05 3. 35 01/07/05 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 Good Practice Recommendations Beacon Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Hill Lodge H56-H05 S26079 Beacon Hill Lodge V222740 310505 Stage 4.doc Version 1.30 Page 21 - 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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