Inspection on 03/03/08 for Beaconville Nursing Home

This inspection was carried out on 3rd March 2008.

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 10/01/07

Beaconville Nursing Home 13/01/06

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 Devon PL21 0AQ Lead Inspector Anita Sutcliffe Unannounced Inspection 3rd March 2008 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 Beaconville Nursing Home DS0000050213.V359667.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. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beaconville Nursing Home Address Beacon Road Ivybridge Plymouth Devon PL21 0AQ 01752 896505 01752 895418 a.taylor@21stcenturycare.co.uk www.21stcenturycare.co.uk 21st Century Care (Plymouth) Ltd 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) Anne Taylor Care Home 36 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (36), Mental disorder, excluding learning of places disability or dementia (5), Mental Disorder, excluding learning disability or dementia - over 65 years of age (36) Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The categories of registration will be DE(E) (36), MD(E) (36), DE(5), MD(5). The home will be occupied by a maximum of 36 service users. 10th January 2007 Date of last inspection 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 in Devon. It is approximately 15 miles from Plymouth, which is accessed by the A38 that runs past Ivybridge. There are two separate entrances into the grounds with driveways leading to the main doors and limited parking spaces. The building has been extended 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-six single rooms, three with en-suites and five 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. It employs qualified nursing staff to lead the Social Care staff to achieve this aim. The home’s design provides two lounges and two dining rooms where recreational activities can take place in addition to their main functions. There is now also a brick built conservatory linking both lounges creating a level walking area for ambulant service users. Several of the Service Users rooms are very large providing space well above the required minimum space. A hotel style kitchen produces the meals for all the Service Users. The home has set its fee, at this point in time, at £585 including the funded nursing care contribution. There are separate charges for such things as hairdressing, chiropody and personal items such as clothing. The last inspection report is available on request at the home. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. Information about the home has been collected towards this inspection since the last key inspection January 2007. This key inspection included one unannounced visit to the home. Surveys were sent to people who use the service and their families. The registered provider sent us current information about the home. Since the last key inspection was completed a Random Inspection was carried out on 2nd July 2007. This included time closely observing how people using the service spent their time and to what degree staff engaged with them. That Random Inspection report is not published but is available on request from the Commission. Reference to the findings of the Random Inspection is made within this report. As part of this visit to the home we looked at all communal areas, and several bedrooms. We spoke with several people who use the service but due to the advancement of their condition they were unable to provide us with their opinion of the home. We therefore spent time observing what happened and saw staff going about their work. We looked at the care and support that three people received by looking at their records. We spoke with the registered manager, a representative of the organisation, trained nurses and care staff. We also spoke with visiting family of people at the home. We looked at several records, which required to be kept at the home. People who use the service may be described within this report as residents, clients or service users and the registered manager may be described as matron. What the service does well: Staff are led by a well-respected manager who has a very good understanding of the needs of people who use the service and how to manage a home and lead her staff effectively. Both the manager and her staff are proud of the standards they achieve and yet ready to review what they do and change if improvement is identified. The standard of nursing and personal care delivered is commendable. Family of people at the home said: “The nursing and care is excellent. And: “The staff appear to be very caring to all the residents and treat them with respect”. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 6 Staff said that what they did best was: “Good standards of care” and “Service to the residents”. High standards are achieved through the thorough and diligent approach of management and staff. The importance of good diet and pressure sore prevention, the appropriate level and competence of staff and a good standard of equipment provided by the organisation, all helps to achieve this. Staff feel well trained and supported in their work and the home’s achievement of 80 care staff qualified to National Vocational Qualification (NVQ) level 2, many level 3, supports this. People who use the service are treated with dignity and as individuals deserving of respect. Assessment of care needs ensures people’s needs are understood and staff can plan how they should be met. There is a high standard of recording, which provides information from which staff can make judgements about future care. Health needs are monitored to provide staff with necessary information which people using the service are unlikely to be able to inform them about. What has improved since the last inspection? What they could do better: There are some areas connected with the handling of medicines, which must be addressed to ensure that the home complies with legislation and therefore further reduces the risk of mistake or mishandling of medicines. The Service User Guide to the home needs to clarify what charges are made for the differing areas of care, such as accommodation and nursing, so that people can be clear about them. