CARE HOMES FOR OLDER PEOPLE
Beaconsfield Court Care Home Galgate Barnard Castle Durham DL12 8EX Lead Inspector
Belinda Parker Announced Inspection 6th December 2005 09:00 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.V257841.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. Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 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 01833 637694 beaconsfield@highfield-care.com Southern Cross Home Properties Limited Mrs Olive Carter 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.V257841.R01.S.doc Version 5.0 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 Purp 8th June 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 who may require 24hr nursing care. It is owned by Southern Cross Homes Properties Ltd and operates within the private sector. The home is located in 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. Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place on 6/12/05 over a period of 6 hours. During the inspection we spoke to service users and staff. A number of records were examined. At the moment temporary management arrangements are in place in the absence of the permanent manager. Two of the three requirements made at the last inspection have been met. What the service does well: What has improved since the last inspection? What they could do better:
The manager must start a formal programme of supervision for all staff. It is important that staff have the opportunity to discuss with their line manager their role of responsibility. And ensure they have the appropriate skills and abilities to provide a good service to the people who live in and visit the home. The manager must ensure staff responsible for receiving medication into the home follow the correct procedure. To ensure the protection of service users. A service user with special dietary needs said, “ The food is repetitive, and I don’t always know the choices”. “ I have a set of menu’s, but the staff do not tell me what menu week it is”. “ I would like to see more soft fruit on the menu, like stewed apple or rhubarb”. The manager should ensure staff support service users who require assistance with choosing meals of their choice and tastes Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 Page 6 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. Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 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.V257841.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2, 3, 4 and 5 The admission process for prospective service users and their relatives is clear. Information is available on the service offered which assists prospective service users to make an informed decision as to whether they wish to come and live in the home. EVIDENCE: A Statement of Purpose and Service User Guide is in place. The company is currently reviewing and updating these documents. Ensuring people living in the home and prospective service users have clear and informative information about the service offered. Comprehensive pre-assessment documentation is in place. The manager said prospective service users, their family and other health professionals are involved in this process. The manager said prospective service users are only admitted to the home if they have the capacity to meet their individual needs.
Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 Page 9 The manager said prospective service users and their family are invited to visit and spend time in the home. This provides them with the opportunity to make an informed decision as to whether they wish to move in. Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 8, 9, 10 and 11 The home promotes the health of service users. But the manager must ensure that staff are aware that if all procedures involving medication are not followed, service users could potentially be put at risk. EVIDENCE: Four care plans examined contained information to show that the health needs of service users was being met. An audit of medication showed that handwritten entries on MAR sheets were not being signed by the staff member responsible for receiving the medication into the home. The correct procedures must be followed to ensure the protection of service users. During discussion staff demonstrated that they treat service users with respect when assisting them with personal care. A service user said, “ The staff are good and helpful, but are very busy all the time”. Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 Page 11 A policy and procedure is in place for death and dying. Staff spoken to during the inspection said they would respect the wishes of the service user and their relative. The manager said in the event of serious illness or dying family members if they so wish can stay overnight with their relative. Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 13, 14 and 15 Flexible visiting arrangements are in place. Service users can make choices as to whom they wish to speak on their behalf. The dietary choices and food presentation for service users who require special diets should be discussed with them by staff on a daily basis. EVIDENCE: The manager said visitors are welcome in the home at any time. A service user spoken to said her relative visits regularly and is made welcome by the staff. The home provides service users with information on advocacy services. This provides service users with a choice if they wish for someone independent to speak on their behalf. A service users spoken to who required a soft diet said, “ The food is repetitive, and I don’t always know the choices”. “ I have a set of menu’s, but the staff do not tell me what menu week it is”. “ I would like to see more soft fruit on the menu, like stewed apple or rhubarb”. The manager during discussion said she would ensure staff discuss menu options with service users who require support when making choices of food.
Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16, 17 and 18 The home has clear policies and processes in place to ensure service users rights are upheld and that they are protected from harm or neglect. EVIDENCE: The home has a clear complaints procedure in place to enable service users to make their views known. Since the last inspection there has been one complaint (Housekeeping issue). The complaint and outcome were recorded. Service users rights are protected. Arrangements where put in place during the recent General election to enable service users to participate in the electoral process. Evidence was available to show that many staff had attended POVA training during the year. This ensures staff have an awareness of dealing with abuse and the protection of the people who lived in the home. A staff member spoken to had limited knowledge of POVA. But said she would attend the next available course, as she realised the importance of protecting the people who live in the home from harm or neglect. Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This standard section was not assessed at this inspection. Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 28 and 30 The provider ensures staff are equipped with the skills and abilities to deliver a good standard of service to the people who live in the home and other visitors. EVIDENCE: The manager said the home is continuing to work towards 50 of care staff achieving NVQ2 in Care. The manager said the home was awaiting further funding for more care staff to commence this course. Training records for staff were viewed. All mandatory training had been carried out during the year. The manager said this is a continuing process for new staff and staff that been unable to attend previous courses. Both staff members spoken to said training was important to develop their skills. This training enabled them to deliver a good level of care service to the people who lived in the home. Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 35 and 36 Appropriate temporary management arrangements of the home is in place to ensure the comfort and care of service users is maintained. Staff have not received 1-1 supervision for some time. This needs to be addressed with all staff, to maintain good quality consistency of care for the people who live there. EVIDENCE: Due to the absence of the manager. The company has put in place appropriate temporary management arrangements. To ensure the smooth running of the home for the comfort and consistency of care for the service users who live there. Money held on behalf of service users by the home is recorded electronically. Service users can have access to a statement of their account if they so wish. Service users have access to their money without restriction.
Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 Page 17 Arrangements for formal supervision of staff remains outstanding since the last inspection. The temporary manager said she will implement this process in the new year. The manager realises it is important to discuss with staff their role of responsibility and development. To ensure they have the skills and abilities to provide a good service to the people who live in the home and other visitors. Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 X X X X X X X X STAFFING Standard No Score 27 X 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 1 X X Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 Page 19 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. Standard OP9 1 Regulation 12,13 Requirement The manager must ensure all medication where a handwritten entry is made on the MAR sheet for individual service users. Is signed by the staff member responsible for receiving the medication into the home. The manager must implement a system of formal supervision for all staff. Timescale for action 06/12/05 2 OP36 18 31/01/06 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 2 3 Refer to Standard OP15 OP28 OP18 Good Practice Recommendations The manager should ensure that staff explain meal choices to service users daily and support service uses with choice where a special diet is required. The manager should continue to pursue additional funding for all care staff to achieve NVQ2 in Care. The manager should make arrangements for all staff to attend a POVA course. Beaconsfield Court Care Home DS0000000693.V257841.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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