CARE HOMES FOR OLDER PEOPLE
Beaconsfield Court Care Home Galgate Barnard Castle Durham DL12 8EX Lead Inspector
Mr Stephen Ellis Unannounced Inspection 11th December 2006 1:30 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 Beaconsfield Court Care Home DS0000000693.V320967.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. Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Beaconsfield Court Care Home Address Galgate Barnard Castle Durham DL12 8EX 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) 01833 637694 P/F Beaconsfield@schealthcare.co.uk Southern Cross Home Properties Limited Mrs Anne Elizabeth Evans Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32), Physical disability (4) of places Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Up to 4 persons above the age of 55 may be accommodated within the category of Physical Disability (PD) commensurate with the home’s Statement of Purpose. 6th December 2005 Date of last inspection Brief Description of the Service: Beaconsfield Court is a registered care home with nursing, providing personal care and accommodation for up to 32 older persons, some of whom may require continuous nursing care. It is provided by Southern Cross Homes Properties Ltd and operates within the private sector. The home is located near to the centre of the market town of Barnard Castle, close to local amenities. The home is a three-storey building, situated in its own private, well maintained grounds. Personal accommodation and communal space is located on all floors. Service areas are located on the ground floor. There are 30 single bedrooms and one double bedroom. Sixteen bedrooms have en suite toilets and wash hand basins. All bedrooms are suitable for wheelchair users. These are all fairly spacious rooms. The weekly fees vary between £364.50 and £521 (plus a free nursing care element, where continuous nursing care is required). The fee covers all accommodation, meals and personal care (plus nursing care for those residents in receipt of continuous nursing care at the home). Hairdressing, toiletries, newspapers, plus services from private opticians, dentists and chiropodists are not included in the fee. The actual amount people pay will depend upon their individual circumstances. Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 hours. It included a tour of the building, examination of a number of records and discussions with 9 residents, 2 relatives and 5 staff. Comments were also received from 5 service users via questionnaires. The overall quality rating for this care home is: ‘good’. This judgment has been made from evidence gathered both during and before the visit to this service. What the service does well:
Residents said they were satisfied with the care and facilities provided. Typical comments included “They’re all so kind and caring…I wish I’d come in sooner…staff are very helpful…the staff are fine…I think it’s alright here; we get good meals, good attention and, when you’re poorly, staff are very good.” They liked their rooms and several residents said they had enjoyed the recent social and recreational activities leading up to Christmas, including carols from local school children, visiting entertainer, party and baking sessions. Positive comments were also received from relatives and visitors to the home, such as “I can visit anytime I want to…the staff are friendly and helpful and the health care arrangements are quite satisfactory…my mother-in-law can have whatever she wants to eat…her lifestyle is better here; she thoroughly enjoyed the Christmas party; I think she loves the company and the various activities on offer.” Most residents said they enjoyed the meals and felt their preferences were well catered for. Residents get on well with the staff and would not hesitate to discuss any concerns or complaints with staff or management. They described a cheerful, happy environment. The home has lounges and dining rooms on each floor, which allow residents to meet in groups of various sizes for a number of social and recreational activities. The home is generally well maintained. Staffing levels and staff training are good. It is anticipated that over 76 of care staff will have achieved National Vocational Qualifications (NVQ) in Care by March 2007. There is a friendly, welcoming atmosphere. Management are keen to receive comments from residents and others about the quality of service provided by the home. The service is well run and the information provided to residents and prospective service users is detailed and explicit. Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Beaconsfield Court Care Home DS0000000693.V320967.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 Beaconsfield Court Care Home DS0000000693.V320967.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): 1, 2 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information needed to choose a home that will meet their needs. They have their needs assessed and a contract which tells them about the service they will receive. EVIDENCE: Comments received from residents and relatives confirmed that full assessments of needs were carried out prior to admission to the home. They said there was enough information from which to make a choice about being admitted. A service user’s guide and statement of terms and conditions of residence are supplied routinely. These are helpful documents and the content is detailed and explicit. Care plans revealed comprehensive, detailed assessments of need being carried out both prior to admission and afterwards, as confirmed by members of staff and management. These assessments showed that the home only admitted people whose assessed needs it could meet. Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Residents said that they believed their health and social care needs were well known by staff and were being fully met. They said that the home’s nursing staff or community nurse or doctor would see them whenever required. Their personal and social care needs were known, understood and respected by the staff team. They said that they felt they were treated with respect and sensitivity. Typical comments included “They’re all so kind and caring…I wish I’d come in sooner…staff are very helpful…the staff are fine…I think it’s alright here; we get good meals, good attention and, when you’re poorly, staff are very good.” This view was reflected in the relatives’ comments: “I can visit anytime I want to…the staff are friendly and helpful and the health care arrangements are quite satisfactory.” Another relative said: “My mother in law
Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 Page 10 was admitted 2 months ago. The difference in her condition is amazing, how she has picked up. I’m really pleased with the way she has thrived in here.” Care plans were detailed and comprehensive about service users’ health and social care needs, providing clear guidance to staff. They were subject to regular review, in keeping with National Minimum Standards. Staff training in Care (for example, National Vocational Qualifications (NVQ) at levels 2 and 3) has included the important issues of privacy and dignity and 76 of care staff are expected to have completed NVQ in care by March 2007. There are good arrangements for the safe administration of medicines. All staff members responsible for medicines have completed Safe Handling of Medicines training. There is good support from a local Pharmacist who supplies most of the medication in monitored dosage blister packs. There are good storage systems and staff thoroughly check all medication when it is received into the home. The home requires medication to be administered only from the container(s) into which the pharmacist dispensed it originally. Medication is kept securely in lockable cabinets and trolleys. Residents may attend to their own medication, but in practice most prefer to delegate this responsibility to staff. Unwanted medicines are returned promptly to the Pharmacist and/or sent for waste disposal using a licensed agency. The home is careful not to stockpile large quantities. Senior staff confirmed that medicine audits are carried out routinely and that the local pharmacist provides consultation and advice. Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet residents’ expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Residents said they enjoyed living at the home and got on well with the staff. All described the staff as being kind and helpful. Typical comments included: “I’ve found it quite alright myself. We get good meals, good attention and when you’re poorly, staff are very good. They sit us up and take good care of us. They’re very nice and the matron is lovely. I really enjoyed the recent Christmas party.” Another resident said “The care here is very good. They do their best. The meals are good…they cater for your preferences”. They confirmed that they could choose how they spent their time in the home and were free not to join in activities and social events if they did not wish to. A part-time activities organizer (20 hours per week) is due to start on 8th January 2007. In the absence of the previous activities organizer, two members of staff have taken the lead in arranging social and recreational activities, including baking, crafts, carol singers from a local school, visiting entertainers, occasional outings to places of local interest, and a Christmas
Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 Page 12 party. Residents, relatives and staff confirmed that relatives and friends may visit at any reasonable time and are always made welcome. Most residents said they liked the meals at the home. There was a good choice of menu and residents’ preferences were catered for wherever possible. Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a robust, effective complaints procedure and are protected from abuse. EVIDENCE: All residents and relatives said that they were confident about approaching staff and management about any concerns or complaints they might have. They described the staff and management as being very approachable, helpful and friendly. A written complaints procedure is provided in the statement of purpose and service user’s guide. Staff and management are aware of the need to safeguard adults from abuse or neglect and most have undergone training in these issues. Further training is planned for January 2007. They are aware of the home’s ‘whistle blowing’ policy, which encourages staff to speak out about any suspected abuse. All staff members have had enhanced Criminal Records Bureau (CRB) checks and Protection of Vulnerable Adults (POVA) checks carried out as required by law. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to ensure that unsuitable people are not employed to care for vulnerable adults. Staff confirmed that new staff members go through induction and foundation training so that they have the right knowledge and skills to do their jobs competently. Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, wellmaintained and comfortable environment, which encourages independence. EVIDENCE: There were no unpleasant odours and the home was found to be clean in all the areas inspected. All nursing and care staff members have completed training in health and safety, fire safety, food hygiene and infection control. Residents said that they were pleased with the premises, finding them comfortable and homely as well as practical. They also described the home as being clean. The home is well maintained with repairs and servicing being carried out promptly and according to schedule. New boilers were installed in October 2006. Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. EVIDENCE: On the day of inspection, there were 31 residents being accommodated, including 14 in receipt of continuous nursing care. Residents and relatives said that they got on well with staff and most felt that there were sufficient numbers of staff to meet their needs. This view was reflected in staff comments. Staff morale was reported to be good. During the day (8am to 8 pm) there is one nurse on duty, plus 6 carers. In addition, there is a dedicated activities organizer (20 hours) who works 4 days per week. The registered manager is also a registered nurse and is full time, Monday to Friday. The home employs an administrator (24 hours per week). A part time maintenance man is available each weekday (20 hours) and there are dedicated catering and domestic staff deployed in sufficient numbers for the needs of the home. At night, there is one qualified nurse and 2 carers on duty. A comprehensive staff training and development programme is in operation. Staff confirmed that they had undergone induction and foundation training. Over 76 of care staff are expected to have completed National Vocational Qualifications (NVQ) in care at level 2 or 3 by March 2007. Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: The registered manager is experienced and competent in her role. Residents, relatives and staff spoke well of her leadership skills and commitment to good outcomes for residents. She was described as being approachable and caring. She aims to complete the Registered Manager’s Award at NVQ level 4 during 2007. Staff confirmed that they participate in regular supervision sessions, as recorded in individual staff files. The manager has planned a full programme of staff supervision sessions for 2007. Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 Page 17 Good accounting procedures are followed, with receipts and signatures obtained for all financial transactions involving residents’ personal monies, in which the home is involved, wherever practicable. Relatives look after the personal monies of many residents. In those situations where the home looks after residents’ monies, such as personal allowances, clear individual records are maintained. Comments received from staff and management confirmed that there are good health and safety policies and practices that promote the health, safety and welfare of residents and staff. All staff members do refresher training in Health and Safety, such as moving and handling, fire safety and food hygiene. This helps reinforce the registered provider’s written policies on Health and Safety. Health and Safety issues are also discussed at regular staff meetings and in staff supervision sessions. Residents, relatives and staff expressed satisfaction with the way the home was run and the good standards that were evident in many instances. They said they believed the home was safe and run in the best interests of residents. For example, there is a annual survey of residents’ satisfaction carried out and the findings are reported within the home. The registered provider’s representative visits the home frequently to check on the welfare of residents and the progress of the home. The manager routinely invites comments and suggestions for improvements from both residents and visitors to the home, via regular meetings, surveys and consultations. Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP31 Good Practice Recommendations The registered manager should try to complete the Registered Manager’s Award during 2007. Beaconsfield Court Care Home DS0000000693.V320967.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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
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