Inspection on 12/12/08 for Beaumond House Care Home

This inspection was carried out on 12th December 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beaumond House Care Home 10/10/06

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Beaumond House Care Home 32 London Road Newark Nottinghamshire NG24 1TW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stephen Benson     Date: 1 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Beaumond House Care Home 32 London Road Newark Nottinghamshire NG24 1TW 01636610556 01636613262 christine.smith@beaumondhouse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Christine Mary Smith Type of registration: Number of places registered: Beaumond House Community Hospice care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 terminally ill Additional conditions: Date of last inspection Brief description of the care home Beaumond House Community Hospice is a registered charity that was founded in 1987, providing care for patients of both sexes with life-threatening or long-term progressive illnesses. It provides respite, day care and care in peoples 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 Care Homes for Older People Page 4 of 27 4 Over 65 0 Brief description of the care home 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 cooperation with the local Primary Care Trust. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our first visit to Beaumond House since 1st April 2008. This inspection involved one inspector; it was unannounced and took place in the daytime, including lunchtime. Prior to the visit an analysis of the home was undertaken from information gathered Care Homes for Older People Page 6 of 27 over the last year including that from the Annual Quality Assurance Assessment they completed. We sent survey forms entitled Have your say about... to a sample of people and 3 of these were returned. The main method of inspection used is called case tracking which involves looking at the quality of the care received by a number of people staying at Beaumond House. We also use evidence from our observations; we speak with them about their experience of their stay; we look at records and talk with staff about their understanding of the peoples needs who they support. The premises were not inspected in detail but various areas of the building were visited as part of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: Care plans must clearly describe how peoples needs are to be met. This will ensure staff know how to meet peoples needs. Controlled drugs must be stored in an approved cabinet that meets current safety guidance. This will ensure that peoples medication is safely looked after. Records made of any complaint must include details of any investigation and outcome of the complaint. This will ensure that peoples complaints are listened to and appropriate action is taken. There must be a programme of staff training. This will ensure staff receive all the training they require to carry out their duties. Care Homes for Older People Page 8 of 27 There must be a quality assurance system in place. This will ensure people using the services are able to comment upon them. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed before they start to use services provided by Beaumond House so their needs can be met. Evidence: Anyone wishing to use the services of Beaumond House undergoes an assessment before they can do so. Other healthcare professionals who are involved with the person contribute to this as they continue to be involved whilst Beaumond House services are used. The same assessment process and forms are used for anyone using any of the services provided at Beaumond House and completed assessment forms were seen. Some people will use more than one service. It was pointed out that some of the terminology used could be improved and the forms were amended doing so. Care Homes for Older People Page 11 of 27 Evidence: A relative was spoken with who said that they had been involved in the pre use of services assessment. In our survey forms everyone said they had received enough information about Beaumond House. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Care Homes Regulations covering the safe storage, handling and administration of medicines have not been taken into account when planning the arrangements for medication in the home. Evidence: A selection of care plans were seen and these included health assessments, including nutrition and tissue viability. Some of the care plans did not give specific details as to how the individuals needs should be met. For example a hygiene care plan said staff should discuss with the person what their hygiene needs are but did not describe what they were and how they should be met. An assistant manager said that staff knew what each person required but this did not always get written down. Care Homes for Older People Page 13 of 27 Evidence: In our survey forms everyone said they receive the care and support they need and one person added that it was willingly given. One person commented, Words seem hardly enough to explain how lovely Beaumond House and staff are. I found my stay comfortable enjoyable and reviving. The treatments were very helpful and easing. One person said I cant fault them, they have done me good. There is a system to record any healthcare visits or advice provided and this showed that people are receiving regular healthcare support. In our survey forms everyone said they receive the medical support they need. One person commented that her doctor had visited her twice last week and was pleased at how she was doing. The system in place for the storage of peoples medication allows for people to be dealt with individually, and this is suitable for anyone self medicating, however this does not conform to the regulations where staff are administering people their medication and the storage of controlled drugs in a registered home. There are Medicine Administration Records kept of all medicine administered, however some instances were seen when changes to peoples medication were made that were not signed and witnessed as being correct. A record of any controlled drugs given is made on the Medicine Administration Record, but there is not a controlled drugs register in use as required which would provide a close monitoring of all controlled drugs received, administered and leaving the home. One person said I have kept on some of my medication, if I forget to take it they soon wake me up. