Inspection on 13/01/06 for Beaconville Nursing Home

This inspection was carried out on 13th January 2006.

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.

Other inspections for this house

Beaconville Nursing Home 03/03/08

Beaconville Nursing Home 10/01/07

Beaconville Nursing Home 01/06/05

Beaconville Nursing Home 05/01/05

Beaconville Nursing Home 13/07/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Beaconville Nursing Home Beacon Road Ivybridge Plymouth PL21 0AQ Lead Inspector Doug Endean Unannounced Inspection 13th January 2006 10:10 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 Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 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. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beaconville Nursing Home Address Beacon Road Ivybridge Plymouth PL21 0AQ 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) 01752 896505 01752 895418 a.taylor@21stcenturycare.co.uk www.21stcenturycare.co.uk 21st Century Care (Plymouth) Ltd Anne Taylor Care Home 35 Category(ies) of Dementia - over 65 years of age (35), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (35) Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Registered for max 35 DE(E) service users 65 years and over. Registered for max 35 MD(E) service users 65 years and over. Over 65 years of age Date of last inspection 1st June 2005 Brief Description of the Service: Beaconville Nursing Home is a large detached building (originally two large houses) within its own walled grounds and is in close proximity to the town centre of Ivybridge, on the edge of Dartmoor National Park. It has an extension to the rear and side of the main house that provides additional single and double room accommodation at ground and mezzanine floor levels. There are twenty-seven single rooms, three with en-suites and three double rooms. The home has good provision of services for people with physical disabilities such as Parker baths, hoists and a shaft lift from the first to the mezzanine floor. Several steps are encountered to progress further to the 1st floor. The homes primary registration is to meet the needs of elderly people with a dementia or mental disorder, and the trained nursing staff, employed at the home, are skilled at this. They supervise a team of Social Care staff of multicultural origins who are also trained to meet the individual needs of the Service Users living at the home. The design of the home provides two lounge’s and two dining rooms where recreational activities can take place in addition to their main functions. Several of the Service Users rooms are very large providing space well above the required standard. A hotel style kitchen produces the meals for all the Service Users. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report should be read along side of the previous report in order to establish the homes performance against the National Minimum Standards during this inspection year. The unannounced inspection began at 10.10 hours and lasted a total of three hours. During this time the inspector observed the interactions between staff and clients in the course of providing personal and social care. He also spent time in discussion with the Registered Manager and Registered Person who was attending the home, a regular visit. The homes policies and procedures were seen and other written and computerised information was shared to demonstrate how the home is progressing. Five staff files were read and three client files were also viewed. During the tour of the home the inspector spoke with three members of staff and several clients. The communal areas were visited as well as bedrooms, bathrooms and the homes kitchen. What the service does well: What has improved since the last inspection? There have been some physical changes to the home as it going through upgrading. Bathrooms are being re-designed and equip to meet the needs of the clients and the office has been totally changed and now provides space for several people to meet and discuss care and management issues having the records at hand. The home has also employed a Office Administrator who works in the home and deals with tasks that allow the Registered Manager more time for clinical issues. In order to develop the office to this extent the medicine storage room has now moved and it provides secure storage facilities. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 6 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. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 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 Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 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): 1, 2, 4 & 5. There are very good levels of information made available to prospective clients or their advocates upon request. The information gathered by the skilled staff on each client is of value in planning their care and is well recorded in the clients “Life Cycle” records. The home is well equipped to provide specialist care to the primary group of people it aims to care for. EVIDENCE: The home has developed their provision of information in several ways that collectively provide a large degree of information to anyone seeking it. There is a Statement of Purpose and Service users guide that were seen by the inspector during this inspection. He also saw a copy of the homes brochure. Each of these items are available at the home or via the post to any interested party. In addition to this the home has developed a website that provides immediate information to the reader including a downloadable brochure. A further development of this site has provided information on employment with a downloadable application form should it be required. Also built into the website is a direct link to the Commission for Social Care Inspection site where the reader can access the inspection report about this and other homes. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 9 The clients record file is named the Service Users “Life Cycle” and holds yet more information that is either given to, or sent to, the prospective client or their advocate. This includes Care Aware information such as their advocacy service, the Office of Fair Trading information entitled “Fair Terms and Conditions” and the Age Concern on “guidelines for referrals”. Further to this the contract/terms and conditions of residency are also held in the Life Cycle and the inspector read it and found that it holds all the detail expected of it by the National Minimum Standards and the Regulations. The website has a link directly to the Commission for Social Care Inspection website where the past inspection reports for the home are found. All of this was demonstrated to the inspector by the Registered Person and the Registered Manager during the inspection including the breakdown in funding and information about trial periods. All the clients are visited and assessed prior to any agreement regarding admission to the home. This may be at the clients own home or hospital. Clients can visit the home prior to any decision to stay if this is a practical thing to do. The home does not accept emergency admissions. The home provides an atmosphere where clients are treated with dignity and respect whilst delivering both personal and nursing care. The clients are mainly local people but there are people whose origins are form other countries in Europe and the staff were observed to communicate well with one person, learning words from his native language to improve understanding and relationships with him. The trained nurses have appropriate experience of managing this client group and assessing their individual needs both physical and psychological. They are helped in the task by a multicultural, multi-skilled group of care staff. Where specialist equipment is required the home has this available to them such as disabled bathing facilities, hoists and other aids. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 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): 7, 9 & 11 The staff are collectively skilled to meet the needs of the clients at the home and have good access to up to date reference material. The homes approach to the care of the dying is good and does take into account the needs of the client, their relatives and the staff. EVIDENCE: In addition to the care plan information that was fully reported upon during the last inspection the staff have a quick reference regarding the moving and handling needs of each of the clients on the notice board in the dining room that uses the traffic light method of identifying the level of risk. There is a policy and procedure relating to the care of clients who are dying that covers pain control, the needs of the relatives and the staff and primarily the importance of treating clients with dignity and respect. This, as with other policies and procedures, has been written by the home with its individual clients in mind. The clients care plans were again looked at and the standardised care plan dealing with dying was read by the inspector who felt it was well written and easy for everyone to follow. The home has moved its medicine store to a more appropriate area that was inspected and found to be suitable for the task and having a satisfactory level Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 11 of security. The drug handling and recording tasks are the responsibility of the registered nurses and the inspector observed that they follow the professional guidance in completing these tasks. There are reference information relating to the drugs that the General Practitioner prescribe to the clients for the nurses to read and the home has a broadband internet connection for the staff to obtain up to date information should they need to do so. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 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): 12 The home provides many suitably varied activities for the clients that meet the individual clinical and social needs as well as that of the home as a community. EVIDENCE: The notice board in the dining room displayed a full calendar of varied activities for the month of January. There was a singer and organist performing for the clients in the lounge during the morning who were involving the clients in this activity with the help of the care staff. The Life Cycle records information about the past interests of individual clients that helps the staff to decide what maybe interesting to them by way of activities. The Friends of Beaconville (an active relatives group) are also able to pass comment on activities that may be provided at the home. Some of the activities are aimed at being therapeutic in that they stimulate memories for the clients who do suffer from short and long term memory problems as a result of dementia. Meals are provided that satisfy the individual needs of the clients in an unhurried way as was observed by the inspector during his tour of the home. The staff were observed speaking to one client from an Eastern European country in his own language (to some degree) so as to improve the communication and relationship with him. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 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): 16 & 18 The homes complaints procedure, recruitment procedure and adult protection procedures are adequate in providing measures to identify and deal with problems relating to any area of abuse. EVIDENCE: All visitors are asked to sign in and out when they visit the home in the book provided at the entrance. There is a complaints procedure displayed at each of the two entrances to the home that does have clear information including how to contact the Commission for Social Care Inspection should this be necessary. Each copy of the Life Cycle also has a copy of the complaints procedure. The homes record of complaints is held on computer and includes the way the complaint was investigated and resolved. The Commission for Social Care Inspection has not received any complaints about the home in this inspection year. The notice board at the main entrance of the home hold many letters and cards complimenting them for the care they have provided and the Registered Manager showed the inspector many more that she has. The home has several Care Aware leaflets that they give to advocates of the clients including one relating to Advocacy. The staff have access to a whistle blowing policy when recruited and there is one in the policies manual. Staff have also had training in adult abuse and have policies and procedures to follow that are accessible to them in the home. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 14 The staff “life cycle” procedure also covers the issue of protection using the Protection of Vulnerable Adults document and ensuring that a Criminal Records Bureau checks is completed before staff are able to work unsupervised. