Inspection on 24/08/05 for Beauchamps Country House Care

This inspection was carried out on 24th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Beauchamps Country House Care 27/01/09

Beauchamps Country House Care 01/12/06

Beauchamps Country House Care 07/02/06

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 Beauchamp House Nursing & Residential Care Village Road Hatch Beauchamp Taunton Somerset Lead Inspector Dee McEvoy Inspection 24 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Beauchamp House Nursing & Residential Care Address Village Road, Hatch Beauchamp, Taunton, Somerset, TA3 6SG 01823 480276 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) enquires@beauchampcare.com Mr David Peter Kohlman Patricia Anne Britten Care Home 40 Category(ies) of OP: Old Age 40 registration, with number of places Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Elderly persons of either sex not less than 60 years, who require general nursing care. 2. 4 places for persons of either sex in the age range 30 - 60 years, who require general nursing care. 3. Up to 20 places for general nursing care Date of last inspection 17 March 2005 Brief Description of the Service: Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the first of the current year and took one day to complete. There were 27 residents living at the home at the time of the inspection and the inspector met and spoken with many of them; 5 were interviewed in some detail about their experience of life at the home. Eight staff members were spoken with, including the general manager, deputy matron, care staff and the maintenance person. A visiting G.P and Community Psychiatric Nurse were also spoken with. Comment cards were received from 4 residents, 2 relatives and a G.P. The inspector also toured the premises and inspected a number of records including residents’ care plans and associated records. There is a small supported housing complex in the grounds that aims to provide personal care to residents with a dedicated staff team. However, on the day of the inspection sickness and leave meant that staff from the home were expected to assist some residents in the complex with personal care needs; the management team helped with the mealtime requirements of the residents at the ‘Gardens’. The general manager said that this was “The exception rather than the rule” but this situation did impact on the service provided at the home. Residents were generally positive about life in the home, some describing the house and grounds as “absolutely beautiful”. The majority of residents and relatives were happy with the overall care provided by the home and many had positive suggestions as to how to improve the service. A satisfactory action plan was received from the registered manager and provider following the inspection. What the service does well: Residents felt that long serving members of staff were a particular asset to the home, one resident said, “The staff are absolutely excellent”, another said, “ The staff here are very good, very caring people.” Staff interviewed also described the staff team as a strength of the home, one said, “We work well together to provide the best care we can.” Residents were happy with the general environment, comments included, “This is a beautiful house and the gardens are really lovely”. Several residents said they enjoyed the garden and many took daily walks, weather permitting. All residents spoken with were happy with their private accommodation. Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home’s assessment process is good and ensures that the home is able to meet residents’ needs. EVIDENCE: The home’s admission process is well managed and includes good assessments and visits to prospective residents at home or in hospital. When possible prospective residents are invited to visit the home prior to admission to ensure that the home meets their needs and expectations. All four assessments looked at were detailed. The home does not admit residents for intermediate care. Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 Residents benefit from care plans that are generally well developed and give clear information to enable staff to meet their health and social care needs but care plans need to be completed in a timely way to ensure needs continue to be met. Attention is needed to ensure that medication records are accurately maintained to reduce any risk to the residents. Residents benefit from caring staff, who respect their privacy and dignity. EVIDENCE: Individual records are kept for each of the residents; four were inspected including records for the most recently admitted resident, who had lived at the home for nearly three weeks. Each contained detailed information, including a social history, ensuring that staff had all the relevant information to satisfactorily meet the health and social needs of the residents, with the exception of the most recently admitted resident. A full assessment had been completed for this resident but the care plan was incomplete which could result in individual needs not being met. This was discussed with the deputy. Staff interviewed had a good knowledge and understanding of residents’ needs and were involved in the development and review of care plans. Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 10 Personal and environmental risks are identified and managed; comprehensive manual handling plans and other risk assessments are present to ensure the safety of the residents while promoting independence where possible. Feed back from one G.P and a CPN during the inspection was in the main positive. Both felt that the home communicated clearly and that staff demonstrated a clear understanding of the care needs of the residents. One felt that the standard of care was “well up to standard” in spite of the staffing levels at times. (Staffing levels are dealt with under standard 27). Residents appeared to have their main personal care needs met, but one resident would have benefited from more attention to detail, for example being suitably dressed and changed when needed. This was discussed with the deputy matron. Medication records were checked. On inspection the Medication Administration Record (MAR) charts were generally good but showed three (unacceptable) handwritten entries on the charts, which were not signed or dated. Residents spoken with and those responding with comment cards said that they were treated well by staff and that their privacy was respected. The hairdresser was visiting several residents during the inspection, one lady told the inspector “I feel good when my hair is done.” Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Social activities are provided and offer some daily variation and interest for people. Further consideration could be given to developing the activities for residents who lack capacity. Residents will benefit from an improvement in the general variety and quality of food. EVIDENCE: Residents’ interests and hobbies are included in their care plans and opportunities are provided to maintain previous interests and contacts. There are records, which state if residents prefer not to join in. Various activities are organised within the home and several residents enjoy contact with the local village and participate with some local activities out side the home. Until recently the home had an activities co-ordinator, several residents commented on the loss of this person. Care staff maintain activities such as outings and Flexercise classes. The home has purchased a mini bus with tailgate to ensure all residents have an opportunity to enjoy trips. It was unclear whether all residents and capacities were included in the activity programme. Relatives confirmed that that they could visit freely and were welcome at the home. One wrote, “Very happy with the kindness and care shown.” Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 12 Mixed comments were received from the residents with regards to the quality of food served at the home. Three residents asked said that they liked the food, one said, “There is too much to eat at times and we generally have a choice.” Four other residents felt that the quality of food had declined recently, one said, “The menu can be repetitive and the quality of vegetables and meat at times is not very good.” Four residents said that they had enjoyed the ‘home made cakes’ previously available at the home but that now “pre-packed” goods were generally offered. The inspector joined some residents in the dining room for lunch. There was a pleasant atmosphere; it was noted that it could not accommodate more than 22 residents at present. Some residents choose to eat in their rooms and one couple stated that they preferred to be able to do this. A choice of main meal was available to residents. Issues raised were discussed with the general manager at the feedback session. The inspector was told that quality assurance feedback from residents was usually good with regards to food, but that new catering arrangements were currently being established and an improvement in the quality of the food would soon be delivered. Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has a satisfactory complaints process and residents and relatives know who to speak with if they are unhappy. Staff do not fully understand the adult protection procedures and this potentially places residents at risk. EVIDENCE: No formal complaints had been received by the home since the last inspection. Concerns raised by residents or issues identified on the monthly feed back sheets are dealt with avoiding formal complaints. Residents and relatives were aware of the home’s complaints procedure but were generally happy to talk to with staff about any day-to-day concerns. One resident felt that not all staff were approachable and said, “I would choose whom I speak with.” Two folders in reception contain many cards and letters of appreciation; comments seen include, “Thank you for the many kindness” and “Thank you for the tender and loving care given to my mother.” Staff interviewed had an understanding of the issues of adult protection but not all had seen the home’s policy and procedure or knew the local procedures to follow in the event of an incident at the home. Senior staff were unaware of any local adult protection team or national and local strategies for dealing with incidents in a multidisciplinary way. This may place residents at risk. Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 The standard of the environment within this home is good providing residents with an attractive, welcoming and safe place to live. EVIDENCE: The home is maintained to a high standard both internally and externally. The communal areas are maintained and furnished to a high standard. Residents’ rooms were personalised with sentimental items, photographs and small pieces of furniture and all expressed their satisfaction with the accommodation provided. The gardens around the home are accessible and used by many of the residents. There are attractive places to sit, summerhouses and gentle walks. Several residents expressed how much they appreciated the grounds but one said, “The gardens could be used more if we had more staff to help people.” A full time gardener is employed to maintain the grounds. On the day of inspection the home was clean and free from odour; quite a few residents said that it was always like this. Two residents particularly praised the laundry service at the home, one said, “The domestic staff are marvellous.” Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 15 There were adequate hand washing facilities and protective gloves and aprons. Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The deployment and number of staff available is not always sufficient to meet the needs and preferences of the residents in a timely way. EVIDENCE: Residents, staff and one visiting G.P raised concerns about the level of staffing at times. On the day of the inspection the usual staffing level for the morning and afternoon shifts had been met. An agency carer, who had not been to the home before and was unfamiliar with the residents, and a carer on induction, were working with four long serving carers and the deputy matron. The home’s care staff had to provide care and support to the supported living cottages; one carer made two visits to the cottages. Staff were busy throughout the morning trying to meet the residents’ needs; two residents told the inspector “the bells are always ringing.” One staff member said, “It feels like a conveyor belt at times, we only have time to do the basic care.” The inspector was told that over half the residents required assistance with personal care and other needs; one carer said, “It takes time to get things right for the residents.” One resident told the inspector, “People are often waiting for attention. I try to find staff to help others” another said, “The staff are marvellous but they need more of them.” Residents were generally positive about the staff team, praising them for their efforts. Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The health and safety of residents is in the main being promoted. EVIDENCE: An in-house Manual Handling trainer ensures that mandatory training is up to date but at least one staff member requires a first aid update. There was a fire alarm triggered by dust during the inspection; the staff and residents were aware of the procedure and all assembled without difficulty in the allocated areas. Residents’ safety is maintained through the provision of thermostatic valves to ensure safe water temperatures and restricted windows. One member of staff takes the ‘lead’ for health and safety and fire safety to ensure residents and staff are protected. Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 1 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 x x x x x x x 2 Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 19 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP 18 Regulation 13 (6) Timescale for action The registered person shall make 20/10/05 arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. (Appropriate training to be given to all staff to ensure procedures are followed to protect residents.) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of the service userensure that at all times suitable, competent and experienced persons are working in the care home in such numbers as are appropriate for the health and welfare of service users. 6/10/05 Requirement 2. OP 27 18 (1) (a) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 20 No. 1. 2. 3. 4. 5. Refer to Standard OP 7 OP 9 OP 12 OP 15 OP 38 Good Practice Recommendations Residents care plans should be developed in a timely way following admission to ensure that individual needs are met. It is recommended that all hand written MAR charts are signed by two people. It is recommended that resident activities are extended and developed according to individual need, with particular consideration given to residents who may lack capacity. It is recommended that residents are consulted to ensure that meals are varied and of good quality, reflecting preferences. It is recommended that first aid training be up-dated for those staff who require it. Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 21 Commission for Social Care Inspection Suite 1, Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 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 Beauchamp House Nursing & Residential Care D54-D06 S3241 Beauchamp House V245546 250805 Stage 4 amended.doc Version 1.40 Page 22 - 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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