Inspection on 24/02/09 for Beane River View

This inspection was carried out on 24th February 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beane River View 29/01/07

Beane River View 14/09/05

Beane River View 25/04/05

Beane River View 08/10/04

Beane River View 24/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Key inspection report Care homes for older people Name: Address: Beane River View 1 Beane River View Port Vale Hertford Hertfordshire SG14 3UD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Julia Bradshaw     Date: 2 4 0 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Beane River View 1 Beane River View Port Vale Hertford Hertfordshire SG14 3UD 01992503619 01992504563 beane@quantumcare.co.uk www.quantumcare.co.uk Quantum Care Limited care home 40 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The home may admit one named service user under the age of 65 years for residential care. Date of last inspection Brief description of the care home Beane River View is a purpose built residential care home, located close to Hertford town centre with its leisure, shopping and transport facilities. It is registered to provide personal care and accommodation for up to 40 older people, including those with dementia or physical disabilities and is operated by Quantum Care Limited of 4 Silver Court, Watchmead, Welwyn Garden City, Hertfordshire, AL7 1TS. The home is organised as three units, including one of 16 beds for older people with dementia. Accommodation is provided over two floors, in single rooms, all of which are en-suite. There is a passenger lift and the home is accessible to wheelchair users. The home Care Homes for Older People Page 4 of 26 Over 65 40 40 40 0 0 0 Brief description of the care home benefits from attractive gardens to all sides, which provide a source of activity and enjoyment for residents and includes an extensive patio area. The current fees range from 425 to 500 pounds per week. Information about the home and the services it offers is contained in its Statement of Purpose and Service Users Guide,both of which can been locted within the main reception of the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of the inspections undertaken by the Care Quality Commission and focuses upon outcomes for the people who use the service and their views of the service provided. The primary method of inspection used was case tracking which involved selecting four people and tracking the care they received through looking at their care records, discussion where possible with the people who use the service, the care staff and observation of care practices. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Older People Page 7 of 26 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides detailed and written information which allows people to make informed choices about entering the home. Full and comprehensive assessments ensure that the home can meet and maintain the needs of the individual service users. Evidence: The home has a Statement of Purpose and Service Users Guide that contains the required information and these are available for prospective service users, visitors and outside professionals. Contracts of occupancy are held on peoples personal files. The manager or one of the trained staff assesses the needs of prospective service users prior to admission and the assessment is used to inform the initial care plan. Several examples of a pre-admission assessments were seen on individual files and confirmed that these assessments are being completed in a detailed and comprehensive way. Several service users spoken to said that visitors were able to visit freely and could be entertained in any of the lounges or the garden. The inspector was also able to observe this practice throughout the day. One relative were very complimentary Care Homes for Older People Page 10 of 26 Evidence: about how the staff were extremely welcoming and friendly in their manner one relative stated that I always see the staff smiling. The Care planning system includes a thorough assessment process ensuring the home can meet the service users needs. Prospective service users are welcome to visit the home prior to admission and a review takes place after 6 weeks to ensure the service users needs are being met. The assessment plans seen contained detailed information in order to develop a plan of care on admission. The care plans incorporated all aspects of care and support required physical, mental health, (including behaviour management) nutrition, and when necessary dealing with falls and pressure sores. The inspector was able to observe several care practices with individual service users which helped evidenced that staff treat people with the respect and dignity they deserve. The care workers spoke to the individual service users in a kind and caring manner and ensured that they were assisting the person at the pace of the individual. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Suitable care planning systems and documentation was in place to ensure that the health, social, medical and physical care needs of the people who use the service were being met. Evidence: Each person has an individual plan of care which is based on the information obtained thorough the assessment process. These are written from the individuals perspective and are person centred. The service involves individuals in the care planning process according to their individual abilities. Where the individual is not able to consent to their care plan or be involved in their care plan the service strives to ensure that significant others are involved. The manager and staff have worked hard to develop and improve on the care plans after the last inspection identified some care plans that were incomplete and did not always identify individual care needs. The arrangements in the home for health and personal care are such that several people spoken to confirmed that they felt they were treated with respect and that staff respected their privacy and their dignity. Generally the records for the management and administration of medicines were Care Homes for Older People Page 12 of 26 Evidence: found to be accurate and detailed with the exception of one discrepancy involving the reconciliation of one persons controlled medication. This was pointed out to the manager at the time of and asked for this to be investigated as a matter of urgency. There was evidence of visits carried out by district nurses, dentist, optician and physio. There is also advice provided by the community dietitian. The service also benefits from the services of the companies nurse practitioner. The latest pharmacist visit was carried out on the 8th October 2008. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provided sufficient and suitable meals and activities for the people who use the service to ensure that their individual needs, choices and preference are taken into consideration at all times. Evidence: People who use the service have the opportunity to develop and maintain important personal and family relationships. On the day of the inspection a number of people who use the service were waiting for family members and or friends to visit and commented that they are able to have visitors as they wish. One person who uses the service commented that my friends and family come to see me as often as they can. Feedback obtained in a questionnaire from a relative stated that provides a caring and homely environment. My relative always enjoys their meals and the laundry is always done. The manager and staff have created a best friends tea room which opens twice a week and is run by the activity worker. This provides an alternative place within the home, in which people can socilaise and invite friends and relatives to enjoy. The service respects the human rights of people using the service with fairness, equality, dignity, respect and autonomy underpinning the care and support being provided. This was directly observed through the practices of the staff on duty. A number of people who use the service were seen to be very relaxed and Care Homes for Older People Page 14 of 26 Evidence: calm within their own environment and engaging with staff in an equal manner. One person commented that we can do what we like, I like reading books, eating fish and chips and chatting with staff . Part of the care planning process identifies peoples preferred activities and comments about their life history. There is an area for activities and notice boards with forth coming events and important updates for the people who use the service. The AQAA determines that We ensure that all Personal Plans are individual and based on the choices and preferences of the residents. The menu is varied with a number of choices including a healthy option. It includes a variety of dishes that encourage individuals to try new and sometimes unfamiliar food. The meals are balanced and nutritious and cater for the varying cultural and dietary needs of individuals. Menus were on display. The food provided appeared appetising and well presented. Comments received included, The food is great here. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The services robust management of complaints ensures that the people who use the service are protected. Evidence: The service has an open culture that allows people who use the service to express their views and concerns in a safe and understanding environment. Complaints leaflets were on display at the service, it was observed that a detailed record of all compliments is maintained at the service and the AQAA determines that three complaints have been received in the last twelve months and all resolved to a satisfactory conclusion by both parties. There has been one safeguarding referral made and one investigation conducted. All of the above have now been closed. People who use the service have commented that they are happy with the service provided, feel safe and well cared for. A number of comments received determined that people who use the service and relatives and friends are aware of what to do if they have any concerns. One person using the service commented that the manager and the staff are so friendly and caring, they are always able to help to sort out any problems I may have. The AQAA determines that Quantum Care Homes has robust allegation of abuse and neglect policies, allowing staff to raise concern within the home or to senior staff outside the home. The PoVA procedures are well documented should the need arise. Care Homes for Older People Page 16 of 26 Evidence: The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Staff commented that they have received training in safeguarding and felt confident in reporting any issues as they occurred. The service understands the procedures for safeguarding adults and would attend meetings as required. One staff member commented that I have completed my abuse training. The AQAA determines that Training is available relating to all aspects of protection. As part of the inspection process, we reviewed a random selection of staff files. Four staff files were audited to ensure suitable checks had been conducted. It was found that all of the staff files contained the required information. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides a satisfactorily maintained safe, clean environment ensuring that all people are in comfortable surroundings and protected from risk. Evidence: The people who use the service are encouraged to personalise their bedrooms by bringing small items of furniture in with them, when they move into the home. All the homes fixtures and fittings meet the needs of individuals and can be changed if their needs change. The building design supports the needs of people using the service. The AQAA states that a number of improvements have occurred within the service since the last inspection was carried out, several of the bedrooms have been re carpeted and redecorated. Two lounges have been redecorated and refurbished. We have increased the size of one room by creating an arch where the wall once was in our unit for people living with dementia. This has given the residents more room to take part in activities. Bathrooms have been redecorated with extra storage put in where needed. The main reception area has been redecorated and refurbished. Rose units bathroom has been refurbished. The garden area has also been extended. The home has an infection control policy. The service is clean, well lit and it smells fresh. A number of people using the service commented that they liked living at the service. One person using the service