Inspection on 05/09/06 for Beggars Roost Nursing Home

This inspection was carried out on 5th September 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.

Other inspections for this house

Beggars Roost Nursing Home 19/02/09

Beggars Roost Nursing Home 13/01/06

Beggars Roost Nursing Home 13/07/05

Beggars Roost Nursing Home 14/12/04

Beggars Roost Nursing Home 26/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

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 5th September 2006 9:30 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 Beggars Roost Nursing Home DS0000024116.V302754.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. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 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.V302754.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th January 2006 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 outskirts of Chichester. The accommodation is on two floors, the upper floor having passenger lift access. Three bedrooms on part of the upper floor can presently only be accessed by steps. Communal accommodation consists of a lounge and a conservatory, which open out onto private gardens. Private accommodation consists of twenty single bedrooms and four double bedrooms. The double bedrooms have en-suite facilities and are currently being used for single accommodation. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Mrs Diane Peel on the 5th September 2006. The intended outcomes for 31 standards were assessed; these included the key standards for care homes providing a service to older people. Prior to the visit to the home the inspector reviewed information provided by the manager in a pre inspection questionnaire completed at the request of the inspector some weeks prior to the visit and other communication received from the provider since the last visit to the home on the 13th January 2006. A case tracking exercise for four residents was undertaken to look at how the assessed needs of this group of residents with high levels of nursing needs were being met. Where possible residents were spoken with to gain some information about what it is like to live at the home, those residents able to express an opinion made positive comments. The inspector spoke with three relatives visiting the home who all made positive comments about the standard of care being provided to their relative. The inspector visited all communal areas during the visit and saw the majority of resident’s bedrooms. Staff were observed assisting and interacting with residents in the lounge at lunch time and in individual residents bedrooms. The atmosphere in the home is calm, relaxed and friendly. The records of three staff were inspected and staff were spoken with informally during the visit to find out what it is like to work at the home. Samples of records and policies required to be kept by the home were viewed during the visit to ensure that the provider is meeting their obligations with regard to the administration of the home. The current scale of fees being charged at the home is from £591.50 to £721.00 per week. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The refurbishment of the home continues. Since the last visit a ramp has been built up to the front door to create easier access. The downstairs toilet adjacent to the small dining area has been redecorated and refurbished. Two bedrooms have been refurbished and there is replacement furniture in the conservatory. A new call system has been installed which is proving effective. A major building project has commenced. The extension is expected to be completed by the end of November will include seven new bedrooms, each with en suite shower facilities. There will also be an assisted bath with overhead hoist and a parker bath. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 7 Alterations to the existing home will then commence, providing a ramped corridor to the five existing rooms, which are currently only accessible via a short flight of steps. A further two rooms will be fitted with en suite shower rooms. The existing sluice facilities are to be replaced and the laundry room is to be refurbished. Staff training has been extended to include Adult Protection Awareness for staff and the homes Adult Protection procedures have been reviewed to ensure that they follow the West Sussex Multi Agency Adult protection process. Staff records have improved and now include identification of staff. 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.V302754.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4,5,6 Prospective residents and their families are provided with the information they need to make an informed choice about the home and are encouraged to visit the home before deciding if they want to live at the home. Residents and their relatives/advocates have a contract to ensure that they know what the fees charged cover and what the terms and conditions of the home are. Residents are assessed prior to moving into the home to make sure that the home can meet their needs. Outcomes for residents are good. EVIDENCE: Beggars Roost has an admissions process, which encourages residents and relatives to visit the home prior to moving in. It also operates a trial period within the contract of residency to ensure that the home can fully meet the needs of residents. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 10 Relatives spoken with during this visit felt that they had been provided with sufficient information about the home and knew that residents could visit if they were well enough before they moved in, but in reality it is usually relatives who visit on behalf of prospective residents who are often too ill to visit themselves. Copies of contracts for the four resident’s case tracked at this visit were viewed in their care records and had been signed by representatives of the residents. A full assessment of need was documented which had been carried out prior to admission to the home either in hospital or in the residents own home for those residents who’s care records were viewed. Intermediate care is not provided at Beggars Roost. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Residents care plans give clear information to assist with all aspects of health, personal and social care needs. Records are in place to monitor the health care needs of residents and record intervention from medical professionals. The homes medication procedures ensure that medication is well managed. Staff respect the privacy and dignity of residents so that residents are treated as individuals Outcomes for residents are good. EVIDENCE: Four care plans were viewed at this visit. They had been developed from the initial assessment of need completed prior to moving into the home and there was evidence to show that each plan had been reviewed regularly. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 