CARE HOMES FOR OLDER PEOPLE
Beaumont Park Nursing & Residential Home Shortmead Street Biggleswade Bedfordshire SG18 0AT Lead Inspector
Katrina Derbyshire Unannounced Inspection 21st September 2007 10:45 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 Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 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 Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Beaumont Park Nursing & Residential Home Address Shortmead Street Biggleswade Bedfordshire SG18 0AT 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) 01767 313131 01767 313181 admin@beaumontpark.healthcarehomes.co.uk Abbott Healthcare Limited - Parent Company Mr James Sewards Care Home 38 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (38), of places Physical disability (5), Terminally ill (5), Terminally ill over 65 years of age (5) Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. The home can accommodate a maximum of 38 service users of either sex. No one falling into the category of PD (40-65 years) may be admitted to the home when there are already 5 persons in this category. No one with a diagnosis of dementia may be admitted to the home when there are already 20 persons in this category. No one with a diagnosis of terminal illness may be admitted to the home when there are already 5 persons in this category. 15th January 2007 Date of last inspection Brief Description of the Service: Beaumont Park Home is a large detached property close to the town centre of Biggleswade, a Mid-Bedfordshire village that is within easy access of the A1 motorway. Accommodation is provided in single and double bedrooms on the ground and first floor. There is a lift and staircases connecting the two levels and a small platform lift where there are steps. The home is registered for 38 people, however one bedroom has been converted into an office so the maximum accommodated is 37. The home is situated off the main road and has parking at the front, for staff and visitors. There is a well laid out garden to the rear with a pond and seating areas. The fees for this home vary from £462.00 (then with additional funding) per week, to £700.00 per week, depending on the funding source and assessed needs of the person. Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The purpose of this visit was to undertake a key inspection. This unannounced visit was carried out on 21st September 2007. The manager was present during the inspection. During the visit the communal areas of the home were seen alongside some of the individual accommodation. The inspector spent time with many of the people who live at the home in the large sitting area. The care of three people was examined. Information from the home had been provided and included documents relating to meals, staff training and activities to assist in assessing the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit, feedback from people who live at the home and the management’s submission of documentation. Observations of care practice and communication between the people living at the home and staff was also made at the inspection. The focus of this inspection was to look at the key standards and to follow up on previous requirements. What the service does well: What has improved since the last inspection?
Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 6 Staff had been making sure they write down every time a person has an accident. This is very important as the manager looks at accidents in the home every month to see if there is a pattern forming, so that he can see if changes need to be made to reduce the risk to the person who may have frequent falls for example. Another area that has changed is when they recruit new staff. All homes must carryout a number of checks on the people applying for jobs, they must do this to protect the people living at the home from harm by ensuring they have sufficient information to know if they will be suitable to work with vulnerable people. The home had previously allowed some staff to start working on their induction to the home before they had received two written references and a safety check therefore allowing them to work before they had checked if they had a suitable working history and were suitable to work at a home. All checks needed were now being undertaken before anyone was allowed to start work in the home. 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. The summary of this inspection report can be made available in other formats on request. Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 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 Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of pre admission assessment continues to be good ensuring the staff have sufficient information to know if they will be able to meet the individual needs of the person. EVIDENCE: Care records examined contained documentation to show that an assessment had been undertaken prior to their admission to the home. Information included the physical, social and emotional needs of the person. Written evidence was also seen from commissioning authorities that had been used alongside the homes assessment information to ascertain if the home would be able to meet the persons needs. Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 9 The manager at the home also stated that prospective people and their families were welcome to visit the home at anytime before they made a decision to move into the home. Intermediate care is not provided. Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are good at supporting people to access health care support so that their health needs are met. EVIDENCE: Care plans were examined within the individual records; a plan of care was in place for all of the assessed needs with a linkage to the assessment described in the previous section. Observation at this visit indicated that personal care is carried out appropriately. Observation of the interaction between people living at the home and staff showed staff speaking in a supportive and encouraging manner as assessed at the previous inspection. One member of staff was seen to gain the selection for the lunchtime meal, her approach was professional and her manner courteous it was very evident that she had established trusting relationships with many people living at the home.
Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 11 Appropriate equipment was in place for the treatment and prevention of pressure ulcers, and risk assessments alongside nutritional screening is in place, and reviewed regularly. Medication were detailed within the individual care records, these gave guidance to staff on all prescription medication that should be given. In addition individual medication administration sheets were maintained and these were noted to match all other records. Medication was kept in a locked storage area and was seen to be secure. Medication records and stocks were examined. In the main the stocks and charts that were seen were noted to be correct. However the stock balance of one prescription medication was incorrect. A full audit could not be undertaken as the balances of previous medication had not been brought forward and a requirement is made relating to this matter. Documentation showed that people had access to medical services if required, appropriate aids were available and advice is sought from Healthcare specialists in their care. Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use 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 this home feel that arrangements in place for activities are good and meet their social needs. EVIDENCE: Several people spoke of the activities available to them in the home and one person commented “ We have music on this afternoon actually”. Information supplied by the home to the Commission for Social Care Inspection showed that activities arranged in the home included outings to local attractions, garden centres and the pub, church services and visiting entertainers and singers. The Bedfordshire library service also visits the home and church services are held. Several people during this inspection were seen to receive visitors. A family member of one person said, “ people are friendly enough, I’m always made to feel welcome”. Everyone spoken to confirmed they were able to receive visitors when they wished and many would chose to see them in the privacy of their
Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 13 own rooms. Entries were also seen within care records that demonstrated that the staff at the home would contact the nominated next of kin if there had been a change in their well being. Options available to people in maintaining control, independence and choices in their lives included, choice of meals, voting, choice of clothing, access to a complaints procedure and access to community healthcare support. People living at the home and records confirmed that the choices associated with people’s daily lives were available to them whilst living there. At this visit a choice was available for the lunch and teatime meal, the options reflected the information detailed on the menu board. Protein, carbohydrates and vegetables were noted to be offered daily providing a balanced diet. Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use 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. Systems in place at this home for receiving and investigating complaints is good so people are assured that their concerns will be acted upon. EVIDENCE: As assessed previously the home had a complaints procedure that was displayed in the hallway. This clearly indicated the complaints procedure including time frames for response, and the Commission for Social Care Inspection contact details, although one of the addresses has since changed. People knew of the process if they wished to make a complaint. Examination of records showed that complaints that had been received by the home had been looked into and responded to by the management in the home, although none recently. There was a policy for the safeguarding of Adults available. Since the previous inspection a referral had been made under the local guidance and subsequent referral of a person onto the list, demonstrating an understanding of the procedure to be followed to safeguard people. Staff had also attended training in this area and were able to demonstrate a sufficient understanding in this area when interviewed.
Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use 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 general maintenance of the environment in some areas of the home is not of a sufficient standard, although this does not place people at risk it does not create a pleasing and pleasant environment to live in. EVIDENCE: Accommodation is provided in single and double bedrooms on the ground and first floor. There is a lift and staircases connecting the two levels and a small platform lift where there are steps. The furnishings, fittings and décor in these areas are of an acceptable standard. The rear garden area provides spaces to
Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 16 sit out in the warmer months. Individual rooms contained personal items of the person to assist in creating a homely atmosphere. However several areas were in need of redecoration for example marks and scuffing along walls, carpets in need of replacement and a broken bath panel. One person also commented that many times when they use the toilet it is not clean. All areas visited on this day were tidy and free of odours. Staff were observed to wear suitable protective clothing when carrying out certain activities. Cleaning schedules were in place and clinical waste was disposed of in an appropriate manner and clinical waste contracts are in place. Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use 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 training arrangements for staff are sufficient with staff demonstrating a clear understanding of their role. EVIDENCE: The induction and training of staff was recorded in the individual records of all employees. Staff through interviewing confirmed that they had undertaken a variety of courses these included health and safety, moving and handling and national vocational qualifications in care. Several of the people living at the home made positive comments on the skills of the staff team, one person said “the nurses are very good”. The homes recruitment policy and procedures are now clear and comprehensive. References were taken prior to staffs’ commencement and the relevant Criminal Records Bureau check was also carried out and evidence of this having been undertaken was seen. Certificates of qualifications are present within staff files. Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 18 Registered Nurses, care assistants, catering and housekeeping staff are employed at the home . Training records examined that were supplied by the home show that staff had undertaken statutory training, including moving and handling, fire safety and food hygiene. In addition staff confirmed that they had attended a variety of courses including dementia awareness. People living at the home who were spoken with felt that the staff had a satisfactory level of knowledge and felt confident in their abilities to meet their needs. Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and safety in the home is managed well and reduces the risk of accidents to people at the home. EVIDENCE: All staff felt that the manager provided the support and guidance that they needed to carryout their roles. Two long-standing staff both expressed their opinion that they felt he provided them with the support that they needed to undertake their roles in the home. People living in the home also praised the manager describing him as thoughtful and kind.
Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 20 Documentary evidence was seen that showed that the home had undertaken a survey to gain the views of people living at the home and their representatives. Where areas had been raised the staff at the home had taken action to remedy this and make improvements for example the laundering of clothes. Balances of small amounts of monies managed by the staff on behalf of people living at the home were checked. All balances were noted to match the amount entered onto the balance sheet. Receipts were also in place for any expenditure, examples of spending included toiletries and hairdressing. Health and safety records maintained by the home show that safety checks are carried out to ensure equipment in the home is kept in good working order. Copies of the most recent inspections undertaken by the fire service and environmental health were seen and evidence was also seen that work had been undertaken in response to any recommendations made. Staff and training records confirmed that they had undertaken training in this area including, moving and handling, fire safety and food hygiene. Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 21 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 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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 OP9 Regulation 13(2) Requirement All medication stock balances must be carried forward to ensure an audit can be undertaken. Records kept relating to people living in the home must be factual and not based upon individual opinion to uphold the dignity of the person. Redecoration and repair within the home must be undertaken to ensure all areas are of a satisfactory standard in which to live in. The toilets must be kept clean, so that people living in the home feel able to use them at all times. Timescale for action 31/10/07 2. OP10 12(4)(A) 31/10/07 3. OP19 16 31/12/07 4. OP26 16 21/10/07 Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Beaumont Park Nursing & Residential Home DS0000017665.V346749.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 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
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