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Inspection on 05/12/05 for Beckfield House Residential Home

Also see our care home review for Beckfield House Residential Home for more information

This inspection was carried out on 5th December 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This home provides a pleasant, homely and clean environment for residents who live here. Residents and a visitor spoke highly about the care that they receive at this home and the positive attitude of staff. A community nurse said that the staff are very professional and make me feel welcome when I arrive at the home. The care staff are a competent team who were observed to be kind and polite when speaking to residents.

What has improved since the last inspection?

The home has taken action to address those requirements apart from one raised at the last inspection. Those files seen recorded how carers are to maintained the privacy and dignity of residents when undertaking their intimate care needs. The home now writes to prospective residents confirming that they can meet their care needs or not. The home operates a thorough recruitment process to help ensure the safety of residents. Body maps are used in the home as a means of mapping any accidents to residents, which may cause cuts or abrasions.

What the care home could do better:

The home has not enabled 50% of their care workers to gain NVQ (National Vocational Qualifications in care level 2. However, evidence was seen that this will be achieved early in the new year. The home has not updated staff with moving and handling training or dementia training. Residents are not empowered to voice their views through residents meetings or regular in house audits. Emergency lighting checks have not been carried out and it was noted that foot-plates on wheelchairs are not always used. The home uses door wedges to keep open fire doors. The fires and rescue service must be consulted for advice regarding this practice.

