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Inspection on 19/07/06 for Beaumanor Nursing & Residential Home

Also see our care home review for Beaumanor Nursing & Residential Home for more information

This inspection was carried out on 19th July 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.

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 service has comprehensive and robust policies and procedures in place that lead to increased protection for residents. Assessment records and care plans were good to ensure that the residents` needs and preferences are met. The management approach at the home was open and inclusive, staff felt supported by the management team.

What has improved since the last inspection?

Channels of communication appear to be satisfactory and the complaints policy and procedure ensures that any concerns, identified by residents and others, are addressed appropriately.

What the care home could do better:

No requirements and only one recommendation following this inspection. The home does not have a designated activities organiser and in consequence there are no daily programmes of activities for the residents to access should they choose to do so.

CARE HOMES FOR OLDER PEOPLE Beaumanor Nursing & Residential Home 41 Cartwright Street Loughborough Leicestershire LE11 1JW Lead Inspector Mrs C A Burgess Unannounced Inspection 19th July 2006 09:30 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 Beaumanor Nursing & Residential Home DS0000001888.V304197.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. Beaumanor Nursing & Residential Home DS0000001888.V304197.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beaumanor Nursing & Residential Home Address 41 Cartwright Street Loughborough Leicestershire LE11 1JW 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) 01509 239443 01509 239446 Rushcliffe Care Limited Mrs Lyn Joy Peach Care Home 53 Category(ies) of Old age, not falling within any other category registration, with number (53), Physical disability (28), Physical disability of places over 65 years of age (53), Sensory impairment (2), Sensory Impairment over 65 years of age (2), Terminally ill (2), Terminally ill over 65 years of age (2) Beaumanor Nursing & Residential Home DS0000001888.V304197.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No one under the age of 55 years may be admitted into the Home To be able to admit the person of Category LD, PD & DE named in variation application number 34229 dated the 22nd July 2002. Service User Numbers TI & TI(E) No person to be admitted to the home in categories TI or TI(E) when 2 persons in total of these categories/combined categories are already accommodated within the home Service User Numbers SI & SI(E) No person to be admitted to the home in categories SI or SI(E) when 2 persons in total of these categories/combined categories are already accommodated within the home No one falling in category PD may be admitted into the home where there are 28 persons of category PD already accommodated within the home 9th September 2005 4. 5. Date of last inspection Brief Description of the Service: Beaumanor is a care home situated on the outskirts of Loughborough and is registered for fifty-three nursing and residential beds, providing personal and nursing care for older persons. The home is a purpose built, well-appointed accommodation on two floors, accessed by a passenger lift. Bedrooms are single with en-suite facilities and all areas of the home, including the safe patio area and garden are accessible to all residents. Located close to the centre of the town and situated on the banks of the Grand Union Canal, the home has pleasant views, and is situated within a ten-minute walk of the train station. There is adequate car parking and the East Midlands Airport is a thirty-minute drive from the home. The Statement of Purpose, Service Users’ Guide & Inspection Report are available on request (these provide information on how the home is organised and what services they provide). The Statement of Purpose and Service Users’ Guide are provided for all new residents. At the time of the site visit the Registered Manager stated that weekly fees were: £437 - £640 (room supplements and additional charges may apply). Beaumanor Nursing & Residential Home DS0000001888.V304197.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day. An opportunity was taken to look around the home, view records, policies and care plans and to talk to staff, residents and their relatives and visitors. The primary method of inspection used was ‘case tracking’. This involves selecting three residents and tracking the care they receive through a review of their records, discussion with them, with other residents, relatives, the care staff and visitors to the home. It also involves observation of care practices. Many of the residents were seen during the inspection. Three residents, four of the residents’ relatives and staff spoken with gave the Inspector their impressions of the home. What the service does well: What has improved since the last inspection? What they could do better: No requirements and only one recommendation following this inspection. The home does not have a designated activities organiser and in consequence there are no daily programmes of activities for the residents to access should they choose to do so. Beaumanor Nursing & Residential Home DS0000001888.V304197.R01.S.doc Version 5.2 Page 6 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 Nursing & Residential Home DS0000001888.V304197.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 Beaumanor Nursing & Residential Home DS0000001888.V304197.