Inspection on 01/12/06 for Beauchamps Country House Care

This inspection was carried out on 1st December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Beauchamps Country House Care 27/01/09

Beauchamps Country House Care 07/02/06

Beauchamps Country House Care 24/08/05

Beauchamps Country House Care 17/03/05

Beauchamps Country House Care 21/07/04

Beauchamps Country House Care 09/03/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Beauchamps Country House Care Village Road Hatch Beauchamp Taunton Somerset TA3 6SG Lead Inspector Shelagh Laver Unannounced Inspection 09:30 24 November 2006 th 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 Beauchamps Country House Care DS0000003241.V321865.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. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beauchamps Country House Care Address Village Road Hatch Beauchamp Taunton Somerset TA3 6SG 01823 480276 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) Mr David Peter Kohlman Patricia Anne Britten Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Elderly persons of either sex, not less than 60 years, who require general nursing care. Four places for persons of either sex, in the age range 30-60 years, who require general nursing care. Up to 20 places for personal care Date of last inspection Brief Description of the Service: Beauchamp Country House Care is in the village of Hatch Beauchamp. The home is a large detached property decorated and furnished in country house style and is very well maintained. The home is well equipped and provides good access for residents, including a lift between floors. The grounds are extensively landscaped to include ponds and summer houses and is accessible to wheelchairs. A small close care housing development has been built in the grounds. There is a registered manager and a general manager. A deputy nurse manager was appointed in February 2003. A registered nurse is on duty at all times. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The previous unannounced random inspection took place on 25th September 2006 and reviewed medications. This unannounced key inspection was carried out by two inspectors over 6 hours on 1st December 2006. Mrs Patricia Britten , Registered Manager was available throughout the inspection. There were twenty eight residents living in the home. During the inspection inspectors spoke to residents and members of staff. Comment cards were received from service users that indicated they felt cared for and were pleased with the standard of service at Beauchamps. The Inspectors viewed the home. All areas of the home were very clean and comfortable. Communal areas are smart and attractive. Staff spoken to were pleased to be working at the home. They were observed to be kind and caring toward residents. Records viewed included care plans; risk assessments; accidents; medication; staff recruitment & training; and health & safety. The Inspector would like to thank the residents and staff for their involvement and participation in the inspection process. As a result of this inspection the home has one requirement and four recommendations. Overall this was a very positive inspection. What the service does well: Residents were very pleased with the care they received in the home. Comments included “this is a well run home and wonderful carers”, and “I don’t think I could better this care home”. The home provides person centred care and tries to meet needs on an individual basis. This means nursing care for very frail and dependent service users is provided to a high standard but it is also a cheerful and comfortable environment for more active service users. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 6 Some friends and relatives completed comment cards for service users unable to express an opinion. One card said “It seems clear that all that can be realistically done to care for ……..and make him comfortable is being done.” Residents benefit from a comfortable environment and are able to make choices in how they spend their time. The grounds surrounding the home are exceptional providing a varied and attractive outlook for many people. The gardens are designed to be enjoyed by service users and even in December were a source of enjoyment. Service users who were able to enjoyed a walk. Others enjoyed feeding the birds or observing the views. Care plans were comprehensive and detailed containing some examples of best practice. There was an attention to personal preferences and a real attempt to promote the dignity and well-being of very frail service users. The plans contain evidence that the home is trying hard to meet each resident’s healthcare & social needs. Staff are friendly and caring. Staff respect resident’s privacy and were observed offering support and choices to residents. One service users spoke particularly of the support she received from “her nurse”. “She really listens and gives me chance to talk about my concerns……” Recruitment practices observed at this inspection complied with NMS and protected service users. What has improved since the last inspection? What they could do better: Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 7 Although there is an activities programme that is enjoyed by many there were comments that some afternoons were long and service users would like more things to do. The manager is implementing a system of involving key workers further in the social needs of service users and this in turn may generate a few more group activities. The system of formal staff supervision should be implemented. Water in some taps is above 50degrees and should be regulated. 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. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12345 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users receive information relating to the home so that they can make an informed choice about where to live. Service users are issued with a contract with terms and conditions. The home has a comprehensive pre-admission assessment in place to ensure that it can meet prospective resident’s needs appropriately. EVIDENCE: Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 10 Service users spoken with confirmed that they had received the home’s service user guide. The residents guide is comprehensive and contains the required information. All service users who completed surveys confirmed that they had received enough information about the home before they moved in so that they could decide it was the right place for them. The home confirms the fees to prospective service users in writing. When there is a change to the cost of care, the home advises service users in writing. Service users spoken with confirmed that they had received a contract when they moved into the home. Contracts were viewed and contained all relevant information. The home had undertaken comprehensive pre-admission assessments to ensure that it could meet the needs of prospective residents. Examples of Social Services assessments and NHS discharge information was seen where appropriate. Residents spoken with confirmed that their needs were assessed prior to moving into the home. Some service users said relatives had visited the home and one person said it had been recommended to her. Some service users are in the home for a short time. One service user spoke of the care she had received to “help her get on her feet” and was hoping to go home. Other service users come into the home for respite care. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are detailed and comprehensive. Medicines are stored securely. The management of medication procedures protects residents. Resident’s privacy and dignity is respected. EVIDENCE: The Inspectors viewed four care plans. These contained plenty of personal detail to enable staff to meet each resident’s healthcare & social needs. Care plans had been reviewed monthly and updated where necessary. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 12 Residents have access to a range of professionals including GP, District Nurse, Dentist, Social Worker, Optician and Chiropodist. The home’s medication policy was viewed and a copy supplied to the pharmacy inspector. All requirements and recommendations made at the random inspection on 25th September had been addressed. Medication is stored securely and has a new lock system. The Medication Administration Record (MAR) Sheets were viewed. There was one gap in the records. This will be followed up to ensure good practice and protect residents. Hand transcribed MAR Sheets contained two signatures and were dated. The home has recorded variable doses on the MAR Sheet. The controlled drugs were double locked. The Inspector checked the balance of one medicine and this was correct. The home had recorded and monitored the daily temperature for one medicine that was stored in the fridge to ensure that a safe temperature is maintained. Most creams viewed in service users’ bathrooms had been dated on opening although there were some omissions. Service users able to self medicate now sign to accept medication. Protocols for the use of some drugs were seen where Staff spoken with demonstrated a good awareness of how to respect resident’s privacy and dignity. Residents confirmed that they are treated with respect. Residents have access to a private telephone line in their bedroom. One comment card mention the effort staff made to understand service users and “pick up on any expressed need.” Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a programme of activities for those residents who wish to participate. Visitors to the home are made to feel welcome. Residents choose how to spend their time. Residents enjoy the meals. Frail service users receive appropriate dignified support at meal times. EVIDENCE: The home’s entertainment programme was viewed. This included a variety of musical entertainment. The manager confirmed that in-house activities include Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 14 flexercise, games and art classes. There are regular trips away from the homes for visits and lunches. On the day of the inspection a Christmas fair was held. Service users, visitors and friends enjoyed mulled wine and mince pies and sold some of the Christmas crafts they had made. All residents spoken to confirmed that their visitors are made to feel welcome at the home. The Inspector observed staff offering resident choices throughout the day. Residents confirmed that they can spend their time as they want to and that they are given choices. Resident’s rooms are attractive and comfortable and personalised with their own possessions. The menus were viewed. Residents spoken with confirmed that they had enjoyed their lunch and that they are offered a choice of dishes. Staff were observed offering residents choices. Residents spoken with confirmed that the food at the home was “very good.” On the day of the inspection lunch was cod mornay or scampi and chips. The dining room is attractively presented. There is a sound system in place to ensure frail service users who need considerable assistance with eating receive help in a quiet and gentle manner. Staff were observed assisting service users in their rooms. Meals are kept warm until they are needed by the member of staff. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 17 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints policy that is available to residents and staff. The home’s procedure in relation to Protection of Vulnerable Adults is robust and protects service users. Complaints raised by service users are dealt with appropriately at the home. EVIDENCE: The home has a complaints procedure. The procedure is kept within the home’s service user’s guide and staff policies file. The home had received one complaint since the last inspection. The manager had investigated the complaint. The complaint was documented and action had been taken as required. Additional actions required following a random CSCI inspection had been acted on. Residents spoken with knew who to speak to if they had any concerns. Four staff files were viewed. All contained evidence of POVA first checks and completed Criminal Record Bureau checks. The home has policies relating to whistleblowing and abuse. