CARE HOMES FOR OLDER PEOPLE
Beamish Residential Care Home Ltd Old Vicarage West Pelton Stanley DH9 6RT Lead Inspector
Pat English Unannounced 7 September 2005
th 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 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. Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Beamish Residential Care Home Ltd Address Old Vicarage West Pelton Stanley DH9 6RT 0191 370 1763 0191 370 1763 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Beamish Residential Care Home Ltd. Mrs Marie Murray CRH - Care Home 21 Category(ies) of OP - Old Age - 21 places registration, with number of places Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 8th March 2005 Brief Description of the Service: Beamish Care Home provides personal care and accommodation for 21 older persons. Beamish Care Home was once an old vicarage and was built in 1882. It was converted to a residential care home and underwent extensive refurbishment before it was registered in 1987. The home now trades as a limited company, Beamish Care Home Ltd. and the directors are Mr. Edward Bell and Mrs. Marie Murray (who is also the registered manager). The home is located on the outskirts of the village of West Pelton in a private residential area and is surrounded by attractive and well maintained grounds which are accessible to service users. It is next to a church and close to shops, and other amenities in the village. The home has two double and seventeen single bedrooms which cover two floors and can be accessed via a passenger lift or stairs. Communal facilities and service areas are located on the ground floor. There are no en-suite facilities but an adequate amount of bathrooms and toilets are provided. Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over approximately five hours and the proprietor, manager, four care staff, three relatives and five residents were spoken to and gave their views. On this occasion the inspector looked at standards under Choice of Home, Health and Personal Care, Complaints and Protection and Staffing. What the service does well: What has improved since the last inspection?
A considerable amount of work has gone into improving the way residents’ care plans are recorded and this has meant that each care plan is recorded in good detail. The care plans clearly identify all aspects of the resident’s health, personal and social care needs and include details of daily progress reports and monthly evaluations. The manager has reviewed the home’s medication procedures and improvements have been made in the medication records with the help of the local pharmacist who supplies the new records. All staff who administer medication have completed an appropriate training course to ensure that they are competent to carry out this task.
Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 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. Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 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 standard(s) 3, 4 and 5 (Standard 6 does not apply to this home) The home’s admission procedures are satisfactory and prospective residents have their needs assessed by a qualified person prior to entering the home to ensure that the home can adequately meet their needs. EVIDENCE: Individual records are kept of each resident and sample of these records were inspected. Residents have been appropriately assessed by care managers (Social Care and Health) prior to their admission to the home, and one of the most recent admissions had a copy of the care manager’s assessment on file. Relatives visiting the home during the inspection all said that they or another family member had been given a copy of the “Service User’s Guide” and that they visited the home prior to agreeing the admission. They were involved in the initial assessment process and that they were “very satisfied” with the home which “has a good name locally”. Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, and 10 There is a clear and consistent care planning system in place to provide staff with the information they need to satisfactorily meet residents’ needs. The health needs of residents are well met with evidence of good multi disciplinary working taking place on a regular basis. EVIDENCE: Each resident’s care plan identified all aspects of their health, mental health, personal and social care needs and clearly specified the action to be taken to meet the assessed needs. These care plans showed a marked improvement from previous inspections in both the quality of the documentation and the detail of the information recorded. Records showed details of daily progress reports and monthly evaluations of each resident’s care plan and were updated to reflect changing needs. Specific records were kept of any involvement or intervention from health care professionals e.g. GP, District Nurse, Dentist, Optician, Chiropodist etc. and these showed that the home was taking the necessary measures to promote and maintain residents’ health care needs. Comments from the manager and staff indicated that they had good working relationships with the Primary Care Team who also provide some of the training for staff. It was noted that
Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 10 residents in the home had been screened by staff from the local Primary Care Team for evidence of Osteoporosis and risk of falls. Those at risk now receive supplements and are monitored twice yearly. Relatives visiting the home had written a number of comments in the home’s comments book as well as in the home’s quality assurance questionnaires, all of them praiseworthy, such as “the staff treat my mother with love and respect”, “my mother has come on in leaps and bounds” and “I am more than happy with the level of respectful care”. Comments were also noted from the community nurses who stated “ standard of care is excellent” and “staff are helpful and friendly”. Residents also remarked that they were “well looked after” and that it was like “home from home”. The home’s medication records were in order and were an improvement on the previous records. The manager stated this has been with the help of the local pharmacist who supplies the printed medical administration records (MAR sheets) and also from the home’s improved medication procedures. All staff who administer medication have completed an appropriate training course in the safe handling of medicines. There were currently no residents who were self medicating. Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed EVIDENCE: Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16, 17 and 18 There are satisfactory systems in place for seeking the views of resident, relatives and people visiting the home, and from the numerous comments recorded it was evident that all feel encouraged to express their views and concerns freely and openly and that they will be listened to The policies and practices of the home ensure that residents are safeguarded from abuse or harm EVIDENCE: There have been no serious complaints to record. One minor concern had been recorded and the outcome was satisfactory. A record of meetings between the manager and relatives included numerous comments made by relatives, all of which were very positive and complimentary about the standard of care provided. It was evident from the entries in the book that people visiting the home were taking the opportunity to personally record their comments and this confirmed that they felt able to express their views freely. During the inspection visitors commented that the staff were “very good, obliging and friendly” and that the manager and staff were “very approachable”. The staff training programme included satisfactory training courses in the safety and protection of vulnerable adults and it was evident that all staff were enrolled on these courses as a priority. It was noted that the deputy manager had recently been confirmed as a qualified trainer on the subject of abuse and will be arranging in-house courses on the subject.
Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 13 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 standard(s) None of these standards were assessed EVIDENCE: Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 - 30 The home benefits from a competent and well trained workforce who work positively with residents to improve their quality of life. Recruitment procedures have not been strictly followed and this could pose a potential risk to service users. EVIDENCE: There were a number of staff who have worked in the home for a long time and the staff turnover is reasonable. All staff spoken to said that they were satisfied with the staffing arrangements in the home and that they all work as a team and were “like one big family”. They felt well supported by the manager who was “very approachable” and that they could “always talk to her”. Staffing arrangements ensure that there is a senior care worker covering each shift and a satisfactory number of catering and domestic staff on duty. The numerous comments received from residents and relatives and professionals visiting the home confirmed that both staff and management were held in high regard and that there were no issues concerning staffing arrangements in the home. The home’s staff training programme included satisfactory levels of National Vocational Qualifications (NVQ) training where a minimum ratio of 50 care staff have achieved NVQ level 2 and four senior staff have their level 3. Mandatory training (e.g. First Aid, Moving and Handling, Food Hygiene, Infection Control, Health and Safety, Fire and Abuse) was being updated appropriately. Staff comments confirmed that they have plenty of opportunity to improve their skills and knowledge through training and that they also benefited from in-house training provided by the community nursing team.
Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 15 All staff employed had undergone the appropriate criminal records bureau (CRB) checks. Recruitment procedures were being followed apart from the checks on new staffs’ employment history where a full employment history was not consistently being sought and some gaps in employment were not being clearly explained. Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed EVIDENCE: Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x x x x x x x x Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 18 no 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. 1. Standard 29 Regulation 7/9/19 Schedule2 Requirement A full employment history must be obtained together with a satisfactory written explanation of any gaps in employment before making an appointment Timescale for action 30 September 2005 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 Good Practice Recommendations Beamish Residential Care Home Ltd B54 S41569 Beamish V240936 080905 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 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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