Inspection on 10/10/06 for Beaumond House Care Home

This inspection was carried out on 10th October 2006.

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

Beaumond House Care Home 12/12/08

Beaumond House Care Home 19/01/06

Beaumond House Care Home 12/08/05

Beaumond House Care Home 14/03/05

Beaumond House Care Home 08/06/04

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

CARE HOMES FOR OLDER PEOPLE Beaumond House Care Home 32 London Road Newark Nottinghamshire NG24 1TW Lead Inspector Vanessa Gent Key Unannounced Inspection 10th October 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 Beaumond House Care Home DS0000008743.V308988.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. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beaumond House Care Home Address 32 London Road Newark Nottinghamshire NG24 1TW 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) 01636 610 556 01636 613 262 Beaumond House Community Hospice Christine Mary Smith Care Home 4 Category(ies) of Terminally ill (4) registration, with number of places Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 Brief Description of the Service: Beaumond House Community Hospice is a registered charity that was founded in 1987, providing care for patients of both sexes with life-threatening or longterm progressive illnesses. It provides respite, day care and care in people’s own homes. It is located in a two-storey, Victorian, former family home in Newark, about half a mile from the town centre, close to shops, doctors’ surgeries and other amenities. It is on a main bus route in and out of the town. The home has two attractive lounges, a dining room and a conservatory. One of the large front rooms is used as a reception and sales area. Upstairs, there are four large single bedrooms, two of which are ensuite with toilet and sink. There are two communal bathrooms, one fitted with a bathing hoist and the other with a specialist bath. Downstairs, there are two toilets, one big enough for access and use by wheelchair users. A passenger lift and two staircases allow access to the upper floor. The grounds are beautifully maintained. At the side of the property is a secure garden patio area with a water fountain and colourful flowers and shrubs which gives a tranquil, relaxing atmosphere. It has room for seating and tables and a barbecue as well as wooden storage sheds. Limited car parking is provided at the front of the building. The hospice’s philosophy of care is, “to provide a ‘home from home’ environment, a special place offering supportive palliative care for people with life threatening or long term progressive illness”. As a registered charity, there are no fees charged: finances are obtained by extensive fund-raising and sponsorships and in co-operation with the local Primary Care Trust. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was made to the home as part of a key inspection. It started at 11.00 and lasted 3½ hours. Information already held on file was used to plan the visit. No ‘Have your Say’ surveys were received as no patients were staying at the hospice when the inspection process started. The manager and staff use the term “patient” for the people who use their services. The main method of inspection used is called ‘case-tracking’, which involves selecting a proportion of patients, and tracking the care they receive through the checking of records, discussion with them, the care staff and observation of care practices. The inspector spoke with one patient, four staff, a healthcare professional and a regular visitor. The manager was present throughout the inspection visit. What the service does well: What has improved since the last inspection? Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 6 The staff supervisions undertaken by the manager are now excellent. Staff say the one-to-one sessions happen at least every two months and are supportive and encouraging. 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. Beaumond House Care Home DS0000008743.V308988.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 Beaumond House Care Home DS0000008743.V308988.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): 1, 2, 3, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Patients know what to expect when they come to stay at the hospice, as information is supplied to them beforehand and their needs are fully assessed. EVIDENCE: The statement of purpose contains current, comprehensive information about the service the hospice provides. The service users guide is contained in a series of leaflets that are available for patients or visitors to take as they need. The manager visits the patient in hospital or at home before offering them a place. Very detailed pre-admission assessments are completed, as seen in the patient’s care plans. Patients are fully involved at all stages of the process. This was confirmed by a patient who said the manager visited them in hospital. Although the patient was only told about coming to the hospice verbally, they “knew about it from a neighbour and didnt hesitate”. They knew which room they would be having and had signed a contract of terms and conditions. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10, 11 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. All aspects of the patients life at the hospice are taken into consideration to ensure that their health needs are met, dignity is maintained and the patient and their relatives are eased through very difficult experiences. EVIDENCE: The pre-admission assessments are used as the basis for creating the care plans. Care plans are detailed and descriptive. A patient described how much they were involved in and knew about the care plans, and this was confirmed in the care plans seen, with patients’ signatures throughout. The care plans show that the patient’s healthcare needs are met at all times. A visiting GP told the inspector that liaison with the doctors surgeries, district nurses, palliative care nurses and other health care professionals is exceptionally good. There is also good communication from hospital about the treatments undergone and following treatments necessary. A visiting chaplain Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 10 stated that patients are definitely treated with dignity and their privacy maintained. A patient said, Staff treat us very well indeed. They are so kind. The hospice follows a care approach known as the ‘Liverpool Care Pathway’. This is a multi-layered approach that ensures that patients receive the right type of support and that their dignity is maintained throughout their stay. Staff say they are very concerned that pain relief and dignity are given right to the end of life. Relatives say they appreciate this concern and are relieved that such a wonderful facility as the hospice is there for them. Staff are trained and very expert at dealing with the dying and death process. Leaflets are available with information including bereavement support, dealing with the practicalities of a death and caring for the carers. The manager & staff offer full support to the patient and their family at all times. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Ample and varied activities and entertainments are provided that meet the needs of the patients as well as bring the hospice to the attention of the community and demonstrate what it can provide for its patients. Food is provided that caters well for the needs, tastes and wishes of the patients. EVIDENCE: Staff provide plenty of varied activities for both the patients staying in the hospice and those who come for day care. These are reported to be interesting and entertaining to suit their wishes and make their lives as tolerable as possible. Some make crafts that are then put up for sale in the charity shop. Patients and staff enjoy regular outings and boat trips. A visiting chaplain said, “Every consideration is given to maintaining their independence, dignity and comfort and making them feel ‘at home’”. He also stated, “everyone who comes in thinks it’s wonderful”. It is “well supported in the community and well regarded”. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 12 The manager showed the inspector the reception and sales area that is an integral part of the hospice. Another two shops are run by volunteers in Newark town centre and Southwell, seven miles away. Fund-raising is an important part of the charity’s work and people in the community are encouraged to have as much contact with the hospice as possible to help in this area. Events and entertainments are put on and advertised widely to encourage this further. A patient said that food is homemade, tasty and appetising. Staff say they concentrate on providing nutritious and appetising food to encourage people whose appetites have often been affected by the treatments they have been undergoing. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Measures are in place that help the patients have safe, comfortable and fulfilling lives, as much as their health limitations and capabilities allow. EVIDENCE: The manager and business manager said, “no complaints or concerns have been received for over a year but compliments are coming in all the time.” A patient stated, “Nothing I could complain about.” A visiting chaplain said, “Staff are first class”. All staff undertake annual updates of training in the prevention of adult abuse. A patient said they feel very safe and well treated. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23, 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The hospice provides a comfortable, clean, attractive environment to make sure that the residents feel well cared for and ‘at home’. EVIDENCE: The house is maintained to a very high standard and provides an attractive, relaxing environment for the patients and visitors. A patient said, “My room is very light. I like the decorations. It’s lovely.” The gardens are well tended. One of the management staff cares for the flowers; the variety of colour enhances the gardens appearance. A secure, attractive patio area at the side of the hospice provides a tranquil setting for patients and their families to sit out in. A water fountain plays soothingly and seating and tables have been provided. Barbecues are catered for in fine weather, attended by patients, their families, visitors, volunteers and staff. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 15 Relatives can stay overnight if they wish or feel it is necessary. A fold-up bed is available to be used in the patients’ rooms, all of which are spacious, light and airy. The sun lounge has a well-equipped refreshment preparation area for relatives and visitors to make food and drink without having to leave the hospice. Patients have any equipment that is assessed as necessary for their comfort and ease. These include contour beds with pressure-relieving mattress and reclining chairs. Communal adaptations include a specialist bath, hoists, passenger lifts and toilets that accommodate wheelchair users. The last Environmental Health Officer’s report found everything to be hygienic and satisfactory. A patient said “Everywhere is spotless. There’s a lovely smell. It doesn’t smell like a hospital or a hospice.” The maintenance records show that repair jobs are put right straight away and other areas for maintenance are dealt with by a person who comes in regularly one or two days a week. The catering and facilites manager also ensures that health & safety is well maintained. She is currently taking the advanced food hygiene course at a local college. The hospice gained a silver award from the local Council for maintaining a high standard of kitchen cleanliness. The kitchen is booked to be re-fitted within the weeks following the inspection. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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, 29, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff are on duty in enough numbers at each shift. Patients are cared for by conscientious, well trained staff who are safe in their practice and provide a happy atmosphere in which to live and work. EVIDENCE: The duty rotas show that staff are provided in sufficient numbers for each patient to receive and appreciate the individual attention and support they need. One patient said, “I only have to ring my bell and they’re here straight away.” Many of the staff have worked there for a long time and there is a low turnover of staff. From the staff files seen, the recruitment and induction practices safeguard the patients. Staff say that their induction is thorough and is ongoing. They shadow more senior staff until they are judged as competent and confident to assist patients on their own. A patient said that the staff are so lovely that when she goes home, she will continue to use the home care service that the hospice provides. A visiting chaplain said, “there is a lovely atmosphere; a good sense of humour among the staff”. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 17 Staff say their training programme is excellent. They say and their records show they are all up-to-date with the compulsory training required and encouraged to take part in other courses and study days to further their knowledge. Staff interviewed said, “I love my job. I can’t imagine wanting to work anywhere else.” “Positive, worthwhile place to work, even though it’s sometimes sad.” “Rewarding.” Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 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, 36, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The hospice is well organised, run and maintained for the health, safety and welfare of the patients and the safe and pleasant working conditions for the staff. EVIDENCE: The manager has been in post for twelve years. She has her Registered Manager’s Award. Most of her time is spent on management, very few in caring shifts. Staff say “she is very supportive indeed” and that they can “talk over any issues”. Patients and visitors say she is very well respected by all who visit the hospice. A patient says “she is lovely; has a nice smile and always has time for a chat. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 19 The responsible person visits the hospice regularly but does not always check monthly on the premises, patient satisfaction, staff feelings or any issues that may arise. Nor has he, in the past year, always written a monthly report on his findings. The manager and staff say they want and need this input to ensure that they are working to a satisfactory standard and that the hospice is maintained at a good level. Staff say they are committed to ensure that a high standard of care is given. Surveys from patients and visitors on the provision of care, both in-house and in the day care service they provide, are undertaken yearly. Staff say, and their records confirm, that they have supervision sessions with the manager at least every two months. These are documented and signed by both parties. Staff say they feel very supported by the manager and the charity that runs the hospice. They say that she will talk over any issues they may have. Staff meetings are held 4-6 weekly with usually about 15-20 staff attending. The meetings are minuted. The support services manager showed that she keeps all the hospices records immaculately. Policies and procedures are computerised and updated yearly. Health & safety is supervised by the catering and activities facilitator. Maintenance of the hospice is undertaken regularly with good records kept. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 X 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X 4 X X 3 STAFFING Standard No Score 27 4 28 X 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 2 X N/A 4 4 3 Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 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. 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 OP36 Good Practice Recommendations The registered manager should record all staff supervision. Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Beaumond House Care Home DS0000008743.V308988.R01.S.doc Version 5.2 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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