Inspection on 12/12/05 for Beaumont House

This inspection was carried out on 12th December 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Beaumont House 23/02/10

Beaumont House 29/09/09

Beaumont House 16/03/09

Beaumont House 29/09/08

Beaumont House 22/04/08

Beaumont House 05/12/07

Beaumont House 25/06/07

Beaumont House 04/07/06

Beaumont House 03/05/05

Beaumont House 08/12/04

Beaumont House 04/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Beaumont House 26 Church Lane Whitefield Manchester M45 7NF Lead Inspector Grace Tarney Unannounced Inspection 12th December 2005 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 Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beaumont House Address 26 Church Lane Whitefield Manchester M45 7NF 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) 0161 796 9666 0161 796 7722 Bankfield Premier Care Ltd Mrs Glenys Enid Gardner Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the maximum of 37 there can be up to 37 OP Old Age. The service should at all times employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 3rd May 2005 Date of last inspection Brief Description of the Service: Beaumont house is a residential care home for up to 37 older people. The home is part of a group of four homes (Bankfield Premier Care) in the Bury/North Manchester area. Beaumont House is a detached home and set in its own well-maintained grounds. It is situated close to local amenities and accessible for local transport as well as the Metro and major bus routes between Manchester and Bury. The Home comprises of four large lounges and a smaller lounge and two dining areas. There are also 37 single bedrooms all with en-suite toilet. They are individually decorated and furnished and include a nurse call. The Home is two storeys with an extension to the rear and side. The home is divided into two units, one on the ground floor and one on the first floor. Communal areas are found on each floor and access is available via a passenger lift. Respite/short stay care may also be provided if a place is available. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was not made aware that this inspection was to take place. This was an unannounced inspection. The inspector spent 7 hours at the home. . During this time she looked at care records to check that the health and care needs of the residents were being met. The Inspector also looked at how the home looks after the residents’ spending money. To make sure that the home and the equipment in it was safe, the Inspector looked at the maintenance and service records. The Inspector then walked around the building and visited residents in their own bedrooms and in the lounge or dining areas. This was to ask their opinions about the care that was being provided for them. The Inspector spent time speaking to 6 residents. A Pharmacy Inspector also visited the home. She spent 5 hours looking at how the home store and give out the medicines. Not all the National Minimum Standards were looked at on this visit. The Inspector looked at the Standards that had not been looked at during the last inspection. The Standards that are looked at during inspections are those that are considered to be important for the residents’ safety and well-being. What the service does well: What has improved since the last inspection? Management now make sure that criminal records bureau (CRB) checks are undertaken before any staff are employed. Staff realise the importance of making sure that residents are weighed on a regular basis and an accurate weight record is kept. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 6 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. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 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 Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 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 Whilst there was a system in place for ensuring that all prospective residents had an assessment undertaken prior to admission, it was evident that the assessments were not detailed enough and therefore did not give an assurance that the home could meet a residents’ needs. EVIDENCE: The inspector was told by the homes manager that before any resident was admitted to the home an assessment of their needs was undertaken either by a senior member of staff from the home or from the professional i.e. care manager, requesting their admission. The assessment documents in use by the home were detailed and looked at the physical, mental and social care needs of the residents as well as the involvement if any, of their relatives. The assessment document of one of the newly admitted residents however, had not been fully completed. This resident belonged to a minority religious group but there was no information in relation to religious practice and diet. The Inspector also looked at the assessment of a resident who was no longer at the home. This assessment identified that this resident had high nursing needs and following a discussion with the staff and further perusal of the care Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 9 records the Inspector is of the opinion that the resident should not have been admitted to the home. Standard 6 does not apply. The home does not provide intermediate care. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 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. The care plans did not fully reflect the support needs of the residents. The failure of staff to undertake risk assessments could result in risks going unnoticed, resulting in possible harm to residents. Records are not always referred to and completed at the time medicines are given, putting residents at risk of not receiving their medicines as prescribed. EVIDENCE: The care files of 3 residents were examined. The newly admitted resident did not have a care plan. The Inspector was informed that, following admission, a care plan is devised over a period of time, normally two weeks. This is acceptable practice. This resident had been in the home for only four days. Management told the Inspector that the care staff rely on the assessment that had been undertaken prior to, or on admission. This residents’ assessment however had not been completed fully. There was very little written information about how the staff were to care for this resident. A