Inspection on 23/02/10 for Beaumont House

This inspection was carried out on 23rd February 2010.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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 12/12/05

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 16/05/2010.

Key inspection report Care homes for older people Name: Address: Beaumont House 26 Church Lane Whitefield Manchester M45 7NF     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: Julie Bodell     Date: 2 3 0 2 2 0 1 0 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 29 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.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 26 Church Lane Whitefield Manchester M45 7NF 01617969666 01617967722 glenysgardner@bankfield.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Bankfield Premier Care Ltd Name of registered manager (if applicable) Manager Post Vacant Type of registration: Number of places registered: care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The service should at all times employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Within the maximum of 37 there can be up to 37 OP Old Age. Date of last inspection Brief description of the care home Beaumont House is a residential care home for up to 37 older people. The home is one of four homes in Bankfield Premier Care group and is situated in the Bury area. The current fees are 380.00 pounds per week. 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 including the Metrolink 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. The home is two storeys with an extension to the rear and side. It is divided into two units, Care Homes for Older People Page 4 of 29 Over 65 37 0 Brief description of the care home 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 and short stay care may also be provided if a place is available. 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: An inspector and a pharmacist inspector carried out this key inspection visit, which took place over nine hours. The home did not know that we (the commission) were going to visit. During the visit time was spent talking with the acting manager, the new head of care, a senior carer, a carer and a domestic. We also talked with two people living at the home, looked at paperwork, checked parts of the building and watched what was happening around the home. At our last key inspection visit on 29th September 2009 we continued to have concerns about how well the home was being managed and the standard of healthcare and personal support people were receiving. We held a management review on 13th October 2009 to discuss what enforcement action we were going to take against the home. Care Homes for Older People Page 6 of 29 We met with the owners of the home on 5th November 2009. We told them that we were considering both closing the home and prosecution because of continuing poor practice in relation to medication. A random unannounced inspection visit took place on 16th December 2009 to check that compliance had been made and sustained. Although significant improvements were noted in most areas, the pharmacist found that no improvements had been made in relation to medication practices. Following a management review meeting on 13th January 2010 it was decided that enough improvements had been made to reconsider closing the home. But we would start prosecution proceedings for failure to meet our statutory enforcement notices in relation to medication practices. We informed the providers and managers at a meeting held at the home on 4th February 2010 of our intentions and that this inspection would be the last chance to put the situation right. Before this key inspection we requested information from the home called an annual quality assurance assessment (AQAA). The AQAA tells us about what the home thinks it does well and what needs to be done to improve. We also received six surveys from relatives and one from a carer. These gave generally positive responses to our questions but there were still some mixed responses to some questions such as the food and laundry services provided. During the key inspection visit the pharmacist found that shortfalls in medication practices had been addressed. There were also ongoing improvements in the day to day management of the home. The acting manager and the new head of care were working alongside staff to improve the care and support people received at the home. However, our assessment of the homes performance is based on the information we had in relation to the previous six months as well as our findings during this visit. Because we need to be sure that the improvements we have seen are sustained the overall quality rating for the service is adequate. We will carry out a random inspection to check that this is the case. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? Communication and teamwork had improved to ensure that people received the healthcare and personal support they need when they needed it. For example a member of the care staff team was in the lounge and dining area of the home at all times to ensure that people were appropriately supported and had the attention that they needed. The atmosphere at the home was better. One relative commented that, At the moment there is a cheerful atmosphere with helpful staff. This has not always been the case in the past. There has been a positive change in atmosphere since a change in management, hope that this continues. Another commented that, The home is getting better since the change in some staff and the bringing in of the new person in charge. Records had been reviewed and were up to date and reflected peoples changing needs. They were written in a more person centred way and relatives had signed to say that