CARE HOMES FOR OLDER PEOPLE Beckfield House Residential Home Station Road Heighington Lincoln Lincs LN4 1QJ Lead Inspector Mr Doug Tunmore Unannounced Inspection 5th December 2005 10:00 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 House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beckfield House Residential Home Address Station Road Heighington Lincoln Lincs LN4 1QJ 01522 790314 01522 790316 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) Allington Healthcare Limited Mrs Beverley Cowan Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31/08/05 Brief Description of the Service: Beckfield House is a late Victorian, two-storey house that is set in its own grounds. The mature gardens are well maintained and accessible to the residents. The home is located in a village that is four miles from the centre of Lincoln. The village of Heighington offers amenities such as a post office, bakers and a small supermarket as well as a number of public houses and a church. The home is a converted private residence that has undergone a considerable amount of refurbishment and development. Accommodation for the residents is on two floors. The first floor is accessed by a stair lift. The home is owned by Allington Healthcare Ltd. The day to day running of the home is the responsibility of a registered manager. The homes Service Users guide states that the principal of the home is to provide a high standard of care and comfort for all residents in a safe, manageable and comfortable environment. Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. The main method of inspection used was called case tracking, which involved looking at policies and procedures relating to maintaining the safety and general welfare of residents. Residents were spoken to as well as a visitor, the manager and care staff and observations were made of care practices. A partial tour of the home took place. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Residents are admitted into the home only after a full care needs assessment has been carried out and the home confirms in writing to prospective residents that the home can meet their assessed needs. EVIDENCE: The home has a detailed care needs admission procedure, which identifies the needs of residents coming into the home. One resident said that ‘she came for day care and was assessed and then came to the home to stay permanently’. One resident had an ‘Easy Care Assessment’ undertaken by the Social Services Department prior to admission. Files seen showed that residents had been written to by the home confirming that the home could meet their care needs. The care worker spoken to knew about the care needs of residents and was aware of the homes care needs admission process and the part it played in care plans for residents. Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 10 There is good care planning in this home, which helps ensure that the delivery of personal care is addressed. EVIDENCE: A carer was aware of the intimate care needs of residents and those principles regarding maintaining the privacy and dignity of all those people in the home. She also confirmed that she had undertaken induction training, which addressed the bathing and toileting of residents. She said that she is to start National Vocational Training at level 2 in the near future. Residents commented that they felt that their privacy was maintained and that staff were very kind and considerate. It was noted that care plans recorded the need to maintain the privacy and dignity of residents being prescriptive to individual residents wishes. Individual care plans evidenced that accidents are recorded in the home’s accident book and in the residents daily notes. The home also uses body maps for the mapping of any cuts or abrasions to residents. Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 The home provides a programme of social and leisure activities. EVIDENCE: The home has an activities worker who works four hours per week split between two days. Four residents said that they join in activities, playing cards or bingo and that the home also has entertainers, which are very good. They confirmed that they undertook a trip to the seaside ‘and it was a lovely day’. Photographs were also seen on the notice board of the day out at Cleethorpes. Residents also stated that they had a trip to a local public house for a meal and war time remembrance. One care plan seen documented that the resident should be informed of all events taking place both inside the home and outside. The manager confirmed that monthly bingo sessions take place in which relatives and other visitors can attend and that preparations for Christmas were underway with sherry and mince pies being available to visitors. Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above standards were not inspected on this occasion. EVIDENCE: Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 The home maintains a good standard of cleanliness and encourages residents to personalise their bedrooms. EVIDENCE: The home was found to be clean and tidy with a pleasant smell throughout. The community nurse who is a regular visitor commented that she has not detected unpleasant odours on her visits. The home does not have a sluice. The proprietors have agreed to install a sluice as part of proposed extension. There has been a considerable delay in starting the extension due to planning difficulties. However, it remains a requirement for the home to have a sluice. Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28, 29 & 30 Residents are protected by robust recruitment practices. Residents benefit from a staff team who are well trained and work well together and compliment each others skills. Staffing levels reflect the needs of residents. EVIDENCE: Two personnel files seen contained CRB checks (Criminal Record Bureau), references, application forms and interview notes. Care workers have been given The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. One carer commented that she has been given this code of practice. The homes training record was seen which showed that, six care workers had NVQ (National Vocational Qualifications) level 2 and two had level 3, three staff are undertaking NVQ 2, two workers are currently awaiting their assessment and two have NVQ level 1. The home does not meet the standard for 50 of staff to be trained to NVQ level 2 by 2005. Care workers personnel files showed that, fire training, adult protection, drug administration, food hygiene and infection control training had been undertaken. Those carers whose files had been seen had not undertaken Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 14 training relating to dementia and moving and handling. Indirect observations made during the course of this inspection were that care workers were sensitive and caring in the manner in which they carried out their tasks. The homes rota showed that there are adequate staffing during the day and night to meet residents needs. Four domestic cleaners, cook kitchen assistants and a handyman support carers in their role. The home also has a registered manager and two supporting managers. A community nurses stated that ‘staff always seem available when I come through and also if I require someone to assist in seeing a patient’. ‘There also does not seem to be a turnover of staff that I am aware of, seems to be the same faces’. Residents commented that ‘staff are very able’, ‘staff quite good, the girls are very nice and they will explain things to you’. Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Residents’ health and general welfare and safety are not promoted. The home does not empower residents to have the opportunity to voice their views and opinions. Appropriate accounting is undertaken to safeguard residents monies. Residents benefit from the positive leadership of the registered manager. EVIDENCE: The manager has the Registered Managers Award in management. She has been a qualified nurse since 1982, working in hospital settings, as a trainer and has worked in this home as a manager for five years. She was able to demonstrate during this inspection a sound knowledge base as to running a care home and was seen to have a caring attitude to the residents. The community nurse stated that the manager is approachable, caring and very professional. Both residents and staff made positive comments about her management style and said that she had a visible presence in the home and was always approachable. Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 16 The home does not hold residents meetings. The home conducts an in-house quality assurance with questionnaires given to residents and relatives. On the day of the inspection residents and relatives questionnaires were seen. A carer stated that the outcome of the in house audit was posted on the notice board. The audit outcome report was not available on the day of the inspection. The manager confirmed that residents meeting are not held and that in house audits are undertaken irregularly. The community nurse said that she had not seen the homes questionnaire and had not been approached to complete one. Residents said that they could not remember any feedback regarding the outcomes. The home limits the amount of monies it handles for residents. All payments are made either by Lincolnshire County Council or relatives, by direct debit/check or standing order. Personal allowances are kept by residents themselves or their relatives. One resident stated that her son takes care of the money side of things. Bills accrued by residents are sent to their families for payment by the home. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm, fire drills and the servicing of these are undertaken. However, emergency lighting checks have not been undertaken. Care staff also receive fire training as part of the homes initial training and as a regular training event. A partial tour of the building found that fire doors were propped open by the use of wooden wedges. The home must contact the Fire & Rescue Service to obtain advice on this practice. Evidence was seen in a letter that self-closure devices are in the process of being purchased for the home. Certificates were available showing that bath hoists had been serviced. Window restrictors were also seen to be in place on two windows checked. All wheelchairs seen on the day of the inspection had footplates. However, the footplates on one wheelchair was not used properly when pushing a resident. This was brought to the attention of the manager. Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 17 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 x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x x 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 2 Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? 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 OP26 Regulation 13(3) Requirement The registered person had planned to incorporate a sluice during the building of an extension. This proposed extension has been delayed because of planning (now granted). However, it is a requirement to have a sluice within the home.(Timescale of 2004 not met) The registered person must ensure that persons employed to work at the care home receive training appropriate (specific to this client group) to the work they are to perform. The registered person so far as practicable must ascertain and take into account the wishes and feelings of residents. Both residents meetings and regular audits must be undertaken so as to elicit the views of residents. The registered person must consult the Fire Safety and Rescue Service regarding the use of door wedges to keep fire doors open. The registered person must DS0000002700.V270482.R01.S.doc Timescale for action 15/02/06 2 OP30 18 (c ) (i) 25/02/06 3 OP33 12(3) 25/02/05 4 OP38 23(4) 25/02/05 5 OP38 23(4) 25/02/05 Page 19 Beckfield House Residential Home Version 5.0 6 OP38 (4)(a) 7 OP38 12(c ) consult the Fire Safety and Rescue Service regarding the frequency in testing the emergency lights. The registered person must take 12/01/06 adequate precautions against the risk of fire and consult with the Fire safety and Rescue service regarding the use of door wedges. The registered person must 25/02/05 ensure that unnecessary risk to residents by the improper use of wheelchairs are identified and eliminated. 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 OP28 Good Practice Recommendations The home should meet the ratio of 50 trained members of care staff with National Vocational training level 2 by 2005. Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Beckfield House Residential Home DS0000002700.V270482.R01.S.doc Version 5.0 Page 21 - 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. 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