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process is well managed and residents receive a satisfactory assessment, thereby ensuring that their health and welfare needs are being met. EVIDENCE: Three residents’ files were reviewed. The pre-assessment process, completed the Registered Manager, was reflective of the health, welfare and social needs of prospective residents. Although the usual pre-assessment documentation had not been completed for a resident receiving emergency respite care, detailed information, provided by Social Services and relatives, and a 72-hour assessment review was in place to ensure that staff were evaluating and providing for the resident’s specific health, welfare and social care needs. Beaumanor Nursing & Residential Home DS0000001888.V304197.R01.S.doc Version 5.2 Page 9 The home does not provide intermediate care. Beaumanor Nursing & Residential Home DS0000001888.V304197.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well looked after in respect of their health and personal care. EVIDENCE: Individual care plans were sufficient in detail to ensure that the residents’ needs were fully met. Records are maintained of consultation with other healthcare professionals; hospital visits and contact with outside agencies where supportive of and appropriate to the needs of the residents. Records are maintained regarding wound care and tissue viability (the treatment and prevention of pressure sores). This may include the involvement and interventions by other healthcare professionals, such as GP’s, district nurses, and attendance at hospital clinics for wound care evaluation and treatment to ensure that residents receive optimal wound care. Beaumanor Nursing & Residential Home DS0000001888.V304197.R01.S.doc Version 5.2 Page 11 Observation during the inspection showed that staff have a good awareness of how to protect residents privacy and dignity and were seen to be kind and patient and treat the residents in a respectful, friendly and supportive manner. Both residents and their relatives confirmed that staff treat residents respectfully at all times. Medication administration is managed effectively within the home’s medication policy and procedural guidelines. Only trained nurses administer the medication: mandatory training is provided and competencies assessed. Internal 3 monthly audits are completed to ensure the safe and timely delivery of residents’ prescribed medicines. On the day of inspection the medicines fridge was 14 degrees Celsius, according to the temperature gauge. It was a very hot day and additional measures to keep the fridge cool were discussed to ensure that medication is maintained at the correct temperature. Beaumanor Nursing & Residential Home DS0000001888.V304197.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality of this outcome area is good This judgement has been made using available evidence including a visit to this service. The staff work hard to ensure that residents experience a safe, homely life style. EVIDENCE: The religious and cultural needs of the residents appear to be well supported. Religious services are held once a month; particular requirements for residents from requiring ethnic and/or special dietary requirements are catered for. Although there are celebrations throughout the year at Christmas, Valentines Day, Easter and Birthdays etc to enable residents and their relatives to enjoy seasonal and community activities. The home does not have an activities organiser or a weekly programme of activities to for residents, which may result in residents social and leisure preferences not being met. Beaumanor Nursing & Residential Home DS0000001888.V304197.R01.S.doc Version 5.2 Page 13 The Registered Manager stated that she felt that this was difficult to implement within the current levels of staffing. Residents spoken with did not appear dissatisfied regarding the unavailability of daily activities in the home, some preferring to read, watch television or receive visitors etc. Nevertheless, for less able residents, organised activities may be therapeutic. It is suggested therefore, that this should be discussed further with the residents and the Senior Manager to ensure that residents’ lifestyle expectations are being fully met. Relatives said that they could visit at any time. The home has two dining rooms, one each of the floors. Both dining rooms were bright and clean and staff were seen to assist residents with their meals in a discreet and sensitive manner. Residents spoken with very were satisfied with the quantity and quality of meals, which are cooked ‘on site’. One resident said that she was happy with the food and that there were always choices, and that the cook would always provide something else if neither choice was appealing. She also said that she would, occasionally, like a roast dinner. This was discussed with the Registered Manager who stated that a roast lunch was provided on Sundays. Another resident spoken with said that the food was “brilliant”. Residents said that they could take their meals in their rooms if they chose to do so. On the day of the site visit it was exceptional hot weather. All residents had jugs of water, juices and additional drinks provided and staff were observed encouraging and assisting residents to take additional fluids. Beaumanor Nursing & Residential Home DS0000001888.V304197.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for receiving and responding to complaints are sound resulting in satisfactory protection of residents’ rights. EVIDENCE: The home’s complaints process reflects the government’s adult protection guidelines, set out in the local Multi Agency Policy & Procedure For The Protection of Vulnerable Adults from Abuse, No Secrets’ publication. Staff are aware of these procedures and receive relevant training. Complaints and concerns made to the home are dealt with appropriately. Residents spoken with said they would feel comfortable making a complaint to staff. Beaumanor Nursing & Residential Home DS0000001888.V304197.