they agreed with them. Risk assessments were fully completed. All areas of medication handling had improved to ensure that peoples health and well being was not being placed at risk from harm There were more activities taking place at the home that encourage stimulation and interaction with other people for example church services, hand massages, music therapy and theme days. The staff team had started to receive the training they needed to ensure that they are competent and are able to meet peoples needs in a safe and effective way. Managers had taken a back to basics approach to training and were closely monitoring staff performance by working alongside staff. They were also addressing staffing issues through formal supervision and identifying areas for further development and training. In the returned survey from a staff member they commented, I feel there has been a big improvement in every area, also the staff have become a team and we work better together, which reflects on the residents. And, I feel that the home is a good place now a lot of changes have been made. We are now kept informed about any incidents that happen at the home, for example, if a person is admitted to hospital. Care Homes for Older People Page 8 of 29 Staff are following health and safety guidelines to protect people from harm for example keeping doors to the kitchen, laundry, linen cupboards and store rooms locked when not in use to reduce the risk of fire. 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 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before they move into the home to ensure their individual care and support needs can be met. Evidence: At this key inspection visit no new people had come to live at the home on a permanent basis. This was because the local authority had been made aware of the homes poor quality rating and also because the owners had made the decision not to accept new people who were self funding until the quality of service had improved. We were told that there were a number of people waiting for the outcome of this inspection and wanted to move in if the necessary improvements had been made. We have told the local authority that the quality of the service has improved and been given an adequate quality rating, on the basis that the home must evidence that they have continued to make and sustain improvements. We will be returning to inspect the home again to check that this is the case. Care Homes for Older People Page 11 of 29 Evidence: The acting manager and the head of care will take responsibility for carrying out an assessment before a person moves into the home, until further notice. We looked at the assessment of a person who had come to the home for a period of respite care. The assessment was detailed and well written. The person had stayed at the home previously and their records were updated when they came back into the home, which included a care plan and risk assessments. Care Homes for Older People Page 12 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. Peoples healthcare and support needs are better met and all areas of medication handling had improved. Evidence: We started our inspection visit at 7.30am. People were getting up at a relaxed pace. A handover was held with the senior night carer and the four senior care staff. The shift pattern at the home had recently changed. Morning staff now start at 7.00am instead of 8.00am. This means that there are more staff around on the early shift to support people who are ready to get up and more time to give out medication. Staff we spoke with said that there was a better routine to the day and they knew what was expected of them. After an update from the acting manager we sat in the downstairs lounge dining room for two hours and watched what went on and how people were being supported. Most people were having their breakfast at the dining tables and were seen to be receiving discreet support from staff to eat their meals were necessary. Throughout this period of observation there was always at least one member of staff in the room. Care Homes for Older People Page 13 of 29 Evidence: We looked at the care plans and risk assessments of the three people who had high levels of need. The care plans had recently been rewritten and updated. They were generally well written, in a person centred way and reflected peoples changing needs. The care plans make reference to privacy and dignity, choice and promoting independence. A care staff member told us that staff were encouraging people to do as much for themselves as they can to help maintain their independence for as long as possible. Two care plans had been signed by relatives. Risk assessments had been completed for people. Personal care records were also now kept up to date. All relatives had been contacted recently to agree end of life arrangements for people, which had been recorded and signed. Wheelchair footplates were seen to be being used throughout the course of the day and wheelchair assessments are planned to take place with the appropriate health care professionals. Arrangements were also in place for a new dentist and chiropodist to come into the home. One persons mental health needs had changed and the home had contacted the appropriate health care professional for support and advice. This situation was ongoing. Managers had introduced a back to basics approach for care staff and were working alongside them to check that they were caring for people in the right way and that they were clear about what standards were expected them. Further health care training was also being arranged for staff that will include Parkinsons disease and dementia awareness. During the inspection the specialist pharmacist inspector looked at how well medicines