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 16 Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 21 22 23 24 25 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable environment with attractive furnishings. The home was clean. The home has systems in place to control the spread of infection. EVIDENCE: The inspectors viewed the home. The environment is well maintained. There is a very high standard of cleanliness and staff take a pride in the house. Bedrooms are decorated regularly and reviewed for each new admission. The home has an airy attractive sitting room and dining room. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 18 The grounds of the home are most attractive and contribute to the well being of service users. All residents have a call bell in their room. It was noted in a care plan that one service user was unable to use hers and alternative measures were suggested. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had sufficient staff on duty to meet the needs of residents. Staff recruitment procedures are robust and protect residents from harm. The home has a comprehensive staff induction programme. Training occurs in the home however an overall plan is needed. The home does not currently meet the minimum ratio of 50 trained members of care staff holding NVQ at level 2 or above. EVIDENCE: Duty rotas were viewed. There are seven members of staff on during the morning; five staff in the afternoon and two staff at night. The Inspector observed that there appeared to be sufficient staff on duty to meet the resident’s needs. Residents spoken with confirmed that staff are there when they need them. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 20 The inspector viewed three staff recruitment files. On the day of inspection, these files contained all of the required documentation. The home has a comprehensive induction and training programme. A planned training matrix is needed to provide a clear overview. Training areas include medication; fire; food hygiene; infection control; first aid; health & safety; manual handling and abuse. Specialist training areas include Parkinsons; Diabetes; Dementia; oral hygiene and nutrition. In response to the previous random inspection a requirement was made to update nursing staff in palliative care. Four staff have now completed the course at the hospice and three more plan to attend in the new year. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and promotes the service users well-being at all times. The home has an established assurance systems. Residents’ monies are safeguarded. EVIDENCE: Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 22 Mrs Patricia Britten is the Registered Manager. Residents spoken with stated that Mrs Britten is friendly and approachable. The home benefits from the support of a General Manager and an Administrative manager. Residents were positive about the way the home was run. Comments included “this is a well run home and wonderful carers”, and “I don’t think I could better this care home”. The Pre-Inspection Questionnaire states that policies in the home were reviewed in January 2006. The home is currently completing the Somerset County Council self assessment to apply for a quality rating. The home has distributes a survey to all service users monthly. The manager advised that the results will be collated and action taken as necessary. The manager speaks to residents on a regular basis. The home holds small amounts of money for some residents. The inspector viewed the records for one resident. The balance was checked and found to be correct. Receipts had been obtained to support transactions. The inspector viewed the home’s health and safety records. The home tests its fire alarm system weekly and emergency lights monthly. The fire alarm system and fire extinguishers were serviced according to requirements. The home’s bath hoists and hoists were serviced on 30/09/06. The passenger lift was serviced on 31/08/06. There are contracts arranged for all significant maintenance requirements. Accidents are recorded in the home’s accident book. The reports are detached in accordance with the Data Protection Act 1998. They are then filed in the resident’s individual care plans. The home undertakes an audit of the accident reports in order to identify trends and minimise risks. Cleaning chemicals were stored securely in accordance with COSHH Regulations 2000 and COSHH assessment sheets were viewed. The standard of cleaning reflects both the good standard of products and the hard work of staff. This is a well organised and managed home. Attention is paid to details. For example a cupboard houses all continence aids. These are labelled according to the service users who needs them and details of use and guidance for ordering are clearly labelled. Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 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 3 3 3 3 3 3 3 Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP25 Regulation 13(4) Requirement The home must ensure water temperatures are managed to protect service users safety. Timescale for action 31/12/06 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 OP12 Good Practice Recommendations It is recommended that further attention is paid to support with resident activities in the afternoon according to individual need, with particular consideration given to residents who may lack capacity. The home should ensure the formal supervision of staff is fully implemented. The training matrix for staff should be completed to demonstrate an annual plan for all staff. The home should ensure that all staff know snacks are available between supper and breakfast if required. 2. 3. 4. OP36 OP30 OP15 Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Beauchamps Country House Care DS0000003241.V321865.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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