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to follow a routine that suits them and have something to eat as and when they fancy. Evidence: People who use the respite service are welcome to join in any of the activities provided in the day care service, in another part of the building, however it is often the case people do not feel up to doing so. There is a television with fitted DVD player and a music system provided in each room. There is a massage therapist employed in the home who will give people a massage or aromatherapy if they want. In our survey forms everyone said they are able to do what they want, but dont feel up to doing much. One person said she was asked if she wanted to join in the day centre but didnt want to, but have been having some massages and they are lovely and magic. Care Homes for Older People Page 15 of 27 Evidence: The assistant manager said people are able to go out if they feel up to it and religious personel visit the home. One person was seen having visits from her family and entires in the daily log showed people regularly visit the home. The assistant manager said there are no set routines for people having respite care and people can choose their own preferred routine. One person said, I can do what I want, there is nobody saying dont do this or dont do that. A main meal is prepared for people using the day care service, which people having respite care can join in, however if anyone want anything different this is provided. The assistant manager said any requests are responded to. Catering staff said they were aware of the importance of getting someone to eat as much as they can ,so will prepare food as and when people want something to eat. Staff were seen taking people their lunch to have in their rooms, one person joined the people receiving day care in the dining room. In our survey forms everyone said they like the meals and comments made included; Too tempting sometimes. Meals are always very good and wholesome. Always a wide choice. First class food. I have never enjoyed my food so much as here at Beaumond House. Two years of chemo radium treatment left me dreading food, but all this has changed now thanks. One person said I was off my food when I came here but am back to normal now. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can raise anything they want to improve their use of the service and staff understand their duty of care to safeguard people. Evidence: There is a complaints procedure that covers all of the services provided at Beaumond House. A record is made of any complaint made in a complaints book, however this did not give details of any investigation and what the outcome is. Complaints seen were concerning daily living matters such as a noisy door, the decor and food. In our survey forms everyone knew who to speak to if they were not happy and how to make a complaint. Comments made included; Staff listen to all needs. Everyone is there and everyone listens and helps I had no need to complain. One person said, There has been nothing to complain about whilst I have been here. The assistant manager could not find the Nottingham and Nottinghamshire safeguarding adults procedures and the managing director contacted the County Council to request a copy. Staff understood the principles of safeguarding the people in their care and knew about the whistleblowing policy. One person said she felt perfectly safe. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The facilities in the home are comfortable and clean. Evidence: The premises provide comfortable and homely respite accommodation as well as operating the day care service and management of the domiciliary care agency. The assistant manager said they try to keep the building homely and make sure everywhere is safe and secure. Maintenance is carried out by a handyman, or if a larger job, local contractors. The lift does not accommodate a trolley so anyone wanting to access the first floor where the residential accommodation is needs to be in a wheelchair if unable to stand. In our survey forms everyone said the home is kept fresh and clean and comments made included; Staff are always busy cleaning. First class top marks. So clean. Fresh and tidy always. Lovely hard working staff and cleaners, so friendly too. The assistant manager said there is a cleaner on duty six days a week and can be called in on Sundays if needed. Care staff do any laundry that needs doing and know about safe practices in preventing the spread of infection. Care Homes for Older People Page 19 of 27 Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff on duty and new staff are recruited following the required recruitment practices. Staff training needs to be more organised. Evidence: There are always a minimum of two care staff on duty and during the weekday mornings there are three. Staff said this was sufficient and in our survey forms everyone said staff were available when they needed them. Comments made included; They always come when you need them, even if they are busy. Always checking I was OK and always a button press away. Always with pleasantness. It was stated on the Annual Quality Assurance Assessment that there are three staff who have completed National Vocational Qualification level 2 and that all staff appointed have been through the required recruitment checks. There is not a training plan in place but the managing director said that work is currently being undertaken on a training needs analysis of staff training needs with the aim of preparing a training plan for 2009. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable management systems in place for the smooth running of Beaumond House, but people using the service should have more opportunity to comment on the services provided. Evidence: The manager has worked at Beaumond House for fourteen years six of these as the registered manager and has completed the Registered Managers Award. The manager is responsible for the residential service, the domiciliary care service and the day care provision. There are two assistant managers to assist with the management of these services and there is a team of support staff comprising of Human Resources, Support Services and Welfare Rights. A managing director has also bee appointed to help with the overall running of Beaumond House. There is not a quality assurance system in place at present. People using the respite Care Homes for Older People Page 22 of 27 Evidence: service are not required to bring any money with them and there is not a banking system for them to use so, if they bring any money they are responsible for looking after it. It was stated on the Annual Quality Assurance Assessment that equipment is tested or serviced as recommended by the manufacturers or other regulatory body. The fire safety records were seen and these showed the required tests are carried out at the correct frequency. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must clearly 01/02/2009 describe how peoples needs are to be met. This will ensure staff know how to meet peoples needs. 2 9 13 A record of all controlled drugs received, administered and removed must be made in a controlled drugs register. This will ensure peoples medication is properly looked after 01/02/2009 3 9 13 Controlled drugs must be stored in an approved cabinet that meets current safety guidance. This will ensure that peoples medication is safely looked after. 01/02/2009 4 16 17 Records made of any complaint must include details of any investigation and outcome of the complaint. 01/01/2009 Care Homes for Older People Page 25 of 27 This will ensure that peoples complaints are listened to and appropriate action is taken. 5 30 18 There must be a programme 01/02/2009 of staff training. This will ensure staff receive all the training they require to carry out their duties. 6 33 24 There must be a quality assurance system in place. This will ensure people using the services are able to comment upon them. 01/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!