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Inspection on 27/10/05 for Beaumanor House

Also see our care home review for Beaumanor House for more information

This inspection was carried out on 27th October 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

The atmosphere in the home is warm and friendly. The staff were observed engaging with residents and visitors in a pleasant and welcoming manner. Staff support the residents to make decision about the their daily life and goals for the future. Residents commented and used various forms of communication including through the staff, indicating satisfaction with their lifestyle in the home. Residents demonstrated how their individual interests and hobbies are supported. Residents are encouraged to access the local provisions and community facilities and participate in activities in-house and in the surrounding areas. There is a good choice of meals with snacks and drinks are available throughout the day.

What has improved since the last inspection?

What the care home could do better:

Since the last inspection the bedroom under refurbishment remains outstanding and the work appears to have ceased. There are several areas in the home, primarily at the entrance to the home and the corridors, with exposed bare plastered walls require decorating. The holes in the ceiling and walls prepared for light fixtures needs to be made good and made safe. The lighting in the corridors, remain poor and poses a risk to residents with visual impairment or poor mobility and staff. Residents would benefit by having access to more current magazines and books in the home.

CARE HOME ADULTS 18-65 Beaumanor House 34 Robert Hall Street Leicester Leicestershire LE3 5RB Lead Inspector Rajshree Mistry Unannounced Inspection 27th October 2005 02:00 Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 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 Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 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 Adults 18-65. 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. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beaumanor House Address 34 Robert Hall Street Leicester Leicestershire LE3 5RB 0116 2664833 0116 2664833 holtjool@leicester.gov.uk 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) Leicester City Council Julian Holt Care Home 21 Category(ies) of Learning disability (21), Physical disability (1) registration, with number of places Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No person falling within category PD may be admitted to the home unless that person also falls within category LD - ie Dual Disability Service User Numbers LD/PD No one falling within categories LD/PD may be admitted into the home when there is already 1 person of categories LD/PD already acommodated within the home. 22nd May 2005 Date of last inspection Brief Description of the Service: Beaumanor House is a registered care home providing accommodation for up to twenty-one adults with learning disability. The home is owned and managed by Social Care and Health Department, Leicester City Council. Beaumanor House is located in a quiet residential area, close to local shops and amenities. There is a car park to the front of the home. Public transport routes are nearby and approximately ten minutes to the city centre by car. Accommodation is on the ground floor with level entry access. Bedrooms are close to the bathrooms and toilets. All areas of the home are accessible for people using walking aids. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the service, which took place on the morning of 25th October 2005 and lasted 3 hours. This is the second regulatory inspection of the service addressing the remaining core standards. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for the resident and their views of the service provided. The primary method of inspection used was ‘case tracking’. This involved selecting two residents and tracking the care they receive through a review of their records, discussion with the residents, their relative, the care staff and observation of care practices. There were opportunities to speak with residents accessing the respite service, primarily on short stay basis. What the service does well: What has improved since the last inspection? The majority of the requirements and good practice recommendations made at the last inspection have been addressed satisfactorily. Since the last inspection the following improvements have taken place: • • • • Three new carers have been commenced employment at the home. All staff have been re-allocated new residents to key work. New risk assessments and care planning has been introduced that are based on ‘person centred plans’. The home has reviewed the Pharmacist service that has resulted in the change of the Pharmacist provider. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 6 • Introduction of the ‘Beaumanor Residential Home Induction Pack’ has been developed and implemented to support the mandatory induction programme for the local authority. Staff have received training in ‘care planning’ and ‘person centred plan’ training. The management team have commenced the Quality Assurance review using the ‘BILD’ programme whereby professional social care and health professionals participate in measuring and assessing the quality standard of the home over a period of time. • • 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. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: The core standards were inspected at the last inspection and were met. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Residents are supported on a day-to-day basis to continue daily choice of lifestyle and interests. EVIDENCE: The home has an open door policy and residents are actively encouraged to approach the Registered Manager and staff. Throughout the inspection of the service residents were observed freely moving around the home, expressing their views, opinions and engaging with the staff. Two residents records showed risk assessments are completed prior to a resident moving to the home. Since the last inspection new person centred care plans and risk assessments have been develop in consultation with the residents through reviewing individuals’ needs. Records viewed showed the risks and the management strategies agreed to pursue their individual lifestyle, activities and interests. For example a resident at the home with who is blind goes to the local pub. The residents’ aspirations and choice of lifestyle is promoted and risks are assessed and managed enabling the resident to be part of the community. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 Residents’ benefit from having a good varied and balanced meals. EVIDENCE: The residents indicated that they have a good choice of meals that is varied, appealing and nutritionally balanced. During the inspection, the Inspector observed fresh vegetables and fruit being offered. Staff and residents spoken with indicated that they enjoy going out for a pub lunch. At present the meals continue to be prepared by the agency cook until one has been recruited. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Management of medication is good and residents are support and receive their medication promptly. EVIDENCE: Since the last inspection the medication storage, recording and practices have been reviewed. The home has recently changed the Pharmacist provider, which has benefited the home. All medication is stored in the medication room and only trained staff administers medication. The medication storage viewed was found safe and supported by good management systems for ordering, storing, recording and returning medication. Medication and respective records were examined for two residents found in good order and up to date. Residents spoken with indicated that they get their medication on time. A new member of staff spoken with had completed a delegated task competency with the District Nurse for administering insulin. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Trained staff and procedures are in place to respond to any suspicion or allegations of abuse protect residents. EVIDENCE: All staff receive training in adult protection at induction and have access to the local authority adult protection procedures. Staff spoken with demonstrated sound knowledge of the procedure and the actions to taken where suspension or allegation of abuse occurs. The Inspector observed residents freely speaking with other residents and staff. Residents spoken with and observed indicated they felt safe with the staff in the home and protected. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. The home environment could be improved to remove the risks presented to the residents. EVIDENCE: The home provides a clean environment that is comfortable. The bedroom undergoing refurbishment remains incomplete and further confirmed by the Registered Manager that the work has stopped. Although the residents or the staff do not use the bedroom, the external areas to the room need to be made good and decorated. During the tour of the premises with the Registered Manager areas of the home were identified as requiring attention: • • The bare, exposed walls identified during the inspection should be decorated and made good. The holes in the walls and ceiling for light fittings should be made good. The lighting in the corridors is poor and poses risk to residents with visual impairment of sight and restricted mobility. This was raised with the Registered Manager, who acknowledged the risks posed and indicated that local authority’s property maintenance team have been informed although works have not been carried out. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 14 Residents and staff that spoke with the Inspector indicated that books and magazines available are ‘old’. Staff spoken with indicated that the residents would enjoy having current magazines, which may reflect residents interests such as football, arts and crafts. The home is clean and cleaning materials are stored in locked storage. Laundry facilities are in a locked room and procedures are in place to prevent the spread of infection. Staff spoken with indicated that residents’ laundry is done promptly especially for residents with incontinence. Residents observed appeared well dressed and indicated that they have clean clothes. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Appropriately trained staff meet the residents needs individually and collectively. EVIDENCE: Since the last inspection, the Registered Manager has developed a stafftraining database. The Registered Manager demonstrated the database and showed details of training undertaken by the staff after the mandatory induction based on Learning Disability Award Framework (LDAF) and probation period completed. Records showed staff have accessed training in moving and handling, health and safety, challenging behaviour, ABC training (primarily for staff working with people with leaning disability). The home now has a qualified NVQ Assessor to benefit the staff undertaken NVQ training. The nature of some residents needs requires some practical support within and outside the home and the trained staff enable residents to be independent. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39. Residents’ views are sought regularly and incorporated in the daily life in the home. EVIDENCE: The home is run in the best interest of the residents. Residents are consulted on a daily basis regarding their plans for the day, with key workers, at the formal review meetings, with social workers, mentors and family representatives. The home has a responsibility to fulfil the regulatory obligation under ‘Regulation 26’ and conduct monthly visits and findings of the visit reported to the Commission on a regular basis. To date the last report received by the Commission was dated April 2005, and there is little evidence to suggest monthly visits have been carried out timely. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Beaumanor House Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X X X DS0000031587.V261091.R01.S.doc Version 5.0 Page 18 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 YA24 Regulation 23(2) Requirement The Registered Manager must ensure that the bedroom currently being re-furbished is accessible and fit for purpose. The work has ceased and remains unfinished, since the last inspection – 22/05/05. Timescale for action 25/11/05 2. YA24 23(2) 25/11/05 The Registered Manager must ensure: (a) The bare, exposed walls identified during the inspection are decorated and made good. (b) The holes in the walls and ceiling for light fittings are made good. (c) The poor lighting the corridors is improved to prevent risks to all residents and staff. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 19 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 2 Refer to Standard YA24 YA39 Good Practice Recommendations The Registered Person should make available current magazines and books of interest for the residents. The Registered Person should make regularly conduct monthly visits to the home and submit the findings from Regulation 26 visits to the Commission, timely. Beaumanor House DS0000031587.V261091.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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. 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