Inspection on 03/01/07 for Beckside Nursing And Residential Home

This inspection was carried out on 3rd January 2007.

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.

Other inspections for this house

Beckside Nursing And Residential... 01/11/05

Beckside Nursing And Residential... 03/05/05

Beckside Nursing And Residential... 30/11/04

Beckside Nursing And Residential... 26/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Beckside Nursing And Residential Home Middle Street North Hykeham Lincs LN6 9QX Lead Inspector Julie Western Key Unannounced Inspection 3rd January 2007 09:30 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 Beckside Nursing And Residential Home DS0000002531.V325194.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. Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beckside Nursing And Residential Home Address Middle Street North Hykeham Lincs LN6 9QX 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) 01522 693461 01522 682032 manager.beckside@osjctlincs.co.uk www.oxfordshire.gov.uk The Orders Of St John Care Trust Mrs Kim Patricia Goldby Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (61) of places Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Beckside Care Home is registered to provide personal care to service users whose primary needs fall within the following category:Old age, not falling within any other category (OP) - 61 The maximum number of service users to be accommodated at Beckside Care Home is 61. 1st November 2005 Date of last inspection Brief Description of the Service: Beckside Care Home is situated in the centre of the village of North Hykeham and is within easy reach of local shops, community facilities and public transport; this transport also runs to Lincoln city centre, some three miles away. The home, a former Local Authority home, is owned by the Orders of St. John Care Trust, a registered charitable organisation managing 15 other homes in Lincolnshire. The single-storey building, comprising four quadrangles each with its own enclosed courtyard garden, is set in its own grounds and there is space for car parking to the front of the building. Beckside is registered to accommodate 61 people over 65 years, for General Nursing and Residential care. On the day of the inspection, 58 people were being accommodated in total, 28 of these requiring nursing and 30 requiring residential accommodation. Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 5 hours. A partial tour of the building took place and care records were inspected. The main method of inspection used was called ‘case-tracking’; this involved selecting three residents and tracking the care they received through the checking of their records, discussions with residents and care staff and observation of practices. Some policies and procedures were examined and records concerning the safety of the home were also seen. Five of the 58 residents, five of the 47 care and ancillary staff and a visitor were spoken with. The Manager was present throughout the inspection, together with the County Care Manager. What the service does well: What has improved since the last inspection? The rolling maintenance programme continues, with bedrooms being redecorated as they are vacated. There are new double glazed windows opening onto one of the courtyards and the ivory lounge also has new double-glazing. The kitchen, dining room and one small lounge have been completely refurbished. The nursing station has been removed and has become an ‘e-learning’ station with a computer for staff to use. The Manager has appointed two volunteers to assist with activities and other general tasks. Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 6 The home now has its own web-site for prospective service users and their families to access. 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. Beckside Nursing And Residential Home DS0000002531.V325194.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 Beckside Nursing And Residential Home DS0000002531.V325194.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 excellent. This judgement has been made using available evidence including a visit to this service. The home clearly sets out what it intends to do for its residents. This information is extensive and freely available to residents. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. EVIDENCE: The statement of purpose was examined and was very comprehensive. A copy of the statement of purpose was in the brochure pack, which was sent or given to all prospective residents or their families. The pack included a copy of the residents’ handbook, a copy of the Quarterly Trust magazine and a summary of the most recent inspection report. The Manager, a trained nurse or the Head of Care [a newly appointed post] carried out the pre-admission assessments of residents, either in their own homes or in a hospital or care setting. Residents were assigned a key care worker who assisted them to settle in. A resident Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 9 described how she had been to the home for a day and token part in meals and activities before becoming permanent resident. The home does not provide intermediate care. Beckside Nursing And Residential Home DS0000002531.V325194.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 adequate. This judgement has been made using available evidence including a visit to this service. The home’s records give a clear picture of the needs of residents but the staff group does not always communicate and therefore does not meet these needs. EVIDENCE: The three care plans looked at in depth contained clear and comprehensive assessments, were reviewed regularly and were signed where possible by the service user or relatives/advocates. However, one care plan stated that the resident needed bathing on alternate days to ensure that cream was applied for a skin condition. This had not been carried out for over a month due to the service user’s key carer being sick. A visiting district nurse said that the standard of care was very good and the staff group was knowledgeable about the needs of her patients. Communication was good and there were always staff available to speak to her. She said she would have no hesitation in placing her own parents in this home, should the need arise. Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 11 There was a clear medication policy and the most recent visit by the pharmacist on 8/12/06 resulted in no requirements or recommendations. Residents said they felt safe and well looked after. The staff team were observed carrying out their duties with kindness and sensitivity towards the residents. The home has been selected by a local surgery to be one of 100 homes throughout England to pilot the Gold Standard Framework national scheme in palliative care. Beckside Nursing And Residential Home DS0000002531.V325194.