Inspecting for better lives 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, 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: Fiona Stephenson
Date: 1 7 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 29 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 29 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 ensuite facilities. Bedrooms 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 £390.00 per week. Additional charges are in place for hairdressing, chiropody treatment and Care Homes for Older People Page 4 of 29 10 0 Over 65 0 10 Brief description of the care home transport to appointments. A copy of the latest Inspection report is available at the home, or it can be accessed via the CSCI 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 29 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: This key inspection included a visit to the service. We (the CSCI) visited Beaumont House on the 17th December 2008. The Registered Provider (Owner), Violet Cadogen and the staff in the home helped us during the visit. We arrived at Beaumont House at 7.30am and finished visiting the home at 4.15pm. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by, - talking to the people who live in the home, - talking to staff and management, Care Homes for Older People
Page 6 of 29 - watching how people are given support, - looking at records. We spoke at length to five people who live at Beaumont House. Of the five people we spoke with, four were satisfied with the care they received They told us: I like it here, staff treat me properly Generally speaking, they (staff) are very kind and helpful I get on well with staff, we can have a laugh with them. Staff treat you well, 110 , you couldnt fault them. One of the five people told us: I dont feel there are many (staff) here that are professional..one in particular is very good, she has helped me on a number of occasions. What the care home does well: What has improved since the last inspection? What they could do better: Care planning could improve to help the service identify and meet the social and emotional needs of people living at Beaumont House. Care plans could include more information about the medication prescribed to people Care Homes for Older People Page 8 of 29 living at the home, and why it is used. This would help staff know more about the medical conditions of people who live there, and how medication helps with their medical needs. Staff must ensure they observe people living at the home taking medication before they sign the medication record to say it has been administered. We saw staff signing the medication record before this was done. Controlled medication must be locked in a controlled drugs cupboard, and medication requiring storage in a fridge, must be stored in a separate fridge to the one storing food. Although medication is securely locked away, the home does not have a separate cupboard for controlled medication, and it is required by law to do so. The provider must look at whether there are enough staff on duty at night to meet the current needs of people living at the home. People living at the home said to us: theres enough staff during the day..but could do with a bit more help at night time, you shout and nobody comes because they are looking after someone else. We were also told by staff that it is becoming more difficult to meet everyones needs during the night. We were told by people living at Beaumont House that there are not enough activities in the home, and for those who rely on staff support, there is little opportunity to have social activities outside of the home unless their relatives take them out. The owner is in the process of recruiting an activities co-ordinator. The owner must ensure that people living at the home have a copy of the homes brochure which includes the Statement of Purpose for the home, and the service user guide. We were told that this information is given to the relatives of people living at Beaumont House. The owner must ensure the Statement of Purpose and service user guide gives up to date information. The current information has been revised since the last inspection, but still requires further up-dating. The owner has not always informed us (the CSCI) of the death or illness of people living at Beaumont House, or other events that adversely effect the well-being of people living at the home. This is called a Regulation 37 notification. Although health and safety procedures are generally good at Beaumont House, staff and people who live in the home have not undertaken a fire drill for a long time. This must be planned at regular intervals to ensure that in the event of a fire, people know how to keep themselves safe. 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. Care Homes for Older People Page 9 of 29 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 10 of 29 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 11 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service ensures it can meet the needs of people who live there, but the information provided to them is limited. Evidence: We talked to people who live at Beaumont House about the information they have been given about the home. We found that they had not received a service user guide or statement of purpose. We were told that information is given to relatives of those who live at Beaumont House. We looked at the brochure of the home which has the information about the service, and found that some of it was not up to date. We checked whether people who come and live at Beaumont House have an assessment undertaken of their needs to ensure the service can meet their needs. We saw that needs assessments had been completed. This provided detailed information about the physical needs of the person, but less information was sought on the mental
Care Homes for Older People Page 12 of 29 Evidence: health and social needs of the person. Care Homes for Older People Page 13 of 29 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. Health and personal care needs are adequately met. Evidence: We checked the care records to make sure they had all the information required to ensure that staff meet the physical care needs of people who live in Beaumont House. We saw that care needs are reviewed regularly and that staff make sure other health care professionals such as nurses, GPs, opticians and dentists are contacted when required. Although the records document what care is being given, it was not always easy to find the information. We checked management and administration of medication. We saw staff respecting the wishes of people who live in the home by putting the medication trolley in the hallway out of sight whilst people were having their meal. We saw the member of staff giving the medication as not always administering it correctly. At times the staff member handled the medication instead of ensuring it went straight from the container into a pot; she also did not always check that the medication had been taken by the
