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Inspection on 31/10/07 for Beatrice Court and City Gate Lodge Home

Also see our care home review for Beatrice Court and City Gate Lodge Home for more information

This inspection was carried out on 31st October 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

At Beatrice Court & Citygate Lodge the focus is on person-centred care, maintaining and encouraging choice and autonomy throughout. They focus on the service users taking ownership of the Home and having a lifestyle of their choice and expectation. They provide high standards of individualised care in a warm,homely environment where residents feel safe,secure and valued. The manager told the inspector that they never view the delivery of care as a series of tasks and are always flexible in our delivery of care to meet the ever changing needs of our residents. Staff are well trained and encouraged to develop their skills further with regular training updates that incorporates changes in best practice and legislation. Staff are valued in each and every role they take on and this in turn keeps morale high and benefits the interaction of staff and service users /representatives throughout. They have an open,transparent, inclusive approach to the provision of care and deal effectively with any suggestions for change or improvements at all times. Service users know that any concerns or problems they may have can be spoken about freely and dealt with quickly and professionally. The environment is homely and kept clean and tidy,free from odours and danger with health and safety issues given a high priority. Activities and entertainment take place regularly and service users are able to choose whether to take part or not. Local community support is sought and maintained, with good relationships being established. There have been no incidents or reports of abuse of any kind and up to date policies and procedures are in place to maintain this high standard.

What has improved since the last inspection?

The Manager has achieved the RMA, two Qualified Staff members have achieved A1 Certification and the majority of the carers have either achieved NVQ 2 or are working towards it. The management have established excellent relationships with external professionals and maintained this at a high level; benefiting service users and staff alike with their valuable knowledge/advice. This is particularly evident in the relationship they have forged with the local CPN team and Consultant Psychiatrist. This has led to the home being able to receive a weekly round from the local CPN and a review of all appropriate service users from a consultant psychiatrist every 1 - 2 months. The home have continued with the refurbishment programme that has included the upgrading of our laundry facilities and they have refurbished a ten bedded ground floor unit with new furniture and variable height beds. The management have incorporated the Mental Capacity Act into the training of our staff. The home have recently attained ISO 9001 status for their quality assurance procedures. They have employed a talented new head chef and revamped the menus in response to feedback and quality assurance questionnaires from the service users. Following a comprehensive review of the homes external agencies in line with our ISO 9001 they have sourced a new more reliable NHS dentist who carries out domiciliary visits to the home and provides a better standard of care to the service users. A multi-purpose Reception/Relatives Room has been created for discussions with prospective service users and their representatives which is homely,warmand inviting. It is conducive to openness and ensures privacy and dignity when all information is being shared.

What the care home could do better:

The home has progressed exceptionally well and the management plan over the next 12 months to continue with the upgrading and refurbishment plans, installing new bedroom furniture where necessary and continuously reviewing equipment needs and purchasing new equipment as and when required. To upgrade the gardens and purchase new garden furniture for same.