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 7 People would benefit from staff having a more detailed knowledge of their social needs and interests. This is especially important where people are unable to communicate their needs verbally. There must be some safe, accessible and pleasant outdoor space available for people to use as this enhances people’s feelings of well being. 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. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 8 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.V359667.R01.S.doc Version 5.2 Page 9 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, 3 & 4 (Standard 6 does not apply to Beaconville) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be assured that their needs will be fully assessed and understood prior to moving into the home. EVIDENCE: We looked at the current information (Statement of Purpose and Service User Guide), which informs people what the service has to offer. There is also the organisation’s web site. Information is well written and very informative to people who do not have advanced dementia but will be of less value to many people admitted to the service. The manager talked of her intension to make improvements in its presentation to address this. We also found that the Service Users Guide has not been updated in line with changes in the regulations. Those changes will provide more detail on the cost of accommodation, nursing and personal care provided. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 10 We looked at the records of two people recently admitted to the home. They included information provided from other agencies, such as specialist assessment units. The manager also completes an assessment of people’s needs. Those assessments include all the information from which it can be decided if the home can provide the necessary care. This information is then regularly reviewed and updated. Family of people who use the service said the home can meet the needs of the people admitted. The layout of the building provides people the opportunity to wander if they wish and bedroom doors are personalised to help people find their way around. Further use of decoration and adaptation could be used to this end. (Also see Environment). As at the Random Inspection in July we also observed most staff engaging with the people using the service with humour, patience and in a respectful way. Nothing was hurried and family confirmed this is normal at the home. Staff understand how to meet the needs of people with dementia and the registered manager and her deputy will both be taking additional specialist training in the autumn to further improve their knowledge. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 11 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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be assured that they will receive a high standard of nursing and personal care and be treated with respect and dignity. Some areas of the handling of medicines need to be improved to meet legislation and further protect people. EVIDENCE: Plans are required to be clear so that staff can look after people in the correct way, and as they wish, once their needs have been assessed. We looked at the plans for three people who use the service. This information included the pre-admission assessment, risk assessments for aspects of people’s care, such as falling, and nursing observations. The care plans were written clearly giving information about the problems that had been identified and the action that was planned to address the problems. We discussed with the manager the Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 12 need to improve the information records relating to the use of bedsides, such as associated risks and the reason for their use. Care plans were pre-determined using a standard format that were then individualised for each of the people they described. The manager showed an example of how she intends to improve the plans further, acknowledging that more information about people’s social and family would be beneficial, although not always easy to achieve. The care plans are regularly reviewed so that care needs are updated and care is properly delivered. Family said of the home: “Matron downwards the home is managed with great skill and excellence – nursing and care cannot be faulted and care is carried out with dedication and diligence. The nursing and care is excellent. And: “The staff appear to be very caring to all the residents and treat them with respect”. Staff felt the standard of nursing care was very high and were proud of their achievements. We found that people, who were toward the end of their life, were especially well cared for. Many are being nursed permanently in bed, but their skin, nutritional needs and pain/anxiety relief was diligently managed. All in the home looked well cared for and comfortable. We looked at the arrangements for the storage and administration of medicines in the home. There is a dedicated room for the medication and dressings, and a dedicated medicines fridge; all is kept locked. However, the medicine keys are kept with other ‘household’ keys, such as the laundry, and we also found some valuables stored in the drugs cupboard. Access to the medicines cupboards must be restricted to the need to access medicines and keys must also be kept separate so that the likelihood of mishandling is reduced. We also found that the more dangerous medicines, called controlled drugs, cannot always be kept