Key inspection report
Care homes for older people
Name: Address: Beaumont House 47 Priest Hills Road Hinckley Leicestershire LE10 1AQ The quality rating for this care home is:
one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Chris Wroe
Date: 0 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People
Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home
Name of care home: Address: Beaumont House 47 Priest Hills Road Hinckley Leicestershire LE10 1AQ 02089334331 01455632011 beaumont_house@talktalk.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Violet Cadogan care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 10 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Beaumont House is a care home for older persons, providing accommodation and personal care for up to ten older people, some of who have a dementia type illness. The home is situated in a popular residential area just off the town centre of Hinckley. It is situated close to local amenities and shops and both the train station and bus routes are within easy reach. The home offers 10 single bedrooms, two of which have en-suite facilities. Bedrooms Care Homes for Older People Page 4 of 27 1 6 0 9 2 0 0 8 10 0 Over 65 0 10 Brief description of the care home are situated on both the ground floor and first floor of the property and a main lounge and dining room can be found on the ground floor. Rooms on the first floor can be accessed by lift or stairs. Current private charges are £413.00 per week. Additional charges are in place for hairdressing, chiropody treatment and transport to appointments. A copy of the latest Inspection report is available at the home, or it can be accessed via the CQC website: www.csci.org.uk. Further information about the home is available from either the owner or the senior care workers. 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: one star adequate 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: We visited the home on 1st December 2009. The owner and manager of the home, Violet Cadogan, helped us with our inspection, as did staff and people who live at the home. Our visit to the home lasted a total of eight hours. We asked for information. The main way we do our inspections is using a method we call case tracking. This means looking at the care given to people in different ways. The ways this was done are: - talking to the people who live in the home - talking to staff and the manager - watching how people are given support - looking at written records. We talked to five people who live in the home during our visit and spent some time with people and with staff. We watched to find out how comfortable people were in their home. Care Homes for Older People Page 6 of 27 We spoke to two members of staff during our visit to the home, who told us about working in the home and gave us their views. We checked all the standards that the Commission for Social Care Inspection has decided are key standards during this inspection. The information in this report just about what we checked in this inspection. We have kept details about individual people out of the report, to make sure these things are kept confidential. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? The manager wrote to us to tell us that the requirements made in the last inspection have been met. Procedures for giving out and storing medication have improved. Care Homes for Older People Page 8 of 27 There are improvements in care records for people. The manager is beginning to introduce a new standex system, with the aim of improving care and recording for people who live in the home. There has been some improved reporting to us under Regulation 37 of the Care Homes Regulations 2001. Whilst the rating for the home remains adequate, due to issues found in some key areas, we have noted that there has been some improvement in the home, and that the care given by staff is good. What they could do better: 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.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 who may come to live in this home benefit from having their needs assessed and being able to make choices about whether they would like to move in. Evidence: There is an assessment policy in the home, which gives details about what people can expect if they are thinking about moving in. People are able to stay for a meal or overnight to see whether they like the home, and to move in for a trial period. Some people have also had assessments prepared by Social Services, if they have had the involvement of a social worker. We saw that one person had asked to move into the home and her wishes were respected. We found that people who come to live in the home have had basic assessments done about their needs. This helps to make sure that they can be given the right kind of care. Care Homes for Older People Page 11 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home have their health and social care needs adequately met, but they could benefit from improved ongoing assessment of any risks to their health. Evidence: People told us that they feel well cared for by staff in the home. One person said to us Its really nice here, the staff look after us well. One relative said The staff are very caring. We watched how staff looked after people, and we saw that they treated people with respect and sensitivity. Staff took time to talk to people. They encouraged people to be mobile and independent where they could be, and gave them calm support where needed. We found that there are written care plans for each person, which give information about the kind of care and support they need. There are also some risk assessments, which talk about how people can do the things they want to do but still be kept safe. We did note that there were not always risk assessments in place for things where there should have been one. We also found that important assessments like nutritional assessments and skin pressure assessments had not always been done for people.
