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Inspection on 13/01/06 for Beggars Roost Nursing Home

Also see our care home review for Beggars Roost Nursing Home for more information

This inspection was carried out on 13th January 2006.

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

The home has high standards and provides a homely environment in peaceful surroundings, for residents to enjoy. To ensure that resident`s needs are met each resident is assessed by qualified staff before moving into the home. Residents say that staff are caring and that they are well looked after. Care plans are clear and provide staff with the information, which they need to meet the needs of the residents. Meals are varied, and residents say that they are offered choices at all meal times. Staff and residents spoken with feel that the manager is supportive and have confidence in the manager`s approach to running the home.

What has improved since the last inspection?

There is an ongoing improvement schedule, which ensures that the home is well maintained. Since the last visit to the home two bedrooms have been completely renovated. The windows in these rooms have been lowered to enable residents to be able to see out from bed. The furniture and carpets have been replaced and the rooms have a much lighter fresh appearance.` Two bedrooms on the ground floor have also been redecorated along with corridor refurbishment and the installation of further radiator covers. There have been improvements for the systems, which record accidents sustained by residents. Staff have been reminded that all incidents should be recorded to ensure that risks of falls can be regularly updated.

What the care home could do better:

Staff records continue to improve but not all staff records include a photograph of the individual member of staff. Regulation 26 reports are not being completed to show monthly monitoring of the home by the Responsible Individual on behalf of the company. The manager has a number of years management experience but does not have a management qualification.