Care Homes for Older People Page 14 of 29 Evidence: less vulnerable residents before signing to say it had been administered. We checked the storage of medication, and found that drugs classed as controlled drugs were not being stored in a controlled drugs cupboard. The medication was in a locked medication trolley which was stored in a locked cupboard. We also found medication that required storage in a fridge, was housed in the fridge with the food, and not a separate medication fridge. Records relating to the storage, management, and disposal of medication were properly kept. We observed the way that staff supported and talked with people who live in the home, and talked to five people who live at Beaumont House. We saw staff treat people who live there with respect, and they were seen to be kind and helpful. Four of the people we spoke to were pleased with the way staff supported them, and one was pleased with one particular member of staff. Care Homes for Older People Page 15 of 29 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 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 at Beaumont House have a good daily life, although opportunities for social activities are limited. Evidence: We looked at meals and mealtimes in Beaumont House. We saw a four-week menu which gave a range of meal options to people who live at Beaumont House. We spoke to people who live at Beaumont House about the menus, and they were happy with the quality and range of food being provided. We saw breakfast and lunch being served, and saw that people were given choice, that they had plenty of time to eat their food, and the food smelled and looked appetising. During the time we visited Beaumont House we saw visitors come and see their friends and relatives. We talked to two groups of visitors who told us that they were made to feel welcome by staff, and they were happy with the care their friends and relatives were receiving. One group said this is the best care home we have visited, we are always offered a drink and made to feel welcome. Another family member said about staff they have bent over back wards for my mum. Care Homes for Older People Page 16 of 29 Evidence: We saw that people who live at Beaumont House who are able to, walk freely, and come and go as they wish. We talked to people who live there and they told us about going out with their friends and relatives. We saw that people living in the home had freedom to move around the home, choosing whether to spend time in their bedrooms or to spend time in the communal areas. We were told by people living at Beaumont House that there isnt a lot of activities for them to take part in. We were told by the manager/owner of the home that this had been recognised and they were in the process of recruiting an activity organiser to support the social needs of people living there. We were also told by people who live at Beaumont House that they can get up when they want and go to bed when they want. Care Homes for Older People Page 17 of 29 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. The provider takes relevant action to ensure that people who live in the home are protected however this is not followed through with notification to the CSCI. Evidence: We saw that the service has a complaints procedure, and we saw that one person had made a complaint through this procedure. The manager assured us that the complaint had been dealt with, but could not find the written response at the time of the visit. During our visit we saw people living at Beaumont House feeling 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. They demonstrated a good understanding of how to protect people, and what procedures to follow if they suspected either another resident or a member of staff abusing a person living at the home. Staff have also received training in reporting safeguarding adult allegations. We checked that the service has been sending the CSCI, Regulation 37 notifications. These are notifications the service is required to send us if a person living at the home had died, has had a serious illness or injury, if there has been any event in the home that has an adverse effect on the people who live there, or if there are have been any
Care Homes for Older People Page 18 of 29 Evidence: allegations of misconduct by staff working at the home. We noted through discussion with the manager, and by looking at records, that the CSCI has not received as many regulation 37 notifications as it should have. Care Homes for Older People Page 19 of 29 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, and free from unpleasant smells. Their bedrooms have been personalised with ornaments, photographs and pieces of furniture from their home environments. People living at Beaumont House who required specialist cushioning for sitting and sleeping were provided with it. We observed staff using equipment such as aprons and gloves when undertaking care tasks, and when preparing and serving food. We asked staff questions about health, hygiene and the control of infection. They knew how to ensure they carried out their tasks to keep the home clean and tidy, and to protect people living in the home from infection and the spread of infection. Care Homes for Older People Page 20 of 29 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. Staff numbers and skill mix are appropriate for the assessed needs of people living at the home during the day and evening. Evidence: We observed there to be enough staff on duty during the day to support the needs of people living in the home. This was confirmed by people who live at Beaumont House, and the staff. We were told by some people living at the home, and by some staff that having one member of staff on duty at night with another on call was no longer sufficient to meet the needs of people currently living in the home. People living at the home, on the whole, spoke highly of the staff who support them. We looked at staff training records, and spoke with staff, and the records and discussions confirmed that staff have received sufficient training to help them undertake their roles and responsibilities. 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; and that they had received two written references for each person.