were handled to make sure that people were being given their medicines properly and their health was not at risk. This was because at the previous inspection we found that people were not safe because requirements made in the Statutory Requirement Notice, regarding medication, dated 5th November 2009 had not been met when we inspected the service on 16th December 2009. During this visit we looked a sample of records about medication together with medicines currently available for those people. We specifically checked to see if the requirements made in the Statutory Notice had now been complied with. During our inspection we did not find any further breaches of the regulations regarding medication. We found that significant progress had been made to ensure that medicines were handled safely and peoples health was no longer at risk from harm. We also identified Care Homes for Older People Page 14 of 29 Evidence: some areas where medicine handling, which could be improved. All medicines were stored securely in a clean and tidy dedicated medication room. Medication was stored at the correct temperature; a record of the fridge and room temperatures was made to make sure of this. The room was very warm and it is recommended that a cooling system is put in the room to make sure medicines are not stored at the wrong temperatures in the warmer months. All medicines awaiting collection for disposal were stored in a locked cupboard to make sure they could not be misused. Almost all creams were securely locked away in the medication room although some were in residents bedrooms. No checks had been made to show it was safe to store creams in bedrooms or that they were stored securely. The manager assured us she would look at the storage of these creams very quickly and make sure they were stored safely in the future. People had an adequate supply of medication available in the home so that they did not miss any doses of important medication. The records for the previous month showed that no one had run out of medicines during that time. The records about the disposal of medication showed that a careful eye had been kept on stock levels and the manager told us that actions were taken if too much stock accumulated. We also saw that the home had kept medication in accordance with legislation for one person who had recently passed away. The records about receipt, administration and disposal of medication were well kept and accurate. We compared these records with the actual medication in the home and found that this confirmed the accuracy of the records. The records showed that people were given their medication as prescribed and medication could be accounted for. The records clearly showed which dose was given when a variable dose was prescribed. When medication was changed by the prescriber we saw that good records were made of the changes. If medication was not given as prescribed for any reason the care staff recorded clearly why they had not done so. When people were prescribed creams it was clear from the records exactly where and how to apply this creams. For some people there was clear information for available for staff to follow when medicines were prescribed when required. This information was not available for all medicines prescribed as required, nor was there any guidance available to tell staff under what circumstances to give 1 or 2 tablets when a variable dose was prescribed. If this information is available it enables people to be given their medication safely and consistently. The manager agreed this was an area which needs further work. The manager told us about the systems she used to check that staff were handling medication safely and to ensure their ongoing competency. In light of the Care Homes for Older People Page 15 of 29 Evidence: improvements it is evidenced that these checks are effective and keep people safe. Although significant improvements have been made it is important for us to ensure that they are sustained. The quality rating for this section of this report is therefore, adequate. Care Homes for Older People Page 16 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have opportunities to participate in stimulating and meaningful activities. Evidence: The activities organiser from within the organisation has returned to the home for two days a week. There were more activities available to people for example church services, hand massages and theme days such as St Patricks day. Some people living at the home had their own hobbies and interests and highly personalised rooms that they enjoy spending time in mainly reading, listening to music or watching television. The hairdresser was at the home on the day of our visit and many people had there hair cut throughout the morning. At previous visits we had been concerned about the lack of interaction between people living at the home and the care staff. Interaction between people and members of staff were seen to be frequent and friendly and there was an overall improvement in the atmosphere at the home. In returned surveys one relative commented that, At the moment there is a cheerful atmosphere with helpful staff. This has not always been the case in the past. There has been a positive change in atmosphere since a change in management. I hope that this continues. Another commented that, The home is getting better since the change in some staff and the bringing in of the new Care Homes for Older People Page 17 of 29 Evidence: person in charge. We talked with to people living at the home. They told us that they were happy living at the home and confirmed that there were more activities available and that the atmosphere had improved. Both people liked to spend time in their rooms, which were nicely set out to individual tastes