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The homes approach to providing security for clients rooms is a sensible and sensitive one and is clearly recorded in each of the clients Life Cycle file. The bedrooms look comfortable and homely yet still provide an adequate environment for the practical tasks caring to be achieved. EVIDENCE: In each of the clients files the home has a risk assessment that relates to the provision of locks for doors and cupboards and keys for the clients. Samples of these were seen by the inspector during this inspection. The risk assessment makes a statement clearly identifying why keys have not been provided to individuals. There are lockable cupboards within the clients bedrooms. At the present time no client has been provided with a key to their bedroom door. The bedrooms are of suitable size and shape for the care that is generally provided to the clients at the home. Each room is adequately furnished by the home and many were seen to be personalised using possessions that the clients have brought into the home. Floor coverings vary according to the needs of the clients with there being a predominance of carpets to most Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 16 rooms. There are some double rooms and these have privacy screens provided so that personal and nursing care can be provided whilst preserving the privacy and dignity of the clients. Where it is needed a height adjustable bed has been provided for the client. Many of these are of new and of modern design that look more comfortable and domestic in appearance, and less institutionalised than a “hospital bed”. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 & 30. The homes recruitment procedures are satisfactory and when followed do provide protection to the clients thought the employment of suitable staff. EVIDENCE: The home has a commitment to training that is ongoing and now includes a Fire Training DVD that they have had made themselves that is personal to the home itself. The inspector saw a list of the staff who have seen this DVD and also completed the exam that the home has produced to verify that the staff have understood what they have seen. The homes policies and procedures are held in the office and also on computer, password protected, for staff to read and act upon. The homes recruitment procedure includes them obtaining references and a Criminal Records Bureau check for each staff member. There are some overseas staff employed at the home for which the home holds work permits. These were viewed by the inspector during the process of looking at staff files. All of the information that is gathered is held in staff files and their Life Cycle file. The inspector read three staff files as a sample number and found them to be satisfactory in that they held suitable amounts of information and identity checks as well as evidence of all the training such as Registered Nurse certificates, manual handling and infection control training. The homes website also holds recruitment information and a downloadable application form. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 18 The number of staff in the home that hold National Vocational Qualification in care does not yet reach 50 but the home have provided a good level of other training for staff as has been commented upon. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 36 & 38. The home has taken measures to meet the safety and welfare of the clients through good training and supervision of the staff and maintenance of the home. The homes records clearly show how they have taken good measures to protect clients from financial abuse or risks to their health and safety. EVIDENCE: The home can demonstrate that it meets its aims and objectives of providing good care to the clients in many ways. Its Registered Individuals are regularly involved with the running of the home and report to the Commission for Social Care Inspection via the Regulation 26 what is being achieved and what may need addressing. The Registered Manager also keeps the Commission for Social Care Inspection up to date with necessary information of the homes activity using the Regulation 37 notice. In addition to this the home has various other monitoring strategies such as the “Friends of Beaconville” that are additional quality performance checks in addition to the traditional Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 20 questionnaires etc that are provided to the relatives to comment on the services provided at the home. The inspector saw the complimentary responses that are received by the home during this inspection. The clients are not able to manage their own financial affairs and the home will advise an advocate to make suitable arrangements for this issue to be managed in the best interests of both parties. The home does not manage the affairs of any clients. Where purchases are made by the home that are not within the contractual agreement, such as hair dressing, chiropody and possibly clothing the home will have an agreement to pay for the items then invoice the appropriate person for recompense. The home employs an Administrator who handles all the financial business of this nature. The inspector saw how the home successfully manage such issues as the safe allocation of money to confused clients, which met the needs of the client involved without any risk of problems from the loss of money. The Administrator has clear records of all financial dealings involving the home that are were not inspected on this occasion. The inspector saw evidence of staff being trained to meet the tasks of caring for clients in ways that address risks to clients, such as manual handling or dealing with body waste (infection control). He also saw clear evidence that equipment has been maintained according to the regulations appertaining to items such as hoists and the fire equipment. The policies and procedures were also looked at and issues such as the recruitment of staff were followed trough with the security of clients being considered. The home provided the inspector with evidence that they have assessed a variety of environmental issues and taken steps to reduce the risks for such things as falls from windows, scalding from hot water or burns from hot surfaces such as radiators, and the safe use of the stair gates. There was also evidence of the homes fire alarm tests, fire door checks, fire training which is now added to by using the homes own DVD, and portable electrical appliance checks. There was also clear evidence in staff files that supervision has taken place involving all grades of staff. Care staff are allocated to teams with Registered Nurses being responsible for the supervision of each team. Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 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 4 3 X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 X 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X 3 X X STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 3 X 3 Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 22 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. Refer to Standard Good Practice Recommendations Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Beaconville Nursing Home DS0000050213.V265448.R01.S.doc Version 5.1 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!