Inspection on 15/01/08 for Beckfield

This inspection was carried out on 15th January 2008.

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

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

Other inspections for this house

Beckfield 08/01/07

Beckfield 25/01/06

Beckfield 22/11/05

Beckfield 30/03/05

Beckfield 19/10/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Beckfield 70 Bolton Lane Bradford BD2 4BN Lead Inspector Sughra Nazir Key Unannounced Inspection 15th and 25th January 2008 10:15 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 Beckfield DS0000033521.V354736.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. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beckfield Address 70 Bolton Lane Bradford BD2 4BN 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) 01274 203001 01274 203002 City of Bradford Metropolitan District Council Department of Social Services vacant Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th January 2007 Brief Description of the Service: Beckfield provides care and support for people over sixty-five in a multi cultural setting. The home is owned and managed by Bradford Local Authority; it is in a residential area, close to local amenities and is about two miles from Bradford city centre. The home can be reached by bus and has car parking space within the grounds. The home is built on two levels and houses four wings and a day centre. The day centre is not currently subject to inspection. The four residential units provide for group living and include bedrooms, lounge, dining room and domestic style kitchen. There are 35 single bedrooms available. The home offers long and short stays, respite and day care. The home is equipped to meet the specialist needs of service users from Eastern European and Southeast Asian backgrounds including those with mobility problems. There is level access into the building. A lift connects each floor and the home has assisted bathing facilities. Outside the home there is a there is a small garden/patio area, which is accessible by wheelchair. The fees are between £98.63 and £ 435.68 per week (as at January 2008) and cover all meals and snacks, care and support and laundry. Service users pay extra for hairdressing, personal newspapers and magazines and personal toiletries. Visitors are welcome at any time. Copies of the service user guide and the last inspection report are available in the home’s reception area. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example “Choice of Home”. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgement categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk This report is based on information gathered in a number of ways. • • A review of the information held on the home’s file since its last inspection. Information sent to us by the registered provider in a document called the Annual Quality Assurance Assessment (AQAA). This tell us what the home does well, what improvements they have made and what they could do better. Eleven surveys sent back to us by people who live at the home, two forms returned by relatives and three survey forms received from staff. An unannounced visit to the home, which lasted about seven hours. This visit included a tour of the premises and talking to people who live at the home, their friends/relatives, staff and management. We also looked at menus, staff rotas, and people’s care plans and watched staff looking after people. A further visit to the home to look at medication records and discussion with the manager. • • • Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Care plans should be in place for everyone including people who come for a short stay. This will mean that staff have clear instructions about how to meet people’s needs. Recordkeeping for medication given must improve so that staff know that people’s medical needs are not being overlooked. Staff must knock on doors and seek permission before entering bedrooms this will make sure that people’s privacy and dignity is respected. The manager should make application to be registered with the Commission as soon as possible this will give the people who live at the home further reassurance that she has the skills and training needed to manage the home. Staffing arrangements should be kept under review and more frequent staff supervision will give staff opportunity to discuss individual concerns and make sure that there is ongoing monitoring of individual training and support needs. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 7 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. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 8 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 Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 9 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): 1, 3 and 6. Quality in this outcome area is good. People who are coming to live at the home have their needs assessed prior to admission to make sure that the service can deliver the care they need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the visit we saw an information pack that is made available to people who may want to stay at the home. This tells them about the care provided. This information is made available in community languages and large print. Information the home sent us tells us that they carry out an assessment of people’s needs before they come to stay. People and their relatives or friends are encouraged and invited to visit Beckfield before making a decision. All the files we looked at contained a detailed assessment of people’s needs. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 10 The home has two dedicated “step-down “ beds for intermediate care. People are referred to this service directly by the NHS and always have a full assessment in place. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 11 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 and 10. Quality in this outcome area is adequate. People’s personal and healthcare needs are usually met but this is not always evidenced in the records kept. Inconsistent record keeping means that there is a risk some needs might not be met and medication might not be given as prescribed by people’s doctors. People’s privacy and dignity is not always respected by some staff attitudes and practice This judgement has been made using available evidence including a visit to this service. EVIDENCE: The local authority has introduced detailed care planning documents for people’s care needs to be recorded. We looked at care plans on three different units in the home. On the short stay wing we looked at 2 files. We saw that staff have instructions to complete care plans within 24 hours on the short stay unit. One file we looked at had a detailed admission assessment but there was no care plan. This was the person’s second stay on the unit. There were no weights recorded Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 12 and no moving and handling or other risk assessments carried out. This is unsafe practice and it means that the person’s needs may not be met. On the second file there was good recording of this person’s personal care needs stating that if given a cloth this person could wash their own hands and face. There were two falls risk assessment tools used, both gave different results. The quality of recording in care plans on other units varied. In most cases the individual needs are clearly identified on the plans but there is not always sufficient instruction on the plans about what staff must do to make sure that each person’s needs are met in a consistent way. There was not enough information on two files about meeting spiritual needs. We saw one example of poor care practice where a person identified as needing a soft diet was given food that did not meet this need at two mealtimes. All staff should refer to care plans to ensure that they are meeting people’s needs and not putting people at risk. From discussions we noted that staff had asked people who live at the home and their relatives about their needs but there was limited evidence of this on files. A district nurse visiting the home told us that the home offers good care to people from different backgrounds and that the home works well with the nursing team. On people’s files we saw that there is recording of health professional’s visits this tells us that advice is sought when needed to meet people’s health needs. We looked at medication records on 2 different units of the home. On both units we found: • There were gaps in recording on medication charts. • Eye ointment prescribed was not administered on some occasions • Inconsistent recording of creams applied • The reason why medication was omitted was not stated • Where dosage varies, staff were not consistently recording the amount given. Recordkeeping for medication given must improve so that staff can make sure that people’s medical needs and health and well being are not put at risk. Two people who live at the home told us that some staff don’t always knock before they come into bedrooms. They also said that individual staff members Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 13 did not always respond to requests for help. This was addressed with the manager Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 14 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 and 15. Quality in this outcome area is good. People have access to activities that meet their social needs; more work is needed to fully address religious and spiritual needs and to make sure people’s dietary expectations are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People have individual activity plans and the home has an activities coordinator. People have access to activities at the day centre that operates from the same building. There is also a range of individual activities that take place on an ad-hoc basis. The home has arranged for people to have access to tv programming in their own language. Some religious services are held at the home and people can attend local places of worship. The unit for people from an Eastern European background had Christmas decorations up and both this and the South Asian wing had religious and Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 15 cultural objects displayed which shows that the home takes these needs into account. At most mealtimes there is a choice of meals that reflect English, eastern European and South Asian diets. This is good practice. We observed lunch and teatime at the home. The tables were nicely set and people offered drinks and condiments with their meals. Some people in the South Asian wing had the same meal served at lunchtime and at teatime. People told us they were not happy about receiving food that had been frozen and defrosted and reheated chapattis, which they found hard to chew. Although there are catering staff available that can individually prepare food to meet certain diets the home should look at hours allocated so that crosstraining and skill-sharing can take place which would allow people to have the meals they want. The South Asian and eastern European meals are not included in the 4-weely plans we saw, the service needs to show that there is planning to make sure people get a variety of meals In the surveys people’s comments about food included;“Always eat my meals, no problems” “little change week by week” “very bland! Although we have an Indian cook who makes the most beautiful tasty curries” One person whose care plan said they need a soft diet was given a cut up apple after lunch. They could not eat this. Staff need to read care plans and make sure that food served meets identified needs. There was no menu displayed in one unit. On one unit the menu had details of meals served two days earlier. We discussed ways of presenting menu information in way that was accessible to everyone at the home. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 16 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 and 18. Quality in this outcome area is adequate. People’s complaints are dealt with and staff are trained to protect people from abuse. Not everyone knows how to make a complaint. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information on how to complain is displayed in the reception area and staff told us that people receive information packs for their rooms. However, two relatives who returned surveys told us they did not know how to make a complaint about the care provided by the home. This was also found at the last inspection. The home keeps a record of any written complaints made and a record of the investigation and letters back to the person who makes the complaint. This shows that people’s written complaints are taken seriously and responded to. However, 2 people who live at the home told us that they had complained verbally about food, staff and environment but there was no record of these complaints or action taken. Keeping such records would show that people who do not or cannot write down their complaints also have their views listened to and acted upon. No complaints have been made to the Commission since the last inspection. All staff have received training in adult protection. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 17 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 and 26. Quality in this outcome area is good. People live in a home that is generally clean and well maintained. Facilities are offered that meet people’s physical and cultural needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is divided into four separate units. Corridors and lounge areas are spacious and suit the needs of wheelchair users. There is a new walk-in shower that allows people to wash independently. A shower curtain in this room would provide more privacy. Five surveys from people who live at the home told us that the home is always fresh and clean. Four others said that it was usually clean with comments including it’s not bad, “General cleanliness is ok but often there is a smell of Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 18 urine.” On the day of the visit the home was clean and there were no unpleasant smells. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 19 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 and 30. Quality in this outcome area is good. People are looked after by staff that are trained to provide good quality care. Staffing levels and arrangements should be kept under review so that everyone gets the care they need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of inspection the home had one member of staff on each unit and a senior carer on duty who acted as “float” across all the units. In addition to this there are domestics and catering staff on duty. During the visit we found staff were busy but had time to spend with people. In surveys people said “Sometimes you have to wait if they are helping someone else.” Staff surveys told us “ we are always short-staffed , I think we need two staff working on a wing.” “ Seniors should do medication”. Staff told us that they wanted the float arrangements to be more structured so that everyone got the help they needed. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 20 The three staff files we looked at showed that thorough checks are being carried out on staff before they start work at the home; this is to make sure they are suitable to work with older people. Staff • • • • • • • • training is good with access to a wide range of courses including; Skills for care induction Food hygiene Moving and handling Adult protection Fire safety Catheter care Diabetes care Domestic abuse and older people We spoke to the manager about making sure that all staff have access to training on meeting the specialist needs of people from Eastern European and South-eastern backgrounds, and that this training should be offered to staff from those backgrounds. There are arrangements in place to give staff opportunities to learn and share practice across other local authority homes. This is good practice. One staff member said, “We learn something new everyday” Another said, “you are always encouraged to widen your own areas of development and always encouraged to speak out.” . Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 21 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, 36 and 38. Quality in this outcome area is good. The home is well-managed and people’s health and safety is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Our records show that the manager is not registered with the Commission. Her registration will mean that people who live at the home will be sure that the home is run by a person who is qualified and trained to do so. The home has regular meetings with people who live at the home and have regular quality reviews using the EFQM (European Foundation for Quality Management) model. There are robust systems in place for handling people’s money. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 22 Carrying out more regular supervision will make sure that staff are supported in the care they provide. The information the home sent us tells us that regular maintenance and safety checks are carried out as required. The home has carried out works to meet the requirements of a fire safety report. This includes replacing door seals and smoke detectors. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 23 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 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 2 17 X 18 3 3 X X X X X X 3 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 2 X 3 X 3 2 X 3 Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Care plans must be in place for people on the short stay unit so that they get the care they need. Care plans must clearly indicate the action that staff need to take to meet people’s needs. All medication records must be accurately maintained showing when medication, ointments and creams have been applied or administered, the dosage and reasons for omissions. Timescale for action 25/04/08 2. OP9 13 25/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP10 Good Practice Recommendations The manager should make sure that all staff respect the privacy and dignity by knocking on doors and seeking permission before entering bedrooms. The home should provide a shower curtain in the walk-in shower room. The manager should make sure that people who live at the home and the relatives or visitors know how to make a DS0000033521.V354736.R01.S.doc Version 5.2 Page 25 2 OP16 Beckfield 3. 4. OP31 OP36 complaint about the care they receive. This information should be displayed on each unit. The manager should register with the Commission to make sure that people have further reassurance of her skills and training. All staff should receive regular supervision to make sure that individual concerns, support and training needs are met. Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB 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 © 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 Beckfield DS0000033521.V354736.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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