CARE HOMES FOR OLDER PEOPLE Beggars Roost Nursing Home Old Park Lane Fishbourne Chichester West Sussex PO18 8AP Lead Inspector Mrs D Peel Unannounced Inspection 13th January 2006 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 Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 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. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beggars Roost Nursing Home Address Old Park Lane Fishbourne Chichester West Sussex PO18 8AP 01243 573750 01243 576064 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) Colville Care Limited Mrs Hilary Ash Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28), Physical disability (2) of places Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2005 Brief Description of the Service: Beggars Roost is a care home able to provide personal care and nursing care for up to twenty-eight residents over sixty-five years of age. Two of the twenty-eight residents may also have a physical disability. The home is situated in a rural area of Fishbourne on the out skirts of Chichester. The accommodation is on two floors, the upper floor having passenger lift access, however three bedrooms on part of the upper floor can only be accessed by steps. Communal accommodation consists of a lounge and a conservatory, which open out onto well-maintained, private gardens. Private accommodation consists of twenty single bedrooms and four double bedrooms. The double bedrooms have en suite facilities and are being used for single accommodation. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 3.5 hours on the 13th January 2006. This was the second visit to the home this year and it was carried out to complete the annual inspection programme for the year 2005 required by the Care Standards Act 2000. The inspector arrived at 10.00am and was met by the registered manager, staff and residents who were in the lounge. During the visit the inspector saw the majority of the 28 residents living at the home and spoke with 4 residents at length about there views of the home. The care records of two residents were viewed during the visit along with other records, which showed how care needs were being met. The records of recently employed staff were also inspected and four staff were spoken with informally during the visit. The manager and a director of Colville Care Limited were present to assist the inspector. Not all the National Minimum Standards for Older People were assessed at this inspection but throughout the year all key standards have been assessed. This report may be read in conjunction with the previous report dated 13th July 2005 to gain broader view of the homes provision of a care service. What the service does well: What has improved since the last inspection? There is an ongoing improvement schedule, which ensures that the home is well maintained. Since the last visit to the home two bedrooms have been completely renovated. The windows in these rooms have been lowered to enable residents to be able to see out from bed. The furniture and carpets have been replaced and the rooms have a much lighter fresh appearance.’ Two bedrooms on the ground floor have also been redecorated along with corridor refurbishment and the installation of further radiator covers. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 6 There have been improvements for the systems, which record accidents sustained by residents. Staff have been reminded that all incidents should be recorded to ensure that risks of falls can be regularly updated. 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. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 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 Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 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): 1,4 Prospective residents and their families are provided with the information they need to make an informed choice about the home. EVIDENCE: Beggars Roost Nursing Home has a Statement of Purpose and Service User Guide, which sets out the aims and objectives of the home and describes the facilities available. Relatives and residents are encouraged to visit the home before they move in but in reality it is usually relatives who visit on behalf of prospective residents who are often too ill to visit themselves. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 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): 7,8 Systems for care planning give clear information to assist with all aspects of health, personal and social care needs. Resident’s heath care needs are monitored to make sure that any signs of residents becoming unwell are recognised. Procedures for recording accidents are now being adhered to, so that fall risk assessments can be reviewed after falls. EVIDENCE: Two care plans were viewed at this visit. They had been developed from an initial assessment of need. The plans give clear information to staff to enable them to meet the needs of the residents in all aspects of heath, personal and social care. The manager explained that when putting together the first care plan, relatives (and where possible residents) are asked to discuss the plan of care and are then asked to agree the plan. Any major changes are then discussed with relatives and residents. One of the care plans viewed at this visit had been recently been reviewed and the other was pending review. Care records showed that the physical heath of residents is regularly monitored. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 10 Systems for recording accidents to residents have been reviewed since the last visit to the home when it was noted that not all accidents had been recorded in the accident book. Accidents records are regularly audited by the manager to identify trends and identify the need to carry out further risk assessments. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 11 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): 15 Meals are well managed and offer choice so that residents have a variable diet and have meals, which they can look forward to. EVIDENCE: Residents spoken with thought that the food at the home was of a good standard and offered choice. The main meal of the day was detailed on the menu as fish pie with a cheesy topping accompanied by poached tomatoes and petit pois. Records showed that residents have been asked if they wanted the main meal on the menu, two residents had chosen to have sausages instead. The desert was jam sponge and custard. Available for supper was minestrone soup, Jacket Potato with tuna and mayonnaise filling or turkey sandwiches. However some residents had chosen cheese on toast. There was plenty of good quality vegetables in the kitchen which the chef confirmed had recently been delivered. Special diets are provided for residents and on the day of the visit five residents had peg feeds. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 12 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 homes adult protection procedure is not clear and staff have not taken part in adult protection awareness training, which could result in incidents not following the West Sussex Multi Agency Adult protection procedures for investigation. EVIDENCE: Beggars Roost has its own policies and procedures to safeguard residents from abuse but they now need to be revised to ensure that they follow the West Sussex Multi Agency Adult Protection procedures and give clear guidance to staff. The manager and the director present at the home confirmed that staff have not yet attended adult protection awareness training. However this is being addressed and the manager has agreed that this will be carried out by April 2006. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 13 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): 19,20,21,22,23,24,25,26 The home is clean and well maintained. Residents have a homely environment to live in. Bedrooms are comfortable and residents have made their bedrooms their own by having their personal possessions around them. EVIDENCE: During this visit to the home the inspector visited all private and communal accommodation. The home was observed to be well maintained and clean. The domestic staff take pride in their work so that the residents have a clean home to live in. There is an ongoing programme of redecoration and refurbishment of bedrooms. Since the last visit two bedrooms on the upper corridor have been completely refurbished with new furniture, carpets and décor. The windows in these rooms have been replaced with ones, which are set lower so that residents can look out onto the well-maintained garden from their bed. It is planned that eventually all these rooms will have been upgraded. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 14 At the time of the visit the inspector was informed that the home is experiencing difficulty with the delivery of hot water to some areas of the home but this is being monitored and steps are being taken to deal with the problem. There is also plans to extend the home to provide a further seven ground floor bedrooms with en suite facilities. However the providers do not anticipate that this will increase the number of residents able to live at the home because further internal refurbishment of the present building will reduce the number of bedrooms but provide additional en suite facilities. The refurbishment will also include a new link corridor from the upper part of the first floor, which at present can only be accessed by a number of stairs. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 15 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): Beggars Roost provides well-qualified staff so that residents are able to feel safe and well looked after. Improved staff records ensure the protection of residents but further items of identification with provide better protection. EVIDENCE: The majority of care staff working at the home are qualified nurses or have an NVQ in care qualification. The ratio of NVQ qualified staff is above the 50 target and the home is now encouraging night staff to undertake an NVQ. There have been improvements to staff records held at the home. The records of two recently employed staff were viewed. Photographs of these staff were not present in their records. The administrator confirmed that photographs were not present in all records. This matter was brought to the attention of the Director present at the home who has agreed to ensure that photographs for all staff are present. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 16 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): 31,33,37,38 The home is well managed providing leadership and guidance for staff. Some improvements to staff records still need to be made to fully protect and safeguard the residents living at the home. Systems for handing residents monies ensure that residents are assured that their financial interests are being safeguarded. Beggars Roost provides a safe environment for residents to live in. EVIDENCE: Residents and staff say that the home is run in the best interests of the residents. The manager is an experienced nurse and has many years of experience in a management role. However standard 31 is now not fully met because the manager does not have a management qualification by the target date of the end of 2005. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 17 Resident’s monies are safeguarded by the homes policies and procedures for dealing with resident’s monies. As far as possible families are invoiced for purchases and services which are not included in the fees. Records are kept for any ingoing or outgoing of monies being kept for a small number of residents. The Responsible Individual on behalf of the company has not provided the CSCI with monthly written reports of unannounced visits to the home as required by Regulation 26 of the Care Homes Regulations 2001. No health and safety issues were identified at this visit unless mentioned in other areas of this report. Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x 1 3 Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP37 Regulation 26 Requirement Monthly reports must be forwarded to the CSCI and the registered manager. Timescale for action 01/04/06 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 OP18 Good Practice Recommendations The homes adult protection procedures should be reviewed to ensure that they follow the West Sussex Multi Agency procedures. All staff must have adult protection awareness training. A recent photograph of each member of staff should be available in the home. All staff should have adult protection training. The homes adult protection procedure should be revised. The manager should undertake a management qualification. 2 3 4 OP29 OP18 OP31 Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Beggars Roost Nursing Home DS0000024116.V276869.R02.S.doc Version 5.1 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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