Care Homes for Older People Page 12 of 27 Evidence: We looked at medication and found that systems were generally safe, and that staff were giving out medicines properly and keeping good records. the manager and staff make sure that people have access to a GP, and that health checks and visits from nurses are kept up to date so peoples health can be maintained. Care Homes for Older People Page 13 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 who live in this home benefit from a generally good lifestyle. Evidence: We saw that people who live at Beaumont House are able to come and go as they wish. We talked to people who live in the home and they told us about going out with their friends and relatives. One person told us: I go out to town on my own because I am quite mobile. People who live in the home have freedom to move around the home, choosing whether to spend time in their bedrooms or to spend time in the communal areas. We saw that staff spend time with people who live in the home and chat to them. People have different views about activities in the home: one person told us there are not really any activities for them to join in with. Other people said they got involved with different things. People have friendships within the home, and regular visitors who are welcomed by staff. During our visit one member of staff who was on a work placement in the home was involving some people in different games. Other activities and events have taken place - a fireworks part was held to celebrate in November, and a Christmas party and carol singing event was planned for December. Staff did tell us they do not have much time to take people out of the home.
Care Homes for Older People Page 14 of 27 Evidence: We looked at meals and mealtimes in Beaumont House. We saw a menu, which gave a range of meal options to people. People we talked to were mainly happy with the quality and range of food being provided. One person told us the food is good. Another said to us The meals are lovely. A third person was a little less praising: The food is passable, its not the Ritz. We saw lunch being served, and saw that people were given choices just before the meal, which is good. The food was freshly prepared and people were given time to eat their meal. Care Homes for Older People Page 15 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although there are procedures in place, people who live in this home cannot be entirely confident that they will be safeguarded from harm. Evidence: We saw that there is a complaints procedure - although it needs to be updated with our new name and address. There are records to show that one person had made a complaint through this procedure, and that this had been looked into by the manager. We learnt that the issues had now been resolved. There is also a charter of residents rights on the wall. During our visit we saw that people living at Beaumont House felt able to express their opinions to staff, and staff treated their views with respect. We talked to staff about how they would protect people living at Beaumont House from abuse. Staff have had training about safeguarding, and they showed us they had a good understanding of how to protect people, and what procedures to follow to protect people. We checked whether the service has been reporting to us about serious incidents in the home as they are required to do. We noted through discussion with the manager, and by looking at records, that we have not received as many regulation 37 notifications as we should have. We made a requirement about this at the last
Care Homes for Older People Page 16 of 27 Evidence: inspection, and we are doing so again this time. We did note that there had been some improvement since the last inspection in this area, but there still needs to be further attention given to this. We have written a letter to the manager to make clear the requirement. We did note from talking to the manager and staff that there was not always a consistent approach to managing one persons behaviour, who could cause some distress to other people. There was not a clear risk assessment, and no proper strategy about how to manage this. We also found that records about incidents or accidents were not properly filed but were kept in a haphazard way. Care Homes for Older People Page 17 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. People living at Beaumont House, live in a homely environment that is safe, clean and tidy. Evidence: We found that people living at Beaumont House live in a clean, tidy and homely environment. They have been able to personalise their bedrooms with ornaments, photographs and pieces of furniture from their own homes. Communal areas have attractive features, like flowers on dining rooms tables, to give a homely feel. We saw from records that safety checks are routinely carried out on equipment to make sure it is maintained and safe for use. During our visit to the home, we saw that the environmental health officer came to check compliance with requirements made they were satisfied with action taken by the service. We looked at the laundry area, which is separate from the kitchen and food preparation areas. We did note that the tiled floor is unfinished, which means that the floor surface is permeable in some areas, and could cause a health and safety risk. This should be put right. Care Homes for Older People Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home could be better protected by improved recruitment and training of staff. Evidence: We saw that there were enough staff on duty during the day to support the care needs of people living in the home. This was confirmed by people who live at Beaumont House, and the staff. There is a cook and a housekeeper employed, which allows care staff to focus on meeting the care needs of people who live in the home. We found that although the manager and staff say that it is better to have two staff working at night, this does not always happen in the home. The manager said that they have been short-staffed but were recruiting new staff. She told us that there are safeguards in place to ensure the safety of people living in the home, even