and overlooked the garden. A small group of people were very good friends and they spent time with each other at mealtimes or visited each other in their rooms. A newsletter is now produced to keep people informed about what is happening at the home. The managers were in the process of reviewing the menu and provision of meals with the cooks. This needs to be done because the responses we received regarding meals remained mixed. Only the downstairs dining room is now in use. People were served a substantial breakfast including grapefruit, cereal and toast. Some people had their breakfast in their rooms on trays. Hot and cold drinks were served with meals and throughout the day. Each of the floors had a small kitchen where drinks and snacks can be prepared, particularly around suppertime. At dinnertime and teatime people had a choice of meal. Staff were seen to give people discreet support to help them eat their meals. Staff were also using blue aprons and gloves in line with control of infection practices. Care Homes for Older People Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People knew who to speak with if they had any concerns and staff had received training to ensure they knew what action they must take to protect people from abuse. Evidence: There had been no formal complaints made to us since our last key inspection visit. One person we spoke to confirmed that the new acting manager had come to see them and asked them if they had any concerns. A copy of an updated complaints procedure was seen in peoples bedrooms. In returned surveys relatives indicated that they knew who to speak to if they had any concerns. There had been no allegations of abuse at the home since the last key inspection. The home had a copy of the new local safeguarding procedures. The acting manager had attended training in safeguarding procedures at an investigation level. Since our last visit all staff with the exception of one person had completed a safeguarding work book and undertaken an e learning training course. Plans were in place for the staff team to undertake Mental Capacity Act training that includes deprivation of liberty. 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. Beaumont House generally provides a clean and comfortable home that is decorated and furnished to a good standard. Evidence: Beaumont House is a large detached property offering pleasant accommodation for the people who live there. The home also provides an enclosed, attractive and wellmaintained private back garden with seating for people. The lounge and dining areas were homely and comfortably and generally furnished to a good standard. People can make use of all communal areas on the ground floor. The lounge areas were seen to be comfortable and the living flame fires made them feel homely. The home has access to a handyman who comes to the home two or three days a week to keep on top of general maintenance. The home provides all single private bedrooms each having an en-suite toilet and wash hand-basin. A lockable space is provided for peoples personal use. Bedrooms had been highly personalised in some cases, with belongings and furniture brought from home by those people who wished to. People we spoke with said that they liked their bedrooms. All fire doors that we checked at this visit closed to the rebate to help ensure that Care Homes for Older People Page 20 of 29 Evidence: people were protected should there be a fire at the home. The kitchen, laundry and linen cupboard doors were also kept locked when unattended. There were a number of toilets and two bathrooms on each floor. One smaller bathroom had been refurbished into an assisted shower room. Liquid soap and paper towels were in place to help reduce the incidence of cross infection. At our last key inspection visit the acting manager said she wanted to see improvements in the levels of cleanliness throughout the home and had introduced a cleaning schedule and was to employ more staff. This had been done. We talked with one of the domestic staff who was able to show us the cleaning rota for the home. The domestics also covered the laundry. The domestic had undertaken control of infection training and understood the red bag system for handling soiled laundry. With the exception of a number of seat cushions on armchairs, no malodours were detected. Care Homes for Older People Page 21 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. The staff team had been safely recruited and had started to receive the training they needed to ensure that people were safe from harm. Evidence: There were usually five care staff members on duty in the morning, five in the afternoon and four in the evening, including the acting manager. There were two carers on duty at night. The care staff team were supported by cooks, kitchen and laundry assistants, domestics and business administration. There has been some staff turnover at the home since our last visit, including the deputy manager and two seniors. We looked at the recruitment files for two staff members and found that they were generally in good order, with a Povafirst being undertaken prior to a person being offered employment and a CRB (Criminal Records Bureau check), being undertaken. References had also been taken up. We spoke with two members of the care staff team. One person had recently been recruited to the home. The staff member said that they had been made welcome and that there was a friendly atmosphere and they were happy to work at the home. The carer said that there had been many changes at the home recently and the atmosphere had improved. There had been more training available to staff and this was being transferred into day to day practice for example control and infection. They said that staff