CARE HOMES FOR OLDER PEOPLE Beatrice Court and City Gate Lodge Home 36 St John`s Street Lichfield Staffordshire WS13 6NZ Lead Inspector Mrs Joanna Wooller Unannounced Inspection 09:00 31 October 2007 st 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 Beatrice Court and City Gate Lodge Home DS0000022312.V351246.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. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beatrice Court and City Gate Lodge Home Address 36 St John`s Street Lichfield Staffordshire WS13 6NZ 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) 01543 418341 01543 418583 Restful Homes Limited Mrs Rosemary Alison Howell Care Home 128 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (20), of places Physical disability over 65 years of age (48) Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. PD(E) Minimum age 60 years DE(E) Minimum age 60 years 10 PD(E) in the City Gate Lodge Unit 10 DE(E) in the City Gate Lodge Unit 1 DE(E) minimum age 60 years in the City Gate Lodge Unit Date of last inspection 25th July 2006 Brief Description of the Service: Beatrice Court and City gate Lodge is a Care Home that provides personal and nursing care to 128 service users aged 60 and over in the categories outlined on the previous page. The main building has nursing staff on duty over a 24hour period. It was built in 1989 and opened and a nursing home in 1991. It comprises of a 2 and 3 storey building and has several communal areas and a hairdressing salon. All parts to the home can be accessed via passenger lifts. There are small garden areas and there is space for car parking. City Gate Lodge is set in the same grounds and offers personal care to service users over the age of 65. Both units share a large kitchen and separate laundry. The whole complex is set in a town location close to Lichfield Cathedral and Beacon park. Visitors using bus and train services can easily access the home, as there is a bus station and railway station in close proximity. The registered care manager (RGN) is in charge of the home. First level nurses (both RGN and RMN), and teams of care assistants, provide care. Local GP practices and a pharmacist service the home. Community nurses, health service professionals, and NHS facilities are accessed as and when required. Several local GP practices and a pharmacist service the home. Activities, hobbies and entertainment take place with transport provided as required. Current scale of charges range from £334 to £575 per week. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 5 Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 31st October by the lead inspector, Mrs Joanna Wooller. The Manager was on duty in a supernumerary role. During the visit the providers arrived at the home and contributed to the inspection process. The deputy manager was in charge of the home with regard to care and 3 trained staff and 18 carers in the main building supported her. The inspection included the following elements; A tour of the buildings, Observation and inspection of records relating to provision of care, Discussions with several service users, Discussions with several of the staff members on duty, Observation and sampling of other services provided such as catering and laundry, and an inspection of the managerial aspects such as staffing issues, training, recruitment and health & safety. The Inspector was made very welcome in the home and all assistance was given to gain the evidence required for the report. The Commission had dealt with no complaints since the last inspection. Service Users and relatives spoken to at the visit were complimentary about the home. “My mother is very settled here, she is content and very well cared for” “My Father is well looked after and safe. His health is much improved” What the service does well: At Beatrice Court & Citygate Lodge the focus is on person-centred care, maintaining and encouraging choice and autonomy throughout. They focus on the service users taking ownership of the Home and having a lifestyle of their choice and expectation. They provide high standards of individualised care in a warm,homely environment where residents feel safe,secure and valued. The manager told the inspector that they never view the delivery of care as a series of tasks and are always flexible in our delivery of care to meet the ever changing needs of our residents. Staff are well trained and encouraged to develop their skills further with regular training updates that incorporates changes in best practice and Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 7 legislation. Staff are valued in each and every role they take on and this in turn keeps morale high and benefits the interaction of staff and service users /representatives throughout. They have an open,transparent, inclusive approach to the provision of care and deal effectively with any suggestions for change or improvements at all times. Service users know that any concerns or problems they may have can be spoken about freely and dealt with quickly and professionally. The environment is homely and kept clean and tidy,free from odours and danger with health and safety issues given a high priority. Activities and entertainment take place regularly and service users are able to choose whether to take part or not. Local community support is sought and maintained, with good relationships being established. There have been no incidents or reports of abuse of any kind and up to date policies and procedures are in place to maintain this high standard. What has improved since the last inspection? The Manager has achieved the RMA, two Qualified Staff members have achieved A1 Certification and the majority of the carers have either achieved NVQ 2 or are working towards it. The management have established excellent relationships with external professionals and maintained this at a high level; benefiting service users and staff alike with their valuable knowledge/advice. This is particularly evident in the relationship they have forged with the local CPN team and Consultant Psychiatrist. This has led to the home being able to receive a weekly