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities are extensive and well promoted, creating a variety of events and activities which residents are informed about. The residents exercise choice about which activities, if any, they wish to participate in and what meals they want to eat. EVIDENCE: Twenty-five hours were allocated weekly for an activities co-ordinator, who was responsible for producing a newsletter informing residents of forthcoming events; there was also an activities folder and a daily calendar of activities in the entrance hall. Recent activities included movement and music for wheelchair users, outings to local pubs and coffee shops, regular painting classes, a visit from a pantomime and ‘kurling’, a special project held at the local sports centre, with a league and cup to be won. One resident described how some residents went to another OSJCT home for coffee and quizzes/games. The kitchen was inspected and kitchen staff members were spoken with. Menus were examined and demonstrated a choice and the use of fresh Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 13 vegetables. Service users were observed eating breakfast and the mid-day meal. Two of the service users spoken with had raised comments about the way the rice pudding was served [too solid] and one preferred his vegetables less cooked; the cook and Manager said they were addressing these issues.. The home had a qualified chef and both he and the cook on duty had achieved NVQ 2 in catering and were undertaking the Intermediate Food Hygiene course. The kitchen diary showed that 9 pureed and 6 diabetic diets were being prepared. The cook said a daily quality audit of the meals involved visiting the residents and asking them their opinions of the meals served that day. Residents also discussed any concerns or suggestions with the cook at residents’ meetings. Beckside Nursing And Residential Home DS0000002531.V325194.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s complaints procedure is clear and gives residents and their relatives the confidence that comments and concerns will be listened to; there is a robust adult protection procedure. EVIDENCE: Residents and visitors spoken with said they knew how to make a complaint and two described complaints they had made which had been addressed. All formal complaints were audited by the Quality Manager at the home’s Head Office. Since April this year there had been five complaints; four of these were not upheld and one was partially upheld. All complaints had been addressed within the given timescales. A suggestions box was located in the front entrance hall and the home had received many letters of praise, which were kept in a folder for visitors and staff to read. One described the staff as ‘a special family’ and praised the care and concern showed to their late father. There was a clear adult protection procedure, which was linked to the Local Authority procedures. Staff members spoken with had all received training on adult abuse as part of their induction training and were knowledgeable about complaints. Beckside Nursing And Residential Home DS0000002531.V325194.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a comfortable, pleasant and safe environment with both private and communal space being on the whole suitable for their needs. EVIDENCE: The rolling maintenance programme continues, with bedrooms being redecorated as they are vacated. Risk assessments are carried out on the premises to ensure that residents are safe from any potential hazards. Recent improvements have included new double glazed windows opening onto one of the courtyards and in the ivory lounge, the complete refurbishment of the kitchen, dining room and a small lounge and the alteration of the nursing station into an ‘e-learning’ station with a computer for staff to use. Some of the rooms had an en-suite toilet separated from the room by a curtain. Overall, the standard of decoration internally was good and afforded Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 16 residents a great degree of comfort. The home smelled clean and fresh throughout. Beckside Nursing And Residential Home DS0000002531.V325194.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent; they undergo an induction programme before commencing their duties. EVIDENCE: The staff rota showed that there were enough staff numbers according to the staffing matrix and recently a head of care has been appointed to manage staff deployment among other issues. Recent changes in the working patterns across the home had led to some unrest among staff and residents had noticed this; the management team were working hard to address this issue. There were no staff vacancies. The Orders of St. John Care Trust have their own training manager at headquarters and there is a full training programme. Training records showed that 12 care staff had achieved the National Vocational Qualification at Level 2 with 15 working towards it and 5 had achieved Level 3 with 1 working towards it. One staff member had achieved Level 4. All statutory training had been completed with each staff member having a skill matrix. Future training includes an ongoing course in dementia, osteoporosis, palliative care by Macmillan nurses and diabetes. Minutes of regular staff meetings were seen Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 18 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): 31,33,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed competently and the staff are supported and supervised in carrying out their respective roles. The views of residents are listened to and they are involved in decisions affecting them, but not always in time for them to adjust to changes in the way the home is run. EVIDENCE: The registered Manager is an RN who has the Registered Manager’s Award, D32 and 33 and 997 and 998 ENB [nursing and caring qualifications]. She has been in the caring profession for 20 years and has been a Manager for 8 years. She has managed this home since February 2006. The quality assurance manual demonstrated a positive approach to seeking the views of residents Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 19 and residents spoken with said they were constantly asked for their views on matters concerning the running of the home. The commission, however, received ten feedback forms from service users stating their unhappiness with the way the home was managed. The Manager said this was due to the general unrest about the staffing changes, which were still undergoing a trial period. Staff and resident meetings demonstrated that the management were keeping everyone informed about the staff changes, but residents said they did not have enough time to adjust to the changes. There was a record of meals with satisfaction, complaints and concerns logged. The home has the ISO 9000 award and the Investors in People award. Letters from residents’ relatives showed that their views were sought. Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 20 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 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 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 3 X 3 X X X X 3 Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 21 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 OP7 Regulation 15[2][b] Requirement The registered person must keep the service users’ care plans under constant review in order to address their needs at all times. Timescale for action 26/01/07 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 OP33 Good Practice Recommendations Service users should be kept advised appropriately and in good time of any changes to the running of the home. Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Beckside Nursing And Residential Home DS0000002531.V325194.R01.S.doc Version 5.2 Page 23 - 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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