were being closely monitored by managers and they were correcting Care Homes for Older People Page 22 of 29 Evidence: poor practice. It was noted that some staff had stayed over at the home during recent severe weather conditions to ensure that people received the care and support that they needed. The organisation was a member of the local training partnership, which provides training through Skills for Care. There have been gaps in training for sometime but progress was being made in addressing the shortfalls and we have received regular updates from the home to tell us what training has been undertaken each month. The home must continue to do this until the staff have received all the training they need to support people safely and effectively. The home also needs to work towards more staff undertaking and achieving NVQ (National Vocational Qualification) Level 2 or above, a recognised qualification for staff involved in the care profession. Care Homes for Older People Page 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is better managed and the staff team is closely supervised to ensure heath and safety is promoted and that the service provided is in the best interests of the people who use it. Evidence: At the time of our last key inspection the acting manager for the home had only been in post for two days. The acting manager had moved to Beaumont House from another home within the organisation that she was registered to manage. The acting manager had submitted an application to become registered with us to manage Beaumont House. The acting manager had some plans in place for training to ensure her continuous professional development. This included Deprivation of Liberty training and a management and leadership course. The acting manager was joined by a new head of care who had previously worked for the organisation. Both have many years experience working with elderly people in residential settings. The managers were working alongside staff on a daily basis. There was no deputy Care Homes for Older People Page 24 of 29 Evidence: working at the home at the time of this visit but there had been an increase in the number of senior care staff. They said that in their view there had been an improvement in communication, organisation and clearer direction for the staff team. They said that staff had a better understanding about their roles and responsiblities, wanted to be more involved and there was better team work. We looked at the minutes from recent staff and senior staff meetings. Areas discussed included personal care, key worker responsibilities, greeting visitors and professionals, wearing the correct uniform and overall greater attention to detail when supporting people. Staff were receiving regular supervision and records were being maintained. The managers were concentrating on changing the culture and previous mind set of the staff team. They accept that there is still more to do to ensure that people receive a consistent service. Evidence gathered as part of this inspection suggest that the hard work has now started to improve the outcomes experienced by people. However the home has had a poor rating for sometime and we intend to visit the home again in the near future to ensure that improvements have continued and sustained. The new head of care was now carrying out regular Regulation 26 visits and sending a copy of the report about her findings to us. We are also now being routinely notified about incidents that had happened in the home for example an admission to hospital or if a person had died. A quality assurance exercise had recently been carried out and thirteen responses had been received. These gave generally positive responses with some comments about what improvements they thought could be made in relation to laundry and meals. The managers said that they were working towards involving families in the running of the home. In our returned surveys people commented that sometimes it took a long time to answer the telephone and the front door at the weekend. We checked maintenance certificates and records for the home and these were found to be in good order. Care Homes for Older People Page 25 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 26 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 30 18 The registered provider must ensure that the staff team continue to receive all relevant mandatory health and safety training they need. This must be done to ensure they are competent to carry out their roles and responsibilities safely and effectively. 21/06/2010 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 9 9 Checks need to be made that show it is safe to store creams in bedrooms and that they were stored securely. Clear information needs to be for available for staff to follow when medicines were prescribed as required. This should include guidance to tell staff under what circumstances to give 1 or 2 tablets when a variable dose was prescribed. It is recommended that a cooling system is put in the 3 9 Care Homes for Older People Page 27 of 29 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 medication room to make sure medicines are not stored at the wrong temperatures during the warmer months. 4 15 The arrangements for the provision of meals need to be reviewed and any necessary changes put in place to ensure a consistent standard. The staff team need to undertake Mental Capacity Act training that includes deprivation of liberty to ensure their continued professional development. The home need to look at ways to increase the numbers of staff who hold an NVQ Level 2 and above. 5 18 6 28 Care Homes for Older People Page 28 of 29 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). 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