round from the local CPN and a review of all appropriate service users from a consultant psychiatrist every 1 - 2 months. The home have continued with the refurbishment programme that has included the upgrading of our laundry facilities and they have refurbished a ten bedded ground floor unit with new furniture and variable height beds. The management have incorporated the Mental Capacity Act into the training of our staff. The home have recently attained ISO 9001 status for their quality assurance procedures. They have employed a talented new head chef and revamped the menus in response to feedback and quality assurance questionnaires from the service users. Following a comprehensive review of the homes external agencies in line with our ISO 9001 they have sourced a new more reliable NHS dentist who carries out domiciliary visits to the home and provides a better standard of care to the service users. A multi-purpose Reception/Relatives Room has been created for discussions with prospective service users and their representatives which is homely,warm Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 8 and inviting. It is conducive to openness and ensures privacy and dignity when all information is being shared. 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. The summary of this inspection report can be made available in other formats on request. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 9 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 Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 10 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): Standard 3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Prospective service users have the information and insight into the home to enable them to make an informed and confident choice prior to moving into the home. EVIDENCE: The manager told the inspector that all prospective service users or their relatives are given the opportunity to spend time in the home. The manager spends time with them enabling them to ask any questions about life in the home. Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective service user. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 11 There was strong evidence that the staff team are qualified and experienced to work with the needs of the service users. Relevant documentation and training logs showed that specialist areas of work have been explored and staff have access to training. The home provides a statement of purpose that clearly sets out the objectives and philosophy of the service supported by the service users guide that summarises the SOP and provides good clear information about the home. The guide is precise in what the prospective service users can expect and gives a good detailed account of the quality of the accommodation, qualifications and experience of staff and how to make a complaint, along with recent CSCI inspection findings. Each service users is provided with a statement of terms and conditions prior to moving to the home. This sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the service user. Terms and conditions are reviewed on a regular basis. The manager assured the inspector that admissions are not made to the home until a full needs assessment has been undertaken. The home are then able to confirm that they can meet the needs of the individual through the service they deliver as detailed in the statement of purpose. For people whom are self funding and without a care management assessment the assessment is always undertaken by a skilled and experienced member of staff. There was clear evidence confirms that the assessment is conducted professionally and sensitively and a family member spoken to at the visit confirmed this. Beatrice Court is divided into seven separate units that allow the manager to closely tailor the provision with the needs of the service users. The manager ensures that all the service users are correctly placed within the individual units within the home in accordance with their choices and needs. Through this flexibility they are able to fully meet all their assessed needs and expand on same throughout as these needs may change. The manager explained that they strive to create a friendly, welcoming atmosphere in which they endeavour to give and receive information throughout with all prospective service users and their representatives; to ensure that they can provide the highest standards of care for each individual with as much knowledge gained as possible about them. The management is committed to communiacting with both service users and their families as much as possible and they are always available to discuss any aspect of life and the provision of care at Beatrice Court. Following on from the pre-assessment, every service user entering the Home has their own individualised careplan implemented with their input and /or Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 12 that of their relatives/friends/advocate and the careplan is verified by all and signed in agreement to the care needs identified. Intermediate care is not undertaken in our home per se, however the home have had service users who have entered the home for long term stay and through excellent care, encouragement and appropriate referrals to other multi-disciplinary agencies/ facilities we have assisted in their reablement in order to return to their own homes. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 13 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): Standards 7, 8, 9, 10 and 11 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Each service user has an individual care plan which sets out their individual needs. Within these care records it is established that the service users needs are being met. Service users are protected by the homes policies and procedures. EVIDENCE: As part of the case tracking process care plans were inspected and found to be individually written appropriately to each service users needs and wishes. Comments from service users / relatives and other professionals evidenced that the particular individuals were receiving individualised care. All health, personal and social care needs were documented as appropriate and the documentation was meaningful, well written and states the current condition of each service user. The care plans were updated regularly and changed accordingly to ensure that the individual needs are met throughout. The care reviews were carried out in conjunction with the service users and their representative where appropriate. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 14 Individual risk assessments were established within the care plan in relation to malnutrition, tissue viability, fall risks, manual handling and needs were identified from these assessments to establish the need for use of specialised equipment as appropriate i.e. pressure relief cushions/mattresses, sensor floor pads, bed rails etc. Service users commented that they feel the care is good and meets their changing needs and is carried out at all times with dignity and respect. Staff were seen to knock on doors before entering, announce who they are and how they are going to offer assistance. All staff have full induction and continuous training to enable them to care for the service users with their utmost understanding and ensuring they assist service users to fulfil their potential with choice and autonomy. The manager told the inspector that they focus on promoting and maintaining independence of each individual, supporting them to make choices and decisions, to take appropriate risks and set attainable goals. Risk assessments are in place to appropriately establish those individuals who may self-medicate and the Home has a policy established for it; along with policies for the Safe Handling and Administration of Medications, receipt of medicines and disposal of medicines. Two local retained GP practices carry out twice weekly rounds in order for all service users to access this facility to meet their needs. The GPs work closely with the Trained Staff and all have an excellent working relationship together. Service users who wish to retain their own GPs may do so with the consent of that GP. All service users are able to access NHS facilities, external professionals, specialists as required. Evidence of good relationships formed with these professionals is found in their documentation within the care plans. A weekly round from CPN services is performed and through this excellent working arrangement have been able to receive a 1-2 monthly visit from a Consultant Psychiatrist to further assist all service users requiring this intervention to access this specialist advice/ care. Service users are able to access NHS Chiropody and Dentistry by direct referrals being sent to register them on admission to the Home. Service users may also access Private practitioners at discounted rates if this is their request and requirement. With the introduction of the Mental Capacity Act the home have been able to utilise the assistance of IMCA - for those service users requiring advocacy within this area. Within the individualised care plans provision is made for the service users wishes at the time of their death to be fully documented. The use of Gold Standards Framework documentation is incorporated for end of life needs to be met along with Non-Intervention Forms if required. All service users and/or their representatives are treated sensitively and with empathy whilst these Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 15 discussions take place and are reassured with these procedures documented that their needs/wishes will be met. The management have assisted an inspector from the CSCI in completing their SOFI training and following this we have begun using the tolls incorporated in SOFI for our internal auditing purposes and our commitment to continuous improvement in providing the best possible outcomes for all our service users. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 16 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): Standards 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users lifestyle matches their expectations and they maintain contact with family and friends. Service users exercise their own choice and receive a balanced and wholesome diet in the home. EVIDENCE: All service users are able to enjoy the company of their visitors within the communal lounges, own rooms or relatives room as to their own preference. There is a main hairdressing salon for all service users to use, however due to some service users physical disabilities the hairdressers will visit them in their rooms if requested to and provide the same high standard of hair care. At Christmas time the manager invites service users representatives to come to the Home for Christmas Lunch/Tea, Boxing Day Lunch/Tea if the service users are not going out with them. This has become a great family tradition within the Home and thoroughly enjoyed by all who choose to accept this offer. Service users are able to access the local amenities with assistance of staff members and/or their representatives as the home benefits from being so Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 17 close to the centre of Lichfield. Day excursions are arranged to the local park, garden centres and tea rooms as and when service users wish to go. The management provide in house entertainment on a regular basis and at special events during the year;such as Rememberance Day, May Day Celebrations, Christmas and New Year, with a variety of external entertainers providing songs/music and reminisence. Posters are sited throughout the Home to ‘invite’ all to these events. The home have yearly Christmas Carol Services with the assistance of children from local schools, also Brownies and the local WI. One lady spoken to had enjoyed knitting prior to her illness but the home had managed to arrange for a knitting aid to assist her. She enjoyed the bingo afternoons and some other events. She said the staff were kind to her but she occassionally felt a bit weepy. She had many relatives who visited her and supported her. Families and service users spoken to told the inspector of their satisfaction with the meals provided in the Home and the Head