commented that my bedroom is lovely, its very comfortable and warm, I am very happy with my room. Care Homes for Older People Page 18 of 26 Evidence: All fire records were up to date with the last fire checks being carried out on the 16/02/09. The last six monthly audit was completed in December 2008. There is an ongoing concern about the current arrangements with regard to the warden controlled flats that are linked to Beane River Views fire panel/systems. In practical terms means that if the alarms are activated in the building next door, the alarms are also activated with Beane River View. This arrangement creates both unnecessary anxiety for the people living within the home and also causes inconvenience and stress for the staff team working within the service and who have no responsibilities for the people living within the warden controlled flats. This is a problem that needs to be resolved between the landlords of the buildings and the property manager within Quantum Care. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are cared for by a conscientious, adequately trained work force ensuing that they are supported and protected from harm. Evidence: There are enough qualified, competent and experienced staff to meet the health and welfare of people using the service. Staffing rotas take into account the needs and routines of the people using the service. The service recognises the importance of training, and delivers a programme that meets any statutory requirements and the National Minimum Standards (NMS) with a particular focus on Dementia training. The AQAA states Beane River View has a skilled mix of staff who work together for the wellbeing of the residents. We have robust policies and procedures in place for recruitment and retention of staff to ensure the proper protection for our residents. The Management team work alongside staff to ensure they continue to support staff. Staff training is ongoing and staff receives the minimum of six review/discussions per year. All staff are clear regarding their role and what is expected of them. People using the service report that staff working with them know what they are meant to do, and that they meet their individual needs in a way that they are satisfied with. One person using the service commented that the staff are always so nice to me. One relative commented that there is always good support for the people who live at Beane River Care Homes for Older People Page 20 of 26 Evidence: View and the relatives too. Staff were indirectly observed supporting people appropriately and it was pleasing to observe people engaging positively with people though out the day. The AQAA states that At present; we have no vacancies for staff, agency usage is minimal. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management systems are in place to ensure that the health, safety and well being of the people who use the service are protected. Evidence: The Manager has been in post since 2006 and has worked hard to further develop and improve systems throughout the service, with a particular focus on Dementia care. The manager has also achieved their NVQ level 4 in management and has a broad range of experiences within the caring profession. The Manager and the staff team have a clear understanding of the key principles and focus of the service, based on organisational values and priorities. They work to continuously improve the service. Feedback received on the day of the inspection from staff and the people who use the service determines that the management are effective and approachable. The Manager leads and supports a stable staff team who have been trained to satisfactory levels. The AQAA determines that 26 of the staff team hold the National Vocational Qualification in Care (NVQ) level 2 and 5 staff are currently working towards achieving this qualification. Care Homes for Older People Page 22 of 26 Evidence: The manager promotes equal opportunities, has good people skills and understands the importance of person centered care and effective outcomes for people who use the service. The service has sound policies and procedures, which are corporately and internally reviewed and updated, in line with current thinking and practice. The manager ensures that staff follow the policies and procedures of the home. The staff team are positive in translating policy into practice and showed good knowledge of care principles, health and safety and safeguarding issues. There was evidence on staff records that staff have supervision and staff reported that they are provided with this support regular basis. Staff commented that they received supervision as well as regular staff meetings. The last meeting was held on the 14/01/09. The home works to a clear health and safety policy. Safeguarding is given high priority and the home provides a range of policies and guidance to underpin good practice. The service provides in house training regarding safeguarding and staff showed a sound working knowledge of action to take in such an event. A training matrix has been developed. Whilst the AQAA determines that staff have completed their mandatory training. It was confirmed that manual handling, fire awareness, dementia training, risk assessment, fire assessment, continence, medication, safeguarding, food hygiene, control of substances hazardous to health (COSHH) have been completed by a number of staff to date. The service also has a wealth of experience in the field of staff dementia care and ensure that all staff have attended the one day dementia in house training course . All health and safety checks observed were up to date and organised. As part of the inspection process, we reviewed a random selection of staff files. Four staff files were audited to ensure suitable checks had been conducted. All four files contained the required information to comply with the National Minimum. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 There must be a system in 30/05/2009 place that ensures that all medication administered is accurate and monitored in order to identify any errors and rectified in order to maintain peoples health and welfare. To maintain the health and welfare of people using this service. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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