Inspection on 14/03/06 for Beaufort House

This inspection was carried out on 14th March 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

Beaufort House 24/02/09

Beaufort House 28/02/07

Beaufort House 25/05/05

Beaufort House 25/01/05

Beaufort House 24/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Beaufort House Rectory Road Burnham-on-sea Somerset TA8 2BY Lead Inspector Shelagh Laver Unannounced Inspection 10:00 14 March 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 Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 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. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beaufort House Address Rectory Road Burnham-on-sea Somerset TA8 2BY 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) 01278 786320 01278 786320 The Royal Agricultural Benevolent Institution Mrs Christine Rowe Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. REGISTERED FOR 32 PERSONS IN CATEGORIES OP AND PD (OVER 50 YEARS OF AGE) 25th May 2005 Date of last inspection Brief Description of the Service: Beaufort House is a residential home owned by the Royal Agricultural Benevolent Institution. It is situated in a pleasant residential area of Burnhamon-Sea and is surrounded by large and attractive grounds. The home is a large Victorian building that is comfortable and very well maintained. There are four large sitting rooms (one with bar facilities) and a spacious dining room. All bedrooms have en-suite facilities and call bells. There is a passenger lift and facilities for assisted bathing. The home benefits from a low staff turnover. Staff are experienced and benefit from an established training programme. General Practitioners and district nurses visit service users in the home to provide professional health care. The management and staff at the home assist service users to live as independently as possible. There is an interesting range of activities within the home and links to the wider community. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on one day over four hours and was conducted by one inspector. A tour of the premises took place where a selection of bedrooms and all communal areas were seen. Ten service users were spoken with individually. Others were observed having coffee together and in the communal rooms. The registered manger Mrs Rowe was on holiday. In charge on the day of inspection was senior care assistant Anne Beckett who was able to assist the inspector. She was supported by care, maintenance, and housekeeping staff. Administration is managed by Susan Lock. Records relating to care, staff and health and safety were examined. All were found to be satisfactory. What the service does well: At this unannounced inspection it was clear that the home continued to run in order to provide the best possible individual care to service users. There is an established positive group of carers although unusually it has been necessary to use some agency staff in the past months. Service users confimed they were well cared for at Beaufort House. One service users said “It is very nice here…I can’t complain at all”. One service user felt the home did not suit her at all. She felt it was “too quiet”. During discussion with care staff and through reading the care plan it became clear that the home went to considerable efforts to meet the service users needs and to provide a satisfactory service. The service user was able to voice her views which were listened to and acted upon. Service users’ benefit from the contributions made by all members of the support staff. Service users enjoy a wholesome and varied menu which takes into account the needs and preferences of people in the home in a very individual way. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 6 The home environment is very well maintained. It safe, clean and comfortable. There are detailed and comprehensive maintenance records. There is evidence of continued investment in the home. Rooms have been redecorated. Communal areas exceed the required Minimum Standards. The gardens are very maintained and at this inspection was full of spring flowers. A new memorial garden is nearing completion. Service users are actively supported in the development of a variety of lifestyles and daily routines that suit them individually. The Standex care planning system is now fully embedded. The documentation provided is clear and comprehensive. Care plans have meaning and informative detail and provide a real blue print for the care to be provided. There is a varied activities and social programme enjoyed by many. There are also opportunities for service users to spend their days as quietly as they wish. The home has excellent support from the local GP practice although service users can choose to maintain their own GP. 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. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 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 the following standard(s): 2, 3 & 4. The manager ensures that the home can fully meet the assessed needs of prospective service users prior to making a decision about admission. The pre-admission process is detailed and well managed. The manager ensures that prospective service users are provided with appropriate information which will assist them in making a decision about admission. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide which is made available to service users, prospective service users and their representatives. The home’s current fee range is dependant upon the room to be occupied and the assessed needs of the service user. Current fees are £339-£416. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 9 The manager ensures that prospective service users are fully assessed prior to admission. Detailed assessment documents are produced that include psychological and social histories. At the previous inspection the manager stated that a service user is visited if possible and information from other health professionals and for example hospital care notes are taken into account. Service users are invited to visit the home whenever this is possible. The assessment period extends to a one month trial in the home during which time in-depth assessments and observations are made. It is a testimony to the effectiveness of the initial assessment that service users rarely leave following completion of the assessment period. Documentation relating to pre-admission assessments was seen in the three care plans examined and contained discharge and transfer information. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 7, 8, 9 & 10. The home takes appropriate action to ensure the health care needs of service users are met. The home’s procedure for the management and administration of medication was found to be satisfactory. Service users are treated with respect. Care practices support privacy and dignity. EVIDENCE: All service users have care plans maintained. Three were examined and were found to be up to date and well maintained. There were monthly reviews. Care plans are compiled from appropriate assessments which include preadmission assessment, prevention of pressure sores, moving and handling needs and nutrition. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 11 The Standex care planning system is used and is initially completed in great detail by the manager. The planning of individual care was noted to be very thorough and included guidance on the psychological care and specific emotional support required by service users. The Dependency scores recorded demonstrate how some service users improve their mobility and general health in the home. It is recommended that a more detailed risk assessment is kept for the service user who leaves the home regularly as discussed with the manager. Sit-on scales should be purchased as soon as possible so that monthly weights can be recorded for all service users. All service users asked confirmed that they are well cared for at Beaufort House. It was observed from care plans that service users have access to appropriate health care professionals. There was evidence of particularly good support from the GP practice with weekly visits from the doctor. Pro-active treatment and monitoring of long term conditions is provided as well as a rapid response to acute illness. Service users received visits from chiropodists and opticians. Some maintain links with services in the community. The home uses the Monitored Dosage System (MDS) with some additional boxed prescriptions and pre-printed MAR charts. All records examined were appropriately completed. Medicines were seen to be appropriately stored. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 12, 13, 14 & 15. Service users are able to chose a variety lifestyle patterns in the home. The home provides a wholesome and varied menu which takes into account the needs and preferences of service users. Arrangements for service users to maintain contact with family and friends is good. The home provides activities and entertainments to enrich the service users lives. EVIDENCE: The home menu is wholesome and appetising, varied and takes in to account the needs and preferences of service users. One service users raised issues about the food with the inspector. The inspector discussed these with the manager who agreed that it was hard to ensure all service users were satisfied at all times. “We use fresh meat and vegetables. we are always listening to people.” Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 13 There is a cooked breakfast choice each day. The dining room is pleasant and tables are set to restaurant standard. One service spoke of the efforts made to ensure she had something to eat she liked. Care is taken to ensure that soft diets are appealing and wholesome. The home seeks the views of a dietician when needed. Visitors are made welcome at any reasonable time in accordance with the wishes of the service user. There is a choice of communal areas ensuring there is always “a quiet spot”. Some service users prefer to meet visitors in their rooms that were seen to contain sufficient seating. Relatives are able to stay at the home. Service users were able to describe how they spent their days. Some enjoyed cross words and reading. Other enjoyed the activities such as quizzes and arts and crafts and social events in the communal rooms. There is a library in the home. Service users were smartly dressed and have the regular services of a hairdresser who was in the home on the day of inspection. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 16, 17 & 18. The complaints procedure in this home is good with evidence that the views of service users/visitors are listened to and acted upon. Procedures and policies aim to protect service users from abuse. EVIDENCE: There had been no complaints since the last inspection. Service users spoken to knew who they were able to speak to if they wished to complain. Staff recruitment procedures, training, supervision contribute to the protection of service users from abuse Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. Service users live in a comfortable, safe and clean environment and are able to personalise their own bedrooms. The home’s environment is able to meet the assessed needs of service users. The home provides specialist equipment to ensure the needs of service users are met. EVIDENCE: All communal areas and most bedrooms were seen at this inspection. Bedrooms were pleasant and comfortable and it was evident that service users were encouraged to bring personal possessions into their rooms. One service had brought her own bed. Specialist beds and pressure relieving equipment were seen to be in place where there was an assessed need. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 16 Service users informed the inspectors that they were very satisfied with their rooms. Some appreciated the views from the bedroom windows across the gardens. There is a choice of sitting areas and the standard of decoration and furnishing exceeds the minimum standards. The home has a lounge, a dining room and a conservatory. There is a large hall that provides additional sitting area. The hall, stairs and landing carpets have recently been replaced. Service users have a choice of where to spend the day. Some prefer to spend a great deal of their time in their bedroom although all are encouraged to come to the dining room for lunch if they are well. Overall the home is very pleasantly decorated and well maintained. The standard of cleanliness was very good. Domestic staff on duty were satisfied with the time provided to care for the home and the equipment provided. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. The home ensures that there are sufficient staff on duty to meet the service users needs. The home’s recruitment practices are robust and designed to protect the service users. Staff are well trained and have access to a range of mandatory and developmental training opportunities. EVIDENCE: On the day of inspection there were five care staff on duty. Also on duty was the chef, housekeeper and two domestic staff and a laundry lady. There is a full-time maintenance man and two gardeners. The number of staff has been increased to reflect the increased dependency in the home. Staff spoken to confirmed they had received Manual handling up-dates and fire training. Infection control and medication training had been provided for some staff. Two recruitment files were observed. Both contained evidence of a thorough recruitment process. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. The home is effectively managed by the registered manager who promotes a clear and inclusive style of management. Measures are taken which ensure the needs and well-being of service users takes priority and that staff are appropriately supported and supervised. The home’s systems for ensuring the health, safety and welfare of service users and staff are structured and well managed. EVIDENCE: On the day of the inspection the home appeared organised and orderly. There is an experienced administrator responsible for managing the finances of the home and maintaining appropriate records. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 19 At the time of this inspection, the home was taking appropriate steps to ensure the health & safety of service users, staff and visitors to the home. The following records were examined: FIRE – Records indicated that appropriate checks were being carried out on the home’s fire detection and fire fighting equipment. Regular training is conducted for all staff. SERVICING – Servicing schedules indicated that hoists are serviced according to LOLER. . There are planned dates for all servicing. ACCIDENT– The home maintains appropriate records relating to accidents at the home. The accident records include action to be taken and evidence of analysis. HOT WATER/SURFACES – Bath hot water outlets are thermostatically controlled to reduce the risk of scalding. Those checked at this inspection were found to be within the acceptable limits. First aid training is provided for staff. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 20 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 X N/A 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 4 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 X 3 X X 3 Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 21 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 OP38 Regulation 13(4)c Requirement All cleaning materials must be locked away and not left in bathrooms. COSHH training updates must be provided to staff. Sit-on scales must be purchased as soon as possible so that weights can be recorded for all service users. Timescale for action 01/04/06 1 OP8 12(1)a 01/04/06 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 OP7 Good Practice Recommendations A detailed risk assessment and plan of care should be in place in the care plan if a service user leaves the home. There should be clear and regular recorded reviews to ensure the service users’ needs are still met in the home. Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Beaufort House DS0000015977.V284640.R01.S.doc Version 5.1 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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