where it was necessary to have only one member of staff on duty at night - such as having other senior staff on call. There was no risk assessment in place to deal with this. One person who lives in the home said to us that they felt the home had been shortstaffed but they felt it was improving. People living at the home, told us good things about the staff who support them. One person told us The staff are good and seem to know what they are doing. Care Homes for Older People Page 19 of 27 Evidence: We looked at staff training records, and spoke with staff, and we found that staff have mostly received sufficient training to help them undertake their roles and responsibilities. However, not all staff have done moving and handling training recently, which is very important to make sure they are working safely. We checked the recruitment procedures for new staff, and we saw that the manager had protected service users by ensuring that staff had undergone criminal record bureau checks before undertaking personal care. But for one person, there were not two written references in place as is required. Care Homes for Older People Page 20 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. Beaumont House is generally satisfactorily managed by the owner. Evidence: The owner of the home is also manager. She is a registered nurse and works in the home alongside other staff. Staff told us that they found the manager to be approachable and supportive and that they can be open with her and talk about any concerns they have. The manager told us about different ways that they get to know peoples views about how the home is running. There are staff meetings and resident meetings in the home. They are held on the same day so that staff can immediately deal with any issues that people who live in the home have raised. This is good, and we learnt about changes that had been made following people expressing their wishes. We looked at the way in which peoples money is managed in the home. We saw records that are kept to show that peoples money is looked after safely and is
Care Homes for Older People Page 21 of 27 Evidence: properly accounted for. Staff have had training in health and safety issues, like fire safety. They have protective equipment to help them do their job safely, and there are policies in the home about safe working. But we did find that the policy about infection control is not being followed properly. Staff have had training about infection control, but soiled laundry is not being dealt with according to the policy and so there may be risks of cross contamination. The manager told us she would make sure this is put right. Care Homes for Older People Page 22 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 18 37 The provider must ensure the CSCI is notified of any death, illness or other event outlined by Regulation 37. This is to ensure the regulator is aware of events happening at Beaumont House and can ensure that the provider is taking relevant action. 17/01/2009 Care Homes for Older People Page 23 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 13 The provider must ensure that all necessary assessments are carried out related to the health of people in the home, such as nutritional assessments and skin pressure assessments. This is to ensure that any necessary steps are taken to maintain peoples health and wellbeing. 31/01/2010 2 18 18 The manager must ensure that there is a consistent approach among staff to dealing with any behaviour that may cause distress or harm to other people, including having risk assessments in place. This is to ensure that people are properly and consistently safeguarded from harm. 31/01/2010 Care Homes for Older People Page 24 of 27 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 3 18 37 The provider must ensure that the CQC is notified of any events outlined by Regulation 37. This is to ensure that we maintain an awareness of events happening at Beaumont House so we can ensure that the provider is taking relevant action. 31/01/2010 4 29 19 The provider must ensure that two written references are obtained before someone is employed to work in the home. This is to ensure that people are safe in relation to staff caring for them. 31/01/2010 5 30 18 The provider must ensure that all staff are kept up to date with essential training, including moving and handling training. This is to ensure that people who live in the home are kept safe from risk when being moved. 28/02/2010 6 38 13 The provider must ensure 31/01/2010 that all staff know about and correctly follow policies put in place to ensure safe infection control. Care Homes for Older People Page 25 of 27 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 This is to ensure that people who live in the home are protected from the risk of cross-contamination of infections. 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 1 8 We recommend that the provider reviews peoples risk assessments, to make sure that there are assessments in place to cover all activities and incidents which may provide some risk to peoples wellbeing. We recommend that the provider looks at making sure each persons needs and wishes are as fully met as possible, by enabling staff to have some time to take people out if they choose, and looking at what kinds of activities people enjoy. We recommend that the complaints procedure is updated to include our change of name and address, to ensure that people are clear about who they can go to if they have concerns. We recommend that records about incidents and accidents are stored in a clear and accessible way, so that the manager can use the records to review peoples care and needs. We recommend that the flooring in the laundry room is properly finished, in order that any potential risk to health and safety can be prevented. We recommend that that manager carries out a risk assessment where staffing levels do not reach the optimum required, in order that any risks are recgnised and measures put in place to safeguard people who live in the home. 2 12 3 16 4 16 5 26 6 27 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC 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!