Chef has developed new menus through finding out service users likes and dislikes and always reacts positively to suggestions made or any problems raised. All special dietary requirements whether due to health, religion or cultural preferences are catered for. The chef told the inspector that fresh, good quality food is sourced from local suppliers who deliver throughout each week. All service users are able to request where they have their meals, whether it be at the dining tables, on vari-tables in the lounge or in their own room and their choice is documented accordingly. Satellite kitchens on all units of the Home stock provisions for service users to access tea/coffee, juices and snacks at any time of day or night. Staff assist those service users who may not be always able to communicate their decision re: choice of meal by using their knowledge of likes/dislikes. Staff assist service users to eat in an unhurried/ discreet manner at all times to promote good nutrition and maintain dignity. One gentleman spoken to felt the home was like a “palace” he felt so settled that it was like home. He felt there were plenty to keep occupied and no reason to feel bored. He was personalising his own bedroom with recently delivered furniture and personal items. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 18 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): Standards 16, 17 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users and their relatives are confident that their complaints will be listened to, their legal rights are protected and service users are protected from abuse by the policies and procedures followed in the home. EVIDENCE: Service users are protected throughout from any form of Abuse. All staff are fully vetted prior to employment including POVA(Protection of Vulnerable Adults) and CRB(Criminal Records Bureau) checks. Staff receive POVA training on induction and continuous updates throughout their employment. Complaints or queries are dealt with immediately and residents/ relatives are assured that should they have any complaints/ queries or suggestions for improvement that they will be listened to and the improvements will be actioned promptly and appropriately. Service users and their representatives are encouraged to voice any concerns they may have. The home has an open door policy where the manager is always available to discuss any issues and this extends to the trained staff who will always set aside time to address any issues that arise immediately. The Complaints Procedure is clearly written and openly accessible to all(copy of same in Main Reception) and all service users are informed of this procedure and are fully supported by the staff in making a complaint. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 19 Complaints received and action/outcomes of same are recorded. Many thank you cards and compliments have been received from appreciative relatives/ friends of service users and are available for perusal by all in Main Reception. Advocacy service information is provided for service users and utilised as required. The policies and procedures for ensuring the protection of our service users are well observed and are regularly reviewed and updated. The policies clearly outline who to contact internally/externally if an incident should occur. All service users are afforded the opportunity to exercise their right to vote, whether by post or in person at local polling stations. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 20 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): Standards 19, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This judgement has been made using available evidence including a visit to this service. Service users live in a safe and well-maintained home, which is comfortable and homely. Service users bedrooms are personalised. The home is clean, pleasant and hygienic. EVIDENCE: Beatrice Court provides a homely, pleasant, hygienic environment that is free from unpleasant odours. All staff have had training in health and safety, infection control, COSHH etc. A team of ancillary staff maintain the high standards of cleanliness in the Home reducing the risk of infection and cross infection. The management have incorporated an external health and safety auditor in Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 21 internal audits. The maintenance contracts that are in place ensure all equipment used is safe and of appropriate standards including gas boilers, emergency lighting, nurse call etc. Most service users rooms have an en-suite facility some contain hand basins; those that are not en-suited are situated alongside bathrooms and further toileting facilities. The dimensions and layout of the bedrooms provided accessible room to meet the needs of the service users. All bedrooms had covered radiators, smoke alarms and emergency lighting was in place throughout the home. The corridors were found to be free from obstruction and well lit and the home provided a safe environment for those who lived there. All service users are able to decorate their rooms how they wish and have their own belongings around them. The Home has a fully maintained call system in place with emergency alarm facilities in every room. All equipment required to maximise service users independence is provided within the home. Access to specialist equipment is sought and assisted provision is made as and when required. A range of specialist equipment and adaptations were in place for the service users including: grab rails, hoists, and ramps etc were evidenced. The home has small-enclosed gardens as well as large open aspect patio frontages to the building, which are accessible to all residents and are utilised throughout the year in accordance with service users wishes. The laundry is separated into clean and dirty access areas with separate entrances/exits. There were sufficient toilet and bathing facilities within the home to meet the needs of the service users. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 22 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): Standards 27, 28, 29 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of the staff, which is appropriately recruited through the homes recruitment procedure, meets Service users needs. Staff are trained and competent to do their jobs and service users are in safe hands because of this. EVIDENCE: The management is very proud of their full complement of trained, care and ancillary staff within the home. They do not use agency staff of any kind as they have a relaible team of staff and a large bank of relief staff who have been trained by the home and who are aware of our ethos of care. There were no changes in the homes recruitment policy, procedures and documentation at the home. All recruited staff have full POVA/CRB checks in place prior to commencement along with references, PIN number verification (if required) and previous training certificates verified. All staff must be able to work in this country and full checks are adhered to within Home Office guidance - work permits/ workers registration certification are in place. There was evidence that all the staff employed are issued with terms and conditions of employment, job descriptions and contracts of employment. Each Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 23 individual member has an employee handbook, personnel file and training file and all in house and external training is recorded in same. Mandatory training is upheld yearly and added to when new or changed legislation is introduced. The management feel that by valuing their staff assists with the smooth running of the Home and all are given support and encouragement in further advancing their skills/ learning opportunities ultimately ensuring greater benefit to all service users. Through induction training and continuous development training all staff benefit in meeting the needs of all the different registered client groups. Good knowledge of each individual resident ensures that their lifestyle choices are maintained and that staff assist to their best abilities in giving quality of life to all throughout. Over 50 of staff have achieved their NVQ 2 or above and the rest of the care staff having commenced this training. A link with the local college assists in meeting the training needs of all our staff. The majority of the staff have undergone their Palliative Care course and others are in the process of completing it so this gives increased awareness of the issues surrounding service users who may be in the latter stage of life and also the effect of this on service users representatives and the staff as well. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 24 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): Standards 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users live in a well managed home, which has the Service Users best interests at the forefront of the individualised care. The health, safety and welfare of all the Service Users and staff are protected. EVIDENCE: From observations made by the inspector and discussions with the manager and staff, it was evident that the home was being run in the interests of service users. Relatives commented that the Manager was very open and approachable. The Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 25 Registered Manager has a wealth of experience within the Care Home Sector and along with eleven years of care home management has achieved RMA qualification status. She competently strives to safeguard the best interests of the service users with high standards maintained and delegated through to all staff/personnel working within the Home. Staff receive formal supervision at least six times yearly. The Home has attained ISO: 9001 Certification and Accreditation through its Policies/Procedures and Quality Assurance. The manager confirmed that the home is financially viable and Directors use suitable accountancy and budgeting procedures at all times. The financial administrator maintains personal ledgers for the service users, which are correct and auditable. Service users who wish to handle their own finances are encouraged to do so. Valuables and belongings that are brought into the Home are documented in Property/Valuables Books. There was evidence that accident/incident forms are regularly audited by the manager to check for patterns that may have formed and introduce changes or measures to reduce the occurrence of same happening again. The manager regularly audits the home and uses quality assurance/feedback forms to ensure quality of services that are provided. The employers/public liability insurance certificates were up to date and prominently displayed in Main Reception. There was evidence of up to date records for the maintenance of the Home including lifts, fire equipment, gas testing, hoists, electrical installation tests, portable appliance testing, water temperatures, emergency lighting and call bell panels. Policies and procedures within the Home are appropriately actioned and are regularly reviewed/updated to ensure the health; safety and well being of service users is paramount. The Inspector checked all relevant records required meeting the National Minimum Standards and a discussion with both Service Users and representatives evidenced that all service users had the opportunity to handle their own finances and all Service Users and their families had chosen to do so. The documentation evidenced by the Inspector for servicing and examination of machinery and equipment was all correct and up to date. Health and safety issues are given a high priority and the evidence seen by the Inspector supported this. The records requested by the Inspector were well kept, in order and up to date. Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 26 Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 27 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Birmingham Local Office Commission for Social Care Inspection Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Beatrice Court and City Gate Lodge Home DS0000022312.V351246.R01.S.doc Version 5.2 Page 30 - 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. 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