in the specialist storage as they must because of the amount of stock being too bulky. The home therefore needs to ensure all controlled drugs are kept according to the specialist regulations for this. We also saw that the temperature of the room where medicines are stored was 24 degrees. As many medicines must not be stored above 25 degrees as it alters their effectiveness this needs to be monitored. Whilst medicine records seen were orderly and clear we found that, where a dose could be variable, the amount given was not always recorded. This means it is not possible to properly audit the amount of medicines given. Also, where a medicine could be given ‘when required’ the circumstances under which it could be given was not recorded as part of the planned care. This is especially important as people using the service are unlikely to be able to ask for it and their vulnerability dictates very strict use of medicines such as those to calm people or help them sleep. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 13 People using the service were not able to provide the inspector with a rational response to any questioning as a result of their dementia. However, we saw people treated with respect and kindness and the manager expects high standards from her staff. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 14 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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to maintain their individuality and live a fulfilled life within the constraints of their condition. EVIDENCE: Family of people at the home said that staff are always kind and caring and people who use the service are never rushed. We observed, over two inspection visits, staff spending time with people. Staff understand people’s ways and needs and make effort to meet those needs. One person was having a lie-in, his choice, the day of the inspection visit. The home provides regular activities for people. They range from old time entertainers and reminiscence to Tai Chi exercises. People benefit from a wellequipped ‘sensory’ room, which is pleasant and relaxing. Staff said they would like some training to help them provide a good standard of activities for people. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 15 The home layout provides the option for wandering and so people are not unduly confined. However, the lack of outdoor space is a disadvantage (see Environment) and the registered manager feels people are not offered enough outings from the home, such as pub lunches. Although only three survey responses were received from family of people who use the service each expressed complete satisfaction with the home and felt they were kept up to date with issues, which might affect their relative. The amount of written information about people’s social, family and cultural needs was limited and the manager’s new format of care planning hopes to address this. However, we found that staff had knowledge and understanding of people in their care and the manager is aware of their possible diverse needs. We discussed the use of language and how the home might improve how it presents. For example, asking for the name of people who are significant in people’s lives not only ‘next of kin’. Visiting can take place at any reasonable time. Relatives are informed of this verbally and in the home’s literature. Visiting can take place in any of the communal areas or in the privacy of the people’s own room if they wish. We shared a meal at the home, which was well presented. We also observed people being offered choice of drinks and snacks, including fresh fruit. We were told that there is a choice at each meal time. A chef is available throughout the day, which is a benefit. He said that the new organisation provides more funding for people’s food and so the quality is improved. One relative of a person at the home said through survey: “Food is of a high standard and there is a variety of snacks and fruit available during morning or afternoon tea breaks”. We saw staff assisting people with their meal. This was unhurried and concern was raised when one person did not eat. The home is very good at monitoring people’s diet and ensuring concerns about diet are dealt with promptly. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 16 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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes complaints procedure, recruitment procedure and adult protection training and procedures provide satisfactory measures to identify and deal with problems relating to any area of abuse. EVIDENCE: The three survey responses from family indicate that they know how to complain to the home and if they have the response is appropriate. One family member said about complaints: “Have none”. Another said: “Matron will always respond to any concerns and will follow up in writing the actions she has taken to rectify any points. This has only been necessary to me, once in 3 years”. The home’s record of complaints is held on computer and includes, in detail, the way the one complaint was investigated and resolved. We have received one complaint about the home since the previous key inspection and this was not substantiated. People who use the service are unlikely to be able to use the home’s complaints procedure but staff are aware of changes in people’s behavior and mood and would report concerns. Staff questioned were aware they are Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 17 expected to report any complaints to the manager and the manager says she takes every complaint, of whatever nature, importantly. We asked staff about the blowing policy, which informs staff what steps they should take if they have concerns about peoples welfare. We were told that each staff member is given key policies when first employed, including how to alert concerns, which might be abuse and the acceptance of gifts. Whilst they knew there was a policy, none directed us to it immediately. Staff should have this information openly available to them should they wish to consult it. It should also include the contact details for the Local Authority Safeguarding team. Staff were able to describe types of abuse adding that the information was part of their NVQ qualification. We were told that other training in protecting vulnerable adults is planned for the near future. The home uses styles of equipment (chairs and bedrails), which if used inappropriately are considered restraint. Although there is no suggestion that the home uses them as such, it has to demonstrate, through the care planning process, the reason why that equipment has been used. (See also standards 7 and 22). Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 18 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, 20, 22 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a home, which is clean, fresh properly maintained and mostly well furnished. People are currently disadvantaged by the lack of suitable outdoor space available to them. The standard of equipment available is high so that safety and dignity are promoted. EVIDENCE: Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 19 We toured the building visiting the communal areas, the laundry, kitchen and some bedrooms. We also spoke with staff, and a representative of the organisation, about the home environment. Most of the home was well furnished and homely in nature. However, bathrooms and the dining room lacked the feeling of ‘homeliness’ being rather too stark and ‘functional’. We also found some carpets looking ‘tired’ and marked. One family said through survey when asked what the home could improve: “Replace the worn carpets in communal areas”. However, all bedrooms seen were comfortably furnished and individual in nature. We discussed the potential danger of light weight free standing wardrobes tipping, but found that window, radiator and the hygiene aspects of safety were properly dealt with. People are aided to find their way around the home by the use of photographs on bedroom doors, but adaptations specific for people with dementia could be much more fully explored. However, the new specialist sensory therapy room is commended and the layout of the lounge areas benefit people who feel the need to wander. (Also see Standard 4). The standard of equipment at the home is very high. Staff said they were very satisfied with what was provided and we saw in place moving and handling equipment to help staff move people safely and two new styles of bed. One style is low to the floor so that the need of bedrails is removed. (See also Standard 18). There are also pressure pads to alert staff that people are awake as none are able to use the call bell system. The home does have substantial grounds that people can access in good weather, but we were told this is only safe with close supervision of staff. This situation is to be improved with the planned extension, but this leaves people with limited outdoor space this summer. A representative of the organization agreed that some safe and suitable outdoor space would be made available at the first opportunity. The home was very clean and fresh at the time of the visit. When asked what the home does best one relative said through survey: “The home is always clean and there are no smells. There is a regular maintenance programme. Rooms are always redecorated and refurbished on being vacated and before the next resident is homed”. We talked to laundry staff and found them fully aware of how to prevent cross infection. There is laundry equipment available at the home, which is appropriate for its size and needs and so will help maintain high levels of hygiene. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 20 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 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service receive care and services from a professional staff safely employed and provided in sufficient numbers that care can be delivered to a high standard. EVIDENCE: Staff said there was very little turn over of staff at the home and the manager records that the home never need to employ agency staff. Staff said they do not have to rush their work adding: “We do have time to be with people”. They describe how additional staff are provided at busy times, such as early morning and in the afternoons. A relative who responded to survey said: “The staffing levels are high, one SRN in addition to matron (and the 2 lounges have at least two carers in the room at any one time) on all shifts”. Trained and care staff are able to spend all of their time with people who use the service because there are adequate domestic and catering staff employed. Staff described the training they receive and said they are quite satisfied that their training needs are met. The three relatives who responded to surveys felt staff have the right skills and experience to look after people properly one adding that Investors in People Award was approved for the home two years Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 21 ago. Another said: “The staff always behave in a professional and calm manner”. There has been a large commitment given to staff training with more than 80 of care staff having achieved NVQ (National Vocational Qualification in care) at level 2 or above. The Registered Manager and her Deputy have the Registered Manager Award (level 4 in Management) and several staff have achieved level 3 and are involved in level 4 training in care. We looked at the way staff are recruited and found that the necessary safety checks are completed prior to them working unsupervised with people. The manager says that new staff are always ‘extra to numbers’ and closely supervised. A recently employed staff member described the good support and welcome she felt when new to the home. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 22 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service live in a home where their welfare is a high priority and the service provided is both caring and professionally delivered. EVIDENCE: The Registered Manager is an experienced first level nurse with proven management skills and a good deal of experience in caring for the elderly person who has a mental health problem. She has achieved the Registered Managers Award to add to her Registered Mental Nurse qualification thus providing further evidence of her competence. Comments about the manager, from her staff include: Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 23 • • “Annie is welcoming in a good manner. She responds to everything”. “Good support”. And from family of people using the service: • “Matron will always respond to any concerns and will follow up in writing the actions she has taken to rectify any points”. • “Matron downwards the home is managed with great skill and excellence”. The manager and her deputy keep themselves fully up to date. Currently they are about to begin a diploma in dementia studies at one of the countries leading universities in the subject. They have also trained in how to use and interpret the Mental Capacity Act, which has continuing relevance in Beaconville. There is a good measure of quality monitoring at the home. This includes regular staff meetings (minutes taken) and regular group meetings with people’s relatives. A further measure is the questionnaire that is passed to relatives and friends for them to comment on the care and home environment. This has recently been done, but the results are not yet collated. The organization does unannounced visits to the home and provides the manager a report of their findings. Staff receive regular one to one discussion about their work as well as supervision on a daily basis. There is also a regular hand over of information both verbally and recorded so that all people are fully aware of what is happening. Much thought has been applied to good and safe systems of working at the home. Family also commented that the home keeps them well informed one saying: “Whenever I have a question it is always answered promptly. Information regarding the home and my mother is sent through the post or by phone”. People at the home 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. 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. Staff are properly trained in all aspects of health and safety and have a good standard of equipment available so as to ensure the safety of both the people in their care and themselves. They are also given the General Social Care Council codes of conduct so they are fully aware of standards of conduct expected of them. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 24 The home has up to date policies and procedures that are useful and informative documents. Fire safety was discussed with staff. They say they receive regular fire safety training, including a film of fire safety in Beaconville itself. We found no evidence to suggest that equipment is not fully serviced and maintained. We found a couple of areas where risk had not fully been thought through: freestanding wardrobes, storage of liquids and some aspects of the handling of medicines. The home keeps the Commission fully up to date with events at the home, which affect people’s welfare although the annual quality assurance assessment (AQAA) which we asked for, could have provided more detailed information. However, we find the manager and staff are keen to meet high standards and work towards continuing improvement. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 25 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 2 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 2 10 4 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 2 X 4 X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 3 X 3 Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 26 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 Standard OP1 Regulation 5 A (1) (2) Requirement The Service Users Guide must include a statement specifying the fees payable for accommodation, nursing and personal care so that the cost of each is clear. Where a variable dose of a medicine can be administered the actual dose given must be recorded so that a full audit of medicines is possible and the effectiveness of the medicine can be properly monitored. The use of medicines must be part of the care planning process, especially where a medicine may be given ‘as required’. This will ensure that staff have clear and unambiguous guidelines as to when they may administer it. Keys to the medicines storage must be kept separately to the household keys and medicines must not be stored with any other valuables. This will reduce the likelihood of mishandling. There must be external grounds, which are suitable for, and safe DS0000050213.V359667.R01.S.doc Timescale for action 30/04/08 2 OP9 13 (2) 03/03/08 3 OP9 13 (2) 31/03/08 4 OP9 13 (2) 31/03/08 5 OP20 23 (2) (o) 31/05/08 Beaconville Nursing Home Version 5.2 Page 27 for use by, people who use the service so that they have the option to spend time outside the home if they choose. 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 OP9 Good Practice Recommendations The temperature of the medicines room should be monitored to ensure that medicines are never stored above the manufactures recommended temperature, as this would alter their effectiveness. Beaconville Nursing Home DS0000050213.V359667.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Colston 33 33 Colston Avenue Bristol BS1 4UA 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 © 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.V359667.R01.S.doc Version 5.2 Page 29 - 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!