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Inspection on 07/11/05 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 7th November 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.

What has improved since the last inspection?

Carolina Simmonds has now become the registered through the Commission to manage Beacon Hill Lodge. The home has implemented further training regarding incontinence and shortfalls identified at the last inspection have been rectified.

What the care home could do better:

Care staff working in the kitchen, preparing meals should complete food hygiene training. The medical room ceiling must be made good. The medication trolley is overstocked which makes it difficult for nurses to find boxed medication.

CARE HOMES FOR OLDER PEOPLE Beacon Hill Lodge Nursing Home 18 Beacon Hill The Downs Herne Bay Kent CT6 6BA Lead Inspector Tina Thomas Unannounced Inspection 7th November 2005 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 Hill Lodge Nursing Home DS0000026079.V261429.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 Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beacon Hill Lodge Nursing Home Address 18 Beacon Hill The Downs Herne Bay Kent CT6 6BA 01227 375536 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) Unique Help Group Limited Miss Carolina Simmons Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Terminally ill (5) of places Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the total of 30 beds 5 are also registered for Residential Care for Older People 31st May 2005 Date of last inspection 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 Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over a one day period. The inspector spoke with people that live in the home, care staff and management. All key standards have been assessed over this, and the Announced inspection of 30/06/05. The home has three requirements with timescales of 07/02/06. Two of these pertain to medication and one to training. 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 Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 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 the following standard(s): These standards were not inspected at this inspection. Standard 3 was assessed at the inspection of 31/05/05 as being met. The home does not offer the care described in Standard 6. EVIDENCE: Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 8 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 Service Users health, personal care needs, and social needs are set out in care plans. Service users health care needs are fully met. Standard 10 was assessed at the inspection of the 30/06/05 as being met. EVIDENCE: The inspector viewed care plans which clearly identified the needs of service users. There was a clear plan of action for staff to follow to meet these needs. Plans were signed by service users or their relatives, which showed that they had some involvement in developing the plan. They were suitably reviewed which ensures that information remains current. The plans are of good quality and holistic in nature, looking at the physical, psychological and social needs of the people who live in the home. The home has worked with the incontinence nurse to improve this area of care planning. Suitable risk assessments had been conducted and were well documented and reviewed, this ensures that people in the home are kept safe. The inspector spoke with the manager regarding the administration of medication. The home has a medication room, which is fitted with a sink, and fitted lockable cupboards. The inspector observed that the medication room Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 9 ceiling is water damaged and has been shoddily repaired. Requirement made regarding this matter.(Requirement 1 Part A) Medication is delivered by Boots in monitored dosage systems. The inspector observed that the trolley holding these medications has become too small for its purpose. Requirement made regarding this matter.(Requirement 2 Part A) The home has a purpose built controlled drugs cupboard. The inspector audited medication against the controlled drugs book and found it to be in order. All staff administering medication are trained nurses. Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 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 the following standard(s): Standards 12,13,and14 were not inspected at this inspection. At the inspection of 31/05/05 they were assessed as being met. Service users receive a wholesome appealing diet. EVIDENCE: The inspector was told by staff and service users that the food in the home is plentiful and of good quality. The inspector was concerned that care staff prepare meals of an evening without having training in food hygiene, this will be discussed more fully in Standard 38 and a requirement made. This practice could compromise health and safety. Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 11 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 Complaints are taken seriously and are immediately acted upon. EVIDENCE: The complaints record clearly shows that all complaints are acted on immediately and in line with the homes own complaints procedure. An adult protection issue referred to in the report of the inspection of 31/05/05 has now been closed and was found to be unsubstantiated, although some areas of poor practice were found. The home has now addressed these issues. Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 12 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): 19,21,23 Service Users live in a well-maintained environment. The home has suitable toilet and washing facilities. Service users have personalised their own rooms. Standards 20, 22, 24,25,26 were inspected at the inspection of 30/6/05 and were assessed as standard met. 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. Bathrooms were clean. Hot Water temperatures randomly selected from some baths and sinks were found to be within an acceptable range, and of a temperature that therefore ensures health and safety, and enables good hand washing practice by staff. The inspector viewed a number of service users rooms. They were individual and personalised, sometimes with furnishings bought from home. Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 13 One room had labels on drawers i.e. pants, pyjamas. The drawers did not hold the items stated and were for the benefit of the staff and not the service user. This practice is institutional and a recommendation has been made that this practice cease, without it is for the benefit of the service user and recorded in the care plan. Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 14 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): 29 The homes recruitment processes protect service users. The Standards 27,28,and, 30 were assessed at the inspection of 31/05/05 as being met. EVIDENCE: At the inspection of 30/06/05 a requirement was made, as the home did not have all the information in staff files that is required in Schedule 2 of the Care Home Regulations. The home did not have current photographs of staff. This has now been rectified. Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 15 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, 37,38 The registered manager is fit to be in charge of the home. Record keeping is of good quality. The health and safety of service users is generally promoted and protected, although it was identified as having been compromised in one area. EVIDENCE: The manager has completed a Registered Managers Award qualification. She is also completing a master’s degree and has become registered through the Commission. Generally, records were well maintained for example, risk assessments, accident book and visitors book. 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. Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 16 Care staff who prepare evening meals do not have suitable training they must have training to enable them to understand correct storage and preparation of food to avoid food poisoning, including labelling and dating of stored food. Requirement made regarding this matter. (Requirement Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 17 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 x 3 x 3 x x x STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x x x 3 2 Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 18 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. 1 2 Standard OP9 OP9 Regulation 13.4(c) 12.2 Requirement The ceiling in the medication room must be suitably repaired The home must ensure that the medication trolley is fit for its purpose. I.e. of a suitable size, or organised in a manner to allow safe practice. The home must ensure that staff dealing with the preparation of food have adequate training Timescale for action 07/03/06 07/02/06 3 OP38 23.5 07/02/06 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 OP23 Good Practice Recommendations The practice of labelling service users drawers should cease, without it is in the best interest of the service user and suitably recorded in that persons care plan. Beacon Hill Lodge Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Kent and Medway Area Office 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 Nursing Home DS0000026079.V261429.R01.S.doc Version 5.0 Page 20 - 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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