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 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. Quality of this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A comfortable, clean and safe standard of accommodation is provided for the residents. EVIDENCE: The home is safe and well maintained with many adaptations to suit residents’ specific needs. It is decorated and furnished to a high standard, which creates a comfortable and homely environment, and there is a system of maintenance and refurbishment. Residents are able to bring items of their own furniture and possessions with them to personalise their rooms. Residents’ rooms were clean and well Beaumanor Nursing & Residential Home DS0000001888.V304197.R01.S.doc Version 5.2 Page 16 decorated. Many rooms were personalised with photographs and ornaments etc. All rooms have en suite facilities and there are additional toilet, bathing and assisted bathing facilities. On the day of inspection all areas of the home were clean and maintained to a high standard, which was commented upon by all of the relatives spoken with. Beaumanor Nursing & Residential Home DS0000001888.V304197.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality of this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff at the home are sufficient in numbers to meet the residents’ health and welfare needs. EVIDENCE: Beaumanor Nursing & Residential Home DS0000001888.V304197.R01.S.doc Version 5.2 Page 18 The Registered Manager is supernumerary and is supported by a Senior Manager and the senior management team. Staffing levels, at the point of inspection were satisfactory and slightly above that indicated by the Department of Health Residential Forum Guidelines, and are sufficient to meet the residents’ needs. The home employs a mixed staff group consisting of Registered Nurses and care staff, supported by domestic, catering and maintenance personnel. There are always qualified nurses on duty, day and night, to ensure that the residents’ nursing needs are met. Relatives said that the staff were capable and caring, and both residents and staff spoken with said that they felt that there are sufficient staff on duty to meet the needs of the residents. One resident indicated that a small number of the overseas care staff needed to improve their English language skills. She said that sometimes when she asked for something she got something completely different. Nevertheless, other comments were that the care “couldn’t be better” and “staff couldn’t do enough”, and another resident said that the care was “one hundred percent” All new staff have an induction programme to complete. Care staff attend an additional three day training course at Epinal Way Care Centre with additional ‘in house’ and mandatory training and annual updates. Care staff also undertake National Vocational Qualifications in Care (NVQ), Level’s 2 & 3 and are well supported by Rushcliffe Care Limited. On the day following the inspection an ‘in house’ training day relating to the Protection of Vulnerable Adults (PoVA) had been arranged for staff to ensure that they are aware of how to protect residents from abuse. NB. Rushcliffe Care Limited, Epinal Way Care Centre undertakes the recruitment process centrally and this is inspected when inspecting the care homes at the Epinal Way Care Centre. Beaumanor Nursing & Residential Home DS0000001888.V304197.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager is a trained nurse, and is knowledgeable, experienced and professional, and effectively supervises staff and manages the home to protect the rights and needs of the residents. EVIDENCE: Beaumanor Nursing & Residential Home DS0000001888.V304197.R01.S.doc Version 5.2 Page 20 A Senior Manager is in day-to-day contact with the home. The Registered Manager is a Registered Nurse and has many years of experience and is well supported by a professional senior management staff team. There is an ethos of openness in the home; staff are friendly, helpful and caring towards the residents and their relatives. Residents’ personal allowances are managed appropriately. Only small sum of cash are kept in the home. Records are kept, checked regularly and signed by two members of staff to ensure that residents’ money is kept safe. Staff receive annual appraisals and regular recorded supervision by the Registered Manager. This ensures that staff are well supervised in the delivery of safe and appropriate care for the residents. Health & Safety Policy and Procedures, such as monthly, recorded fire drills, regular fire alarm tests and hot water checks are completed, to assure the health and safety of the residents and staff. Beaumanor Nursing & Residential Home DS0000001888.V304197.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 X X 3 X 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 4 4 4 4 4 4 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 4 X 3 X 3 X X 3 Beaumanor Nursing & Residential Home DS0000001888.V304197.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. 1 Refer to Standard OP12 Good Practice Recommendations The Registered Person(s) are recommended to re-visit the provision of activities to ensure that the home matches the expectations and preferences of their residents. Beaumanor Nursing & Residential Home DS0000001888.V304197.R01.S.doc Version 5.2 Page 23 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. Extracts may not be used or reproduced without the express permission of CSCI Beaumanor Nursing & Residential Home DS0000001888.V304197.R01.S.doc Version 5.2 Page 24 - 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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