Inspection on 22/09/07 for Beaufort House Care Home

This inspection was carried out on 22nd September 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 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 Care Home 11/01/07

Beaufort House Care Home 07/06/06

Beaufort House Care Home 31/01/06

Beaufort House Care Home 17/08/05

Beaufort House Care Home 15/03/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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 Beaufort House Care Home High Street Hawkesbury Upton South Glos GL9 1AU Lead Inspector Jon Clarke Unannounced Inspection 09:30 22 October 2007 nd 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 Care Home DS0000061734.V346163.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. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beaufort House Care Home Address High Street Hawkesbury Upton South Glos GL9 1AU 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) 01454 238589 F/P 01454 238589 Beaufort Care Ltd Ms Glenda Elizabeth Graham Care Home 28 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (22) of places Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2007 Brief Description of the Service: Beaufort House is a family run home in an attractive village location where there are shops, community facilities and a bus service. Several staff members working in the home live in the village. The home is registered to accommodate 27 older people and may accommodate 6 people with dementia. The home is approximately 4 miles from Wotton-Under-Edge and 8 miles from Chipping Sodbury. Bristol and Bath are within easy commuting distance. The property is a large mature house that has been extended. Accommodation is arranged on three floors. There is a passenger lift. Rooms consist of 25 single bedrooms and one double room. 17 bedrooms have en-suite toilet facilities. The home is set in attractive, well maintained gardens with lawns and a patio. The gardens are accessible to all service users and have been made safe. Fees are currently £428-£460 based on level of care needs. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the home as part of an inspection the manager was present throughout the visit. As part of this inspection a number of records were looked at including pre-admission assessments, care plans, staffing recruitment and training, medication administering and storage arrangements. I also had an opportunity to talk with a number of individuals who live in the home and a small number of staff. I found the manager welcoming to discuss any matters relating to this inspection. A number of Have Your Say questionnaire were sent to the home before this inspection responses were received from 10 residents 11 relatives and 7 health professionals. As part of this inspection the manager completed a Annual Quality Assurance Assessment (AQAA) which set out the areas of practice based around the National Minimum Standards summarising what the home does well, the evidence for this, what they could do better and how they have improved in the last 12 months. The information from the AQAA and questionnaires has been used to help make a judgement about the quality of care provided in the home. What the service does well: What has improved since the last inspection? A number of requirements were made at the last inspection relating to care planning, training, record keeping, fire drills and medication. I looked at these requirements on this visit and was satisfied that the requirement had been met which has resulted in improved practice in these Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 6 areas. It is of note that the owner, manager and staff have made considerable effort to address the number of concerns and resulting requirements made at the previous 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. The summary of this inspection report can be made available in other formats on request. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 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 Care Home DS0000061734.V346163.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose provides the required information about the home, the facilities, staffing arrangements, admission procedure and aims and objectives of the home so that individuals can make an informed choice about the suitability of the home. The home undertakes full and comprehensive assessment of prospective residents so that they are able to make an informed decision about the capacity of the home to meet health and social care needs. EVIDENCE: The home’s Statement of Purpose provides the required information about the services, facilities available to individuals who live in the home. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 9 The Service User’s Guide also gives information about the home so that perspective residents have the information they need to make a judgement about the quality of care provided in the home and the service they expect. All of the respondents to the Have Your Say questionnaire said they had received sufficient information about the home. A number of pre-admission assessments were looked at and they showed that the home had undertaken an assessment of care needs as part of the admission. Where individuals are known to social services a copy of their assessment is also obtained by the home. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 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. 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 Planning and arrangements for meeting health care are good providing staff with the necessary information so that the health and social care needs of residents are met. Arrangements for managing resident’s medication make sure that resident’s health needs are protected. