Inspection on 06/02/07 for Bedhampton Nursing Home

This inspection was carried out on 6th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Bedhampton Nursing Home 16/05/07

Bedhampton Nursing Home 13/02/06

Bedhampton Nursing Home 08/08/05

Bedhampton Nursing Home 03/02/05

Bedhampton Nursing Home 20/04/04

Bedhampton Nursing Home 11/11/02

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Bedhampton Nursing Home 55 Hulbert Road Bedhampton Havant Hampshire PO9 3TB Lead Inspector Tim Inkson Unannounced Inspection 6th February 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 Bedhampton Nursing Home DS0000011476.V323766.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. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bedhampton Nursing Home Address 55 Hulbert Road Bedhampton Havant Hampshire PO9 3TB (023) 92 475125 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) Cheer Health Limited Mrs Lindsey Janet Gurney Care Home 30 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (30), of places Physical disability over 65 years of age (30), Terminally ill over 65 years of age (30) Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th February 2006 Brief Description of the Service: Bedhampton Nursing Home is residential Care Home for older persons. It is registered to accommodate 30 individuals over the age of 65 years who require nursing care. It is situated in a residential area close to local amenities and is accessible by train and local bus services. It was a family residence that has been extended. There is a mature garden the rear of the home. Car parking space is available at the front. Potential residents and/or their representatives are invited to visit the home and view the premises. They are provided with a “residents Guide” that contains information about the service that the home provides. They are also advised to visit and view other homes in order that they can compare and make an informed choice about whether to move in. The “residents guide” includes a reference to the availability of the most recent reports of inspections of the home conducted by the Commission for Social Care Inspection (CSCI). Copies of these reports are kept in the entrance hall to the home. The home’s fees at the time of a site/fieldwork visit to the home on 6th February 2007, ranged from £513 to £895 and this did not include the cost of hairdressing, chiropody treatment and newspapers and magazines. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was part of the key inspection of the home and it was unannounced and took place on 6th February 2007, starting at 09:30 and finishing at 16:15 hours. During the visit accommodation was viewed including bedrooms, communal/shared areas and the home’s kitchen and laundry. Documents and records were examined and staff working practice was observed where this was possible without being intrusive. Residents, visitors and staff were spoken to in order to obtain their perceptions of the service that the home provided. At the time of the inspection the home was accommodating 29 residents and of these 5 were male and 24 were female and their ages ranged from 69 to 101 years. No resident was from a minority ethnic group. The responsible individual representing the company that owned the home and the home’s deputy manager were present throughout the visit and were available to provide assistance and information when required. Other matters that influenced this report included information that the Commission for Social Care Inspection (CSCI) had received since the last fieldwork visit made to the home on 13th February 2006, such as statutory notices about incidents/accidents that had occurred. What the service does well: Detailed records were in place that gave nursing and care staff information that enabled them to provide the help that residents’ needed. Residents felt safe and secure and happy that staff could look after them properly and treated them with respect. Residents’ health care was promoted through the use of among other things monitoring the nutritional needs of individuals when that was necessary. The home had also developed good working relationships with healthcare specialists. Residents and relatives described the staff group as friendly and relationships between staff and residents were relaxed and informal. Daily routines in the home were flexible and residents were encouraged to make choices for themselves and exercise personal autonomy as far as was reasonably possible. Residents were positive about the food that the home provided and were pleased with the range of activities in which they could participate and the condition of the accommodation that they occupied. Staff, residents and relatives had confidence in the effectiveness of the home’s manager. Systems and procedures in the home worked well including, the management of medication, dealing with complaints, staff recruitment, quality monitoring, and health and safety. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 6 There was a strong commitment to staff training and development to ensure that staff were able to fulfil their roles and responsibilities and meet residents needs. 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. 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. Bedhampton Nursing Home DS0000011476.V323766.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 Bedhampton Nursing Home DS0000011476.V323766.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were procedures in place to ensure that the home identified the assistance and support that potential residents needed before they moved into the home. EVIDENCE: A sample of the records of 4 residents was examined including those concerned with the actions that the home took to identify the help and care that people needed. There was evidence from these documents that the admissions to the home of the individuals concerned had all been planned with staff with the appropriate knowledge and skills and that the process included visiting potential residents and identifying the level support that they would need and to ensure that the home could provide that. The home’s pre-admission assessments were complemented by more thorough and comprehensive assessments of a resident’s needs when they actually moved into the home. Residents and relatives spoken to commented about the process referred to above and their comments included: • “She came to see me when I was in hospital at Petersfield to see what help I needed and if I could come here” (resident). Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 9 • • “Two nurses went to visit my Mum in the War Memorial Hospital to assess whether they could cope with her here” (relative). “She was in another care home before she moved here. Someone from here came and visited her to assess her” (relative). There was documentary evidence that assessments of residents needs were reviewed regularly and revised as necessary when an individual’s circumstances had changed. The home does not provide intermediate care. Bedhampton Nursing Home DS0000011476.V323766.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 excellent. This judgement has been made using available evidence including a visit to this service. The home had systems in place to ensure; the personal and healthcare needs of residents were met and medication was managed safely and effectively. Among other things staff working practice helped to ensure that residents’ privacy and dignity was promoted. EVIDENCE: The care plans were examined of the same sample of 4 residents as in the section above at page 9. Among the sample was an individual who was receiving treatment for a pressure sore. The documents examined were comprehensive and the plans were based on the assessments the home carried out in order to identify what help individuals needed (see page 9). Assessments included a range of potential risks to residents e.g. pressure sores; falls; moving and handling; malnutrition; etc. Where a pressure sore assessment indicated that an individual was at risk it was noted that the corresponding plan of care for the person concerned referred to the use a pressure relieving aid. The plans examined also set out clearly the actions staff had to take and what specialist equipment was needed to provide the support and assistance each person required. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 11 There was evidence from documentation and discussion with residents and relatives that wherever possible individuals and/or their representatives had been involved in developing the plans and agreed with the contents. Where care plans referred to the use of equipment or how a specific need was to be met this was observed to be available, provided or in place e.g. pressure relieving aid; Zimmer frame; or hoist. Records indicated that care plans were reviewed at least monthly and daily notes referred to the actions taken by staff to provide the needs set out in those plans. Staff spoken to knew the needs of the individuals whose records were sampled and they were able to describe the contents of the care plans. Comments from residents about the abilities of staff the care and support that they provided included: • “I can’t walk so I have to go in a hoist. They take me to the toilet and help me with washing”. • “They give me as much help as I need”. • “I can’t bath on my own so they help me. I feel safe when they do that”. • “You get help from them if you want it”. • “Somebody has to bath me and someone goes with me when I go for a walk. They help me with things that I can’t do for myself”. • “They help me with everything that I need. They encourage me to do what I can. I must admit that they are very good”. Care plans examined were not simply task focussed but also included references to the fundamental principles that underpin social and health care such as privacy, dignity and choice and entries in plans illustrating this included the following: • “When using toilet close door behind her to ensure privacy” • “Cover with blanket to keep warm and to ensure dignity maintained” • “Use screen in shared room” The records examined also indicated that a range of healthcare professionals visited the home and that arrangements were made for treatment for service users when it was necessary. Residents said that they saw and received treatment from among others, doctors, podiatrists and opticians and when required arrangements to attend outpatient clinics were made by the home. • “They bring the doctor if I am bad and need one and arrange for me to go to hospital. I had my cataracts done. It is wonderful. The optician comes every year. I have had 3 or 4 pairs of glasses. There was documentary evidence that when an individual had a wound/pressure sore that specific plans were implemented to manage the wound and monitor progress with healing. The home’s deputy manager said that if it was necessary they sought advice and support form a specialist “tissue viability” nurse and that recently this support had resulted in providing treatment for an individual with a positive outcome. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 12 Where weight loss or eating difficulties had been identified as a problem for an individual, specific plans for that person included ensuring that their diet was supplemented and enhanced if required and their food and fluid intake was carefully monitored. The home had also implemented a strategy to ensure that where individuals needed help/assistance with feeding that they could be easily identified. Individuals’ health was monitored routinely and regularly e.g. weight, blood pressure and temperature. Two visitors spoken to commented about how the home’s staff promoted the healthcare needs of their relative: • “The staff all seem very attentive and they all know her and her ways … I noted a rash on her arm the other day and they had already spotted it and arranged for a doctor to visit. They are on the ball”. The home had written policies and procedures concerned with the management and administration of medication. Medication was kept in locked and secured medicine trolleys, cupboards and where required in a medical refrigerator. Controlled drugs were stored securely and appropriately. A sample audit of controlled drugs indicated that the records were accurate and up to date. A monitored dosage system for the management of medication was operated by the home. A local pharmacist provided most prescribed medication every 28 days in blister packs for each person concerned. Other medicines that could not be put into these packs because they could spoil, such as liquids or those that were to be taken only when required were dispensed from their original containers. The only staff in the home that dispensed and were responsible for the management and administration of medication on a day-to-day basis were registered nurses. The home’s registered manager had attended a “train the trainer” course organised by the adult and older persons service of the local authority in “the management of medication”. Good practice noted during the fieldwork visit included: • Recording the temperature of the refrigerator used for storing some medication • Dating of containers of certain medications when they were opened because of limited shelf lives i.e. eye-drops and thyroxin • Sample copies of the signatures of the Registered General Nurses that dispensed medication • Some sedative medication was treated as if it was Controlled Drug • Copies were being kept of all medical alerts received by the home The home strongly promoted the independence of residents and those residents assessed as being able and who wished to were encouraged to keep, and take their own medication. At the time of the fieldwork visit however no resident was managing his or her own medication. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 13 Records were kept of the ordering, receipt, administration and the disposal of medicines and these were accurate and up to date. The contents of a recent medical device alert sent out to all care homes and concerned with “Lancing Devices” used for blood glucose monitoring was discussed with the home’s deputy manager and she said that the practice in the home was, “One needle for one person”. There were only three shared bedrooms in the home and these were all provided with screens. Consequently the privacy of vast majority of residents was promoted by the fact that they were accommodated in singe rooms. Residents spoken to said that staff always knocked before entering their rooms. This latter practice was observed during the fieldwork visit. Residents and relatives spoken to described the staff as respectful and polite. Bedhampton Nursing Home DS0000011476.V323766.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. This judgement has been made using available evidence including a visit to this service. The home organised a range of social activities that provided stimulation and it also promoted residents self-determination, enabling residents to exercise choice about all aspects of their daily life. Residents were able to maintain links with relatives and representatives. The dietary needs of residents were well catered for with a balanced and varied selection of food available that met their tastes and choices. EVIDENCE: A list of social activities that were organised by the home was on display in its entrance hall and they included the following: Bingo; reminiscence; music and movement; art works; baking; sing-a-long; board games; and manicures. A harpist was scheduled to visit the home in the near future to provide entertainment, as was a speaker to talk about a wild bird sanctuary. During the site visit small group and individual/ one to one activities being provided by a visiting “therapist” and a bingo session were observed. Local clergy visited the home and there were regular communion services. All residents spoken to indicated that they enjoyed the activities that were organised, that their life style preferences were respected, that routines in the home were flexible, relationships wit staff were informal and friendly. Comments from residents about these matters included the following: Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 15 • • • • • • • “There are no rules. I don’t have to be up or in bed by a certain time. I can join in the activities if I want to. I have visitors and they can come at any time. I does alright here”. “It is very good like a first class hotel a five star … They are very friendly ... We have bingo and different things, we are left to our discretion, we have talks, someone is coming soon to talk about birds. We have parties”. “You can join in if you want to, sometimes I join in but I read a lot”. “They are very good and don’t interfere”. “It is nice because they cheer you up. It is always jokey … Some people come from the local church”. “There is plenty to do and we have talks and entertainment … There are no strict rules here. We automatically get our freedom at our age”. Residents and relatives spoken to confirmed that there were no restrictions concerned with visiting the home and relatives said that they were always made welcome. There was information in the entrance of the home with details about an organisation that could provide impartial advice, information and guidance to residents and/or their families. Residents were able to bring personal items into the home including furniture and it was apparent from discussion with residents and observation during a tour of the building that some individuals had taken trouble to personalise their bedroom accommodation. Sensitive information that the home held about residents was kept secure and the home had written policies and procedures about maintaining confidentiality and residents rights to access their personal files and case notes. All residents spoken to were complimentary about the food provided and confirmed that they had 3 meals a day and could have snacks and drinks at other times. Fresh fruit and fluids were readily available in the home’ communal rooms. The menus and records of food provided indicated that the food was nutritious and there was a wide range of meals provided with a selection of choices every day. In addition special diets and individual preferences and needs were catered for e.g. soft and pureed meals and diabetics. Residents could choose where to eat and some preferred to eat in their rooms. Individuals were asked what choices they wanted from the menu a day in advance. Food preferences, dislikes, food related allergies and nutritional and dietary requirements were recorded in residents care plans and the information was also readily available to catering staff. The main meal of the day was observed and it was unhurried and staff were sensitive when providing assistance. The home had implemented a system of coloured trays for identifying individuals that needed assistance with feeding Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 16 and whose diet had to be monitored. A chef described how food for individuals on a high protein diet was enhanced by adding extra cream and butter to items like mashed potato or carrots. Comments from residents about the food provided included the following: • “The food is very good, we have cooked breakfast, then lunch and a cooked evening meal. We have drinks and biscuits or what you like between”. • “The food is beautiful. You can have as much as you want. You can ask for more if you want it. We have cooked breakfast. I have never known a place like it”. • “The food is lovely, there is plenty and sometimes too much”. • “The food is good. They come and ask us what we want the day before, what we want for breakfast and lunch. You can have cooked breakfast if you want and I do. • “The food is excellent. I think we must all be putting on weight. They come around every day and ask what choice you want for the next day”. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 17 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 excellent. This judgement has been made using available evidence including a visit to this service. The home had a clear and satisfactory complaints procedure to address the concerns of residents and relatives/representatives. Robust procedures were in place to protect service users from the risk of abuse. EVIDENCE: The home had a written policy and procedures about how complaints could be made about the service that it provided. A copy was included in the home’s “Residents Guide” and in the terms and conditions of residence/licence agreement issued to all residents. All residents and relatives spoken to were confident about raising any concerns with the home’s manager or any of the senior staff working in the home. The home kept records of complaints that detailed the issue, and set out any agreed action to remedy the matter and its outcome. There had been no complaint made to the home since the last inspection on 13th February 2006. The Commission for Social Care Inspection (CSCI) had also received no complaints about the home during the same period. The home had written procedures available concerned with adult protection. These were intended to provide guidance and ensure as far as reasonably possible that the risk of residents suffering harm was prevented. Staff spoken to said that they received training about protecting and were also able to demonstrate an awareness of the different types of abuse and the action they would take if they suspected or knew that it had occurred. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 18 As part of their contract of employment all staff working in the home had to read and sign a statement about the abuse of vulnerable adults. It required them to report any incidents they witnessed or suspected that they believed constituted abuse. The home had written policies and procedures about the use of bed rails and mechanical restraints. Where subsequent to an assessment it was considered necessary for a resident’s safety to use bed rails written permission/consent was obtained and their use was reviewed regularly. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 19 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. This judgement has been made using available evidence including a visit to this service. The home’s environment was safe and well maintained. There was an infection control policy and procedures in place and staff practice ensured that as far was reasonably possible residents were protected from the risk of infection. EVIDENCE: At the time of the fieldwork visit the exterior and interior of the premises, its décor, furnishings, fittings and equipment were in good repair. There was also no unpleasant odour anywhere in the building. The home employed maintenance personnel to; undertake minor repairs and re-decoration; keep the grounds and garden maintained; and ensure that safety systems were checked and serviced. Comments from residents and relatives about the condition of the premises included: • “Oh! yes they are particular about keeping it clean, the windows ands so on, I think they also look after the building”. • “It is kept spotless and the building itself is kept up with decoration”. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 20 • “I am a painter and decorator and I think that it is well looked after and maintained, everything the gardens and so on. They certainly keep the place clean”. The home’s registered manager had attended a “train the trainer” course organised by the adult and older persons service of the local authority in “infection control” and there were comprehensive procedures and guidance including posters on display concerned with infection control. It was noted that in accordance with best practice all communal WCs that were seen were provided with liquid soap dispensers (that were full and working), alcohol gel sanitizers and paper towels. Protective clothing was readily available and staff were observed using gloves and aprons appropriately. The home’s laundry was appropriately sited and equipped and effective procedures were in place for the management of soiled laundry items. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 21 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. This judgement has been made using available evidence including a visit to this service. There was an appropriate and satisfactory level and mix of staff that ensured the needs of residents were met. The home had clear staff recruitment, training and development procedures that ensured that service users were protected and supported. EVIDENCE: The care team working in the home comprised, 8 registered nurses and 19 health care assistants. Out of the latter 4 (i.e. 21 ) had obtained a qualification equivalent to at least National Vocational Qualification (NVQ) at level 2. The responsible person representing the company that owned the home said that a further 6 were pursuing NVQ level 2 and another 3 were due to start later that month. If consequently those health care assistants also obtain the qualification the percentage of care staff with at least NVQ level 2 will increase to 68 . At the time of the fieldwork visit the care staff rota setting out the minimum number and skill mix deployed in the home was as follows: 0800 to 14:00 14:00 to 20:00 20:00 to 08:00 Registered 2 1/2 1 nurses Health care 6/7 4/5 2 assistants Total 8/9 5/7 3 Apart from registered nurses and health care assistants the home employed other staff and these comprised. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 22 Registered manager/matron Consultant nurse manager Administrator Chefs Kitchen assistants Cleaners Laundry assistant Maintenance personnel All residents and relatives spoken to were complimentary about the staff and their abilities (see also at section about “Health and Personal Care” above). Residents, staff and relatives spoken to about their perceptions of the adequacy of staffing levels indicated that the number of staff deployed in the home was sufficient and comments included the following: • “As far as I am concerned there are enough staff”. • “I think that they are run off their feet but they come quickly if I ring the bell”. • “I think that staffing levels are OK. Sometimes we have 7 in the morning and sometimes 5, sometimes 4 or 5 in the afternoon including registered nurses (staff member). • “Staffing levels are usually very good and there are always a lot of nurses on duty” (staff member). • “I think that there are enough staff” (relative). • “There always seem to be enough staff. There is always someone available if you need help” (relatives). Records were examined of 2 staff that had been employed to work in the home since the last fieldwork visit to the establishment on 13th February 2006. It was apparent that all statutorily required pre-employment checks, intended to ensure that people unsuitable to work with vulnerable adults were not employed, had been completed before the individuals concerned actually started working in the home. All new staff received comprehensive induction and health care assistants completed a programme that satisfied the requirements of the training body for the social care workforce i.e. “Skills for Care” (previously the Training Organisation for Personal Social Services [TOPSS]). Conversation with staff indicated that in addition to their induction training they attended training in subjects that ensured that they kept their clinical and other skills up to date. One registered nurse said that she was due to attend a course about male catheterisation. Staff comments about their induction and further training opportunities included the following: • “I have done fire safety and moving and handling”. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 23 • • • “. I am always on courses. I had to cancel one yesterday because of staff sickness, I was due to do “male catheterisation”, so it has been rescheduled for June”. “I got my NVQ level 2 in February 2006 it has certainly helped me with my job … We have training sessions when people come here and I go to as many as I can. We had one about continence promotion and we have fire safety training every 6 months”. “I am in the middle of NVQ at the moment. It is good and we are doing it through Highbury College and go to the council offices … My induction included moving and handling I had to complete a TOPSS course book. I filled it in a bit at a time and also did a short course with “Learn Direct”. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 24 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s manager provided effective leadership There were systems and procedures in place for monitoring and maintaining the quality of the service provided and promoting the safety and welfare of everyone living and working in the home. EVIDENCE: The registered manager had first been employed in the home as deputy manager in 1997 and in her current post approximately 5 years. She had been qualified as a registered nurse since 1984 and had specialised in elderly care and also had another qualification relevant for her post i.e. Registered Managers Award (RMA). From discussion with staff, residents and relatives it was apparent that the registered manager was; highly motivated; enthusiastic; concerned; sensitive and empathetic. The term most used to describe her was “lovely”. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 25 Examination of the home’s documentation and management systems indicated that she was organised, kept up to date with developments in health and social care and was committed to staff training and development. The home had systems in place for monitoring the quality of the service that it provided that included the use of questionnaire to obtain the views of residents and relatives. The responses from these and details of any action that that was taken as a result, was summarised in the home’s “Residents Guide”. Representatives of the company that owned the home conducted monthly visits to the home in accordance with Regulation 26 of the Care Homes regulations 2001. These visits were also used to monitor the quality of the service the home provided and the persons visiting completed audits of the home’s systems including; plans of care; staff training; and the environment. Residents meetings were held regularly and minutes from these indicated that residents were able to influence day-to-day life in the home. There were a range of written policies and procedures available for staff to refer to as guidance and to inform their practice. These included the following: • Admission, discharge and transfer of residents • Human Rights • Confidentiality and access to personal records • Abuse of the person • Restraint • Guidelines for use of mechanical restraint • Drug administration • Self administration of medication • Infection control • Complaints procedure • Whistle-blowing • Sexuality • Health and safety at work There had been one requirement arriving from the last inspection concerning the home’s system for looking after money on behalf of residents and this had been addressed. The home looked after small sums of money for some residents that was left with or handed over by relatives or representatives. On this occasion a sample of monies held on behalf of residents and the corresponding records was examined and all were accurate and up to date. Records examined indicated that the home’s equipment, plant and systems were checked and serviced or implemented at appropriate intervals i.e. passenger lift and hoists; fire safety equipment portable electrical equipment; hot water system; etc. There were contracts in place for the disposal of clinical and household waste. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 26 Records were kept of accidents. Staff said that they attended regular and compulsory fire and other health and safety training. There was a fire risk assessment for the premises and regular risk assessments of the premises and working practices were undertaken. Guards covered all radiators in the home and all windows above the ground floor were fitted with restrictors. There were two staff employed in the home who were accredited moving and handling trainers and there were hoists, and other equipment in the home to promote safe working practices. Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 27 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 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 28 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. Standard Regulation Requirement Timescale for action 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 Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Bedhampton Nursing Home DS0000011476.V323766.R01.S.doc Version 5.2 Page 30 - 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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