moving and handling risk assessment was in place and it was judged that this resident was medium risk. There was no code or guidance however, on which to base the judgment. The care plan of another resident showed that, despite having a recent fracture of the arm there was no care plan in place for the care of the arm and plaster Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 11 cast and nothing in relation to pain relief. It was identified in the communication book that this resident had been given a painkiller, although none were prescribed and the home does not have a homely remedy policy. It was identified that this resident had sustained several falls and had been referred through to a physiotherapist in relation to the falls but there was no falls risk assessments in place. This resident also had bed rails in place but whilst the family had given written permission to use them, there was no risk assessment in relation to their use. There was a moving and handling risk assessment in place that had last been evaluated on the 21/9/05. Risk assessments should be evaluated at least monthly alongside the care plan. In view of the change in this residents’ mobility following the fall and fractured arm, the moving and handling assessment should have been evaluated on return from hospital. This resident had lost 1stone 12 pounds in 14 months. There was no eating and drinking plan in place to address the weight loss and no nutritional and pressure sore risk assessments in place. The care plan of another resident identified that there was no nutritional and pressure sore risk assessments in place. This resident had a history of falls but there was no falls risk assessment in place. None of the care plans showed evidence of resident or relative involvement in drawing them up. A discussion with the residents showed that they had access to other healthcare professionals, such as dentists, opticians, chiropodist and district nurses. Evidence of these visits was kept in the residents’ individual files. The Inspector was informed that the district nurses would supply any equipment that was required for pressure relief. The CSCI Pharmacy Inspector looked at the medication system. The medication policies and procedures have been reviewed and must be implemented. Consideration should be given to expanding these to include the management of ‘leave’ medication – that administered outside the home. Where possible pre-printed medication administration records (MARs) are used, these were generally up-to-date. However, new, short-term, or infrequently used medication not pre-printed onto the MAR was poorly managed. A notice was left at the home requiring immediate action to address this concern. On arrival at the home the morning medicines had been given but records had not been completed (downstairs). The senior carer administering medicines (upstairs) had not completed assessed and certificated training. Several residents are supported to self-administer medication. Written assessment has been completed for residents taking oral medicines (e.g. tablets) but not for those using inhalers, applying creams of lotion. The existing assessments should be expanded to clearly detail the support needed from care staff. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 12 Medicines within the medication rooms were securely stored but medicines are kept in both the secure medicines fridge and less securely in the kitchen ‘fridge. The temperature of the medicines fridge and the medicines rooms are not monitored. There were some expired medicines in stock and a bottle of medicine prescribed for one resident did not have a pharmacy label. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 13 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): 15 The dietary needs of the residents were catered for, however the timing of the evening meals reduced their enjoyment and appetite. EVIDENCE: The above Standards were looked at in detail during the last inspection. During this inspection however, the Inspector sought the views of the residents in relation to the food provided for them. Some of the residents felt that the mealtimes were not staggered enough. They felt that there was very little time between lunch and the evening meal and that quite often the residents were not hungry when it came to the evening meal. Also concerns were raised about the long time gap between having the evening meal and breakfast the following morning. Residents and staff told the Inspector that the supper snack was usually toast or biscuits. Residents said that they wanted something a little more substantial. One resident stated that on occasions for the evening meal there was only soup and no sandwiches, as detailed on the menu. The other residents spoken to stated that they felt the food overall, was good. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 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): EVIDENCE: Not inspected on this visit. Compliance was checked however in relation to the previous requirement that all complaints are recorded with the complaint file and include details of all action taken. This had not been complied with. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 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): EVIDENCE: Not inspected on this visit. It was identified however that there were no staff hand washing facilities in the residents’ bedrooms. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 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. The residents were cared for by sufficient numbers of staff EVIDENCE: Examination of the duty rotas, a discussion with staff and with residents identified that there was sufficient staff on duty throughout the day and night to meet the needs of the 34 residents living at the home. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 17 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): 33 35 36 & 38. A satisfactory accounting system was in place that ensured the residents’ interests were protected. The inadequate supervision of care staff could result in the needs of the staff and the residents not being met. Some current practices did not promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The Inspector was informed that a new quality assurance system was to be implemented in January 06. The systems in place for the management of residents’ money were good. The home had a satisfactory accounting system in place. Receipts were retained for all financial transactions. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 18 Several staff supervision files were examined. It was clear that the home had made good progress in relation to the supervision of staff, however the supervision provided covered only the practical aspects of the carers work. Supervision should cover all aspects of practice, the philosophy of care in the home and career development needs. Supervision needs to be a structured and dedicated time that is set aside for the member of staff to receive support and supervision from their mentor. This could take different forms. It could be on an individual one-to-one basis, a group supervision session or observation of professional practice. It has to be more than just the practical aspects of a carers work. Most of the equipment and services within the home were serviced on a regular basis in accordance with the individual requirements. There was, however, no documentation to show that the thermostatic control valves had been serviced. The lift engineer was present whilst the Inspector was in the home as there had been problems with the lift not working over the previous weekend. The Inspector noted that the lift room was being used to store items of furniture. The lift room must be kept locked and must not be used for storage. The lift engineer confirmed this was so. The fire alarm system was been serviced whilst the Inspector was in the home. Inspection of the file logbook showed that it was up-to-date and that fire training had been undertaken on the 2/12/05 for several members of staff. The Inspector was advised that this training is ongoing and further sessions have been booked. Doors to several bedrooms and the kitchen were wedged open with wooden blocks. This is a fire hazard. Greater Manchester County Fire Service identified these hazards in a letter to the home in November 05. A letter to CSCI on the 21st of November 05 from the home informed that they had been removed. They had not. An immediate requirement form was issued in respect of this. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 19 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 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 1 x 3 2 x 1 Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 Requirement That comprehensive assessments are completed on new service users given explicit details of the support required (previous timescales of 28/2/05 & 01/06/05 not complied with) That care plans are developed to provide a clear plan of support needs and how these are to be met (previous timescale of 31/07/05 not complied with) That risk assessments are developed for all identified areas and reviewed and updated on a monthly basis (previous timescales of 28/02/05 & 31/07/05 not complied with) There must be evidence of resident/relative involvement when drawing up the care plan. That the nutritional needs of service users are fully assessed and monitored (previous timescale of 31/07/05 not complied with) The provider must ensure that the most recent procedures are implemented. Medications must only be given DS0000008399.V263900.R01.S.doc Timescale for action 31/01/06 2. OP7 15 31/01/06 3. OP8 13 31/01/06 4 5 OP7 OP8 15 12 31/01/06 31/01/06 6. 7 OP9 OP9 13(2) 13(2) 16/01/06 12/12/05 Page 21 Beaumont House Version 5.0 8. OP9 13(2) 9. OP9 13(2) 10. OP9 17(1)(a)(i 13(2) 11 OP9 13(2) 12. OP9 18(1)(c) 13. OP16 22 14. OP18 13 15. OP26 13(3) 16. OP38 23(4) in accordance with the prescription or the homely remedy policy. The provider must ensure that the MAR are referred to and completed at the time of administration. The provider must ensure that all self-administration is assessed and supported in accordance with the homes policies. The provider must ensure that there is a complete, up-to-date and accurate record of all medicines kept in the home for each resident, and the date that they were administered. The provider must ensure that all medication is securely stored and is administered from the pharmacy labelled container. The provider must ensure that all carers handling medication complete assessed and certificated training. That all complaints are recorded with the complaints file and include details of all action taken (previous timescale of 01/06/05 not complied with) That policies and risk assessments are developed in relation to bed rails and risk management in order to ensure the protection of service users (previous timescales of 28th February 2005 & 31/07/05 not complied with) To reduce the risk of cross infection staff hand washing facilities must be provided in the residents’ en-suite toilets. Fire doors must not be wedged open. If residents wish to have their doors open then guidance and advice must be sought from the Greater Manchester County DS0000008399.V263900.R01.S.doc 12/12/05 16/01/06 12/12/05 30/12/05 30/01/06 31/01/06 31/01/06 31/03/06 19/12/05 Beaumont House Version 5.0 Page 22 Fire Service. An immediate requirement form was issued in respect of this CSCI must be informed by Monday 19/12/05 of the action taken. This was complied with and is an ongoing issue. 17. OP38 13(4) The thermostatic control valves must be serviced in accordance with requirements. Evidence of this must be forwarded to the CSCI The lift room must be kept locked and must not be used for storage. 31/03/06 18. OP38 23(4)(a) 13/12/05 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 OP8 2 3 4. 5 OP9 OP9 OP15 OP36 Consideration needs to be given to devising moving and handling, pressure sore and nutritional risk assessment documents that give clear guidance on how to reach a judgment The temperature of the medication storage rooms and the medication refrigerator should be monitored and recorded. A signature list for staff authorised to handle medication should be maintained. Residents should be consulted with regards to the timing and content of the evening meals. Management should ensure that staff supervision covers all aspects of practice, the philosophy of care in the home and career development needs. Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Beaumont House DS0000008399.V263900.R01.S.doc Version 5.0 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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