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld. EVIDENCE: A number of care plans were looked at they contained full information about health and social care needs including sections relating to personal hygiene, mobility, communication, memory and orientation, emotional and mental health. Of note was the frequency of reviews. Moving and Handling assessments are completed to identify any risks associated with individuals and staff assisting with these tasks. Risk assessments are completed in one instance where bed rails where being used however there was not a risk assessment for the use of prn medication for one individual. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 11 (The home advised the inspector on the day after this visit that one had been completed and a copy supplied). I looked at the storage arrangements for medications and these were satisfactory and included separate secure storage for controlled drugs. Administering records were examined and had been completed as required with two signatures for controlled drugs. For one individual medication had been given but the number of tablets stored was not recorded against the occasions given and therefore no method to show that additional medication had been given but not recorded. I was advised on the day after my visit that this had been corrected and that records will now show stock numbers. Individuals who live in the home have full access to community health services and records confirmed this. Services such as chiropody, dental, optician are available on a regular basis. The home has good links with community nurses who visit the home as required. Records are kept of doctor’s visits. Eight of ten respondents to questionnaire said they “always” receive the medical support they need 2 said “usually”. One individual I spoke with said they “can rely on staff doing something quickly if I am unwell and need a doctor”. Because of the mental health of some individuals in the home there were limited number of individuals I could speak however I was able to speak with a small number of residents. They all were very positive about the approach of staff “all very nice” “friendly and helpful” “treat me well have no complaints”. I was able to observe staff on a number of occasions when they were with individuals or assisting at mealtimes. They did so with sensitivity and always in a dignified and respectful manner. Comments received by the home also confirmed this “staff extremely friendly and welcoming and I feel my relative will be treated with sympathy and respect” “incredible warmth, friendliness and care shown to residents and their families”. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 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. 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 arrangements for meeting the social and recreational needs of residents are generally good and there are opportunities for residents to maintain links with family, friends and the local community. It is welcomed that the home is making real efforts to improve the quality and frequency of activities in the home. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals, which are balanced and meet the dietary needs of individuals in the home. EVIDENCE: I spoke to a number of individuals about activities in the home there was a varied response from “there’s enough for me” “not one for a lot of activities” to “get bored sometimes”. Activities arranged included quizzes, outside entertainers, music quiz, massage therapist. It is hoped to recruit an activities organiser for 8-10 hours weekly and this will certainly improve this aspect of the home’s life. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 13 A number of comments were received from relatives about what they perceived as “boredom” lack of interaction between staff and residents. Residents who responded to the questionnaire said that there was “always” 4 and “usually” 6 activities available. Staff I spoke with also spoke of how they would welcome more time with residents and this was something identified in the home own quality assurance questionnaire “extra cover to do activities with residents” “more time with residents” (staff comments) and in the AQAA as an area for improvement. The home has an open visiting policy and recognises the importance of individuals maintaining contact with family, friends and the local community. This was confirmed by comments received by the home and from questionnaires from relatives: “friendly and hospitable to visitors” “there’s always a nice friendly atmosphere whenever I visit” “welcoming whatever time of day we arrive” “to be free to visit any time of the day”. I spoke to a number of individuals about the routines of the home and their ability to spend their time as they wished one individual told me that they felt “able to spend my time as I want its up to me” another when asked about getting up and gong to bed said “its my choice”. There was real sense that the home is as flexible as possible and tries to meet individuals needs and wishes wherever possible. The menus of the home offer a varied and attractive range of “home” cooked meals. Individuals were all very complimentary about the food provided and importantly “there’s always a choice”. One individual told that they were always asked if there was anything they didn’t like. The only negative comment was that teas could be more varied. Comments received included “excellent quality meals” “10/10 for food”. The home has received a 5star award from environmental health for the standard of hygiene and practice in the kitchen this is to be commended. On the day of my visit the meal was well presented and there was a relaxed and unhurried atmosphere. Staff were available to offer assistance and a number of individuals needed to be fed by staff this was done in a sensitive and appropriate manner. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear procedures in place and this enables individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. EVIDENCE: There have been no formal complaints made to the home since the last inspection however there were 4 dissatisfactions and these have all been addressed and responded to as required. In talking with individuals they all spoke of being able to say if they felt unhappy about anything “I would definitely tell someone”. All respondents to the questionnaire said they were aware of the home’s complaints procedure. I spoke to a group of staff about how they protect individuals and what may be seen as abuse and the action they would take. They all had a good understanding of the nature of abuse in a care home setting and were very clear that they would report any concerns they had. Some staff have completed Safeguarding Adults training and they home has a policy and procedure relating to protecting adults and whistle blowing. In a recent incident of concern they acted professionally in dealing with the matter. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe and hygienic environment for the residents and staff. People who live and work in the home benefit from a warm, welcoming and well-maintained environment. EVIDENCE: There have been extensive improvements to the environment of the home including new carpeting, new flooring in some rooms and new dining room furniture. The heating and water system has been totally renewed. One comment received form a relative was “the home provides a safe homely environment that cares” and from homes questionnaire “general décor of home has much improved” “you are always trying to improve the service and environment for residents and don’t stand still”. One area, which would benefit from some improvement, is that of the lounge area I discussed this with the manager. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 16 The layout of the lounge does not in my view lend itself to being attractive and welcoming, new carpeting and updating would improve this area of the home. It is even more crucial that this lounge be attractive in that it is the only lounge area in the home again it would be of benefit to individuals if there was an alternative lounge or seating area. Individuals I spoke with were very positive about cleanliness of the home and all respondents to the questionnaire said that the home was “always” clean. At the time of my visit the home was clean and free from offensive odours. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 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. 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. Staffing arrangements in the home are generally satisfactory so that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. Over 50 of staff have achieved NVQ qualification. The recruitment and selection of staff is undertaken to make sure that as far as possible the health and welfare of resident is protected. EVIDENCE: The home has adequate staffing and this was confirmed from staff rotas. Individuals I spoke with said they always found staff “available” “there when you want them”. Currently there are 9 members of staff who have achieved NVQ level 2 or above qualification with a further 2 undertaking this training. I looked at recruitment records and they showed that the required checks had taken place: Criminal Records Bureau check, two references and a full and detailed application form. Staff had also completed Skills For Care Induction. Training records for 4 members were looked at and showed that staff had completed moving and handling, fire training, infection control, medication and POVA. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 18 Other training available to staff included Dementia Awareness, Promotion of Continence, Insulin and Diabetic awareness, Pressure Care. The manager advised that they hope to introduce Yesterday, Today & Tomorrow training which will provide staff with improved skills and knowledge around working with individuals who have dementia. They are also introducing SOFI, which is an observation tool that looks at how staff interact with residents. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 19 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): 31,33,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good opportunities for individuals who live in the home and others to express their views about the service they receive. The practices of the home help to make sure that the health, safety and welfare of residents and staff is protected. EVIDENCE: The manager has been in post for 12 years and has NVQ Registered Manager’s Award. Individuals I spoke with described her as approachable “someone we can talk to”. Staff were also positive about her open approach. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 20 The home undertakes quality assurance questionnaires obtaining views from relatives and relatives about the quality of the service they provide. Comments from the last questionnaire in October were received following my visit. They provided a number of positive comments as well as suggestions. Included were: “caring attitude of staff-this is most important”, “very friendly manner of staff”. Record relating to health and safety were looked at and confirmed that equipment is serviced and maintained on a regular basis: hoists 08/10/07,lift 06/06/07, fire system 10/07. A fire risk assessment has been completed. Staff undertake fire training and drills as required. Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 21 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 X 3 X X X 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 X 18 3 3 X X X X X X 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 X X X 3 Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 22 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. 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 Beaufort House Care Home DS0000061734.V346163.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection 4th Floor Colston 33 33 Colston Avenue Bristol BS1 4UA 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. 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