Care Homes for Older People Page 21 of 29 Evidence: Care Homes for Older People Page 22 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Beaumont House is satisfactorily managed by the owner. Evidence: The owner is also the manager of the service. We talked to the owner of the service and the staff and were made aware of changes that have happened in the home. The changes are mostly linked to staff. The owner is a registered nurse and has had managerial responsibilities in other care homes prior to taking on the ownership of Beaumont House. This information is not recorded on the Statement of Purpose. We saw that the owner has placed herself on the staff rota when she is undertaking care duties, but there is little written evidence of her being at the home at other times when she is operating purely in a managerial role. The owner was working on the day of our visit, but this had not been recorded. The owner has started the process of getting feedback from people who live at
Care Homes for Older People Page 23 of 29 Evidence: Beaumont House. She has sent out questionnaires to people, and a residents meeting has been held and the views of residents have been recorded. We checked to ensure that the money of people living at the home was kept safe, and there was proper recording of money received into the home, and receipts kept for money that was spent. We found proper procedures were in place for this. We looked at working practices to ensure they were safe. We did this by looking at training records, observing staff, and looking at safety records. We found that most health, safety and welfare practices were being observed, except fire drills. Although staff have received fire training, there has not been a fire drill in the home since the new owner took charge. Care Homes for Older People Page 24 of 29 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 25 of 29 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 13. (1) The service must ensure there is a separate, secure fridge that is only used for medications requiring cold storage. To comply with good practice guidance from the Royal Pharmaceutical Society 17/01/2009 2 1 4 Each person who lives at the 14/01/2009 home should be provided with a copy of the statement of purpose and service user guide. Beaumont House, know what service to expect. The provider should ensure that the care plans give proper consideration to the emotional, behavioral and social needs of people living at the home, and detail how the service can meet their needs. 17/01/2009 3 7 15 Care Homes for Older People Page 26 of 29 To ensure that people living at Beaumont House have all their needs identified and supported. 4 9 13 13.(1) The provider must 17/01/2009 ensure the storage of medication meets the Misuse of Drugs (safe custody) regulations 1973. To comply with the law relating to the storage of controlled medication. 5 9 13 The provider must ensure that all staff follow correct procedures in the administration of medication. To ensure that people living at Beaumont House are taking their medication as prescribed. 6 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. The provider must consider whether night time staffing arrangements fully support the needs of the people currently living at Beaumont House. 17/01/2009 17/01/2009 7 27 18 17/01/2009 Care Homes for Older People Page 27 of 29 To ensure people living at Beaumont House are properly supported during night time. 8 38 23 23.4.(e)The provider must 17/01/2009 ensure that fire drills are regularly undertaken by staff and people living at the home. To ensure that staff and people living at Beaumont house know what to do in the event of a fire. 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 2 3 7 The needs assessment should provide more information about the persons mental health and social needs. Care plans should include information about the medication people have been prescribed, the reasons why it has been prescribed, and the effects medication may have on the person. The provider should continue to implement plans to improve the social life of people who live at Beaumont House The provider should ensure there is evidence of the time she spends at the home in a management capacity. This provides evidence of how much support staff and people living at the home are receiving from the services manager. 3 12 4 31 Care Homes for Older People Page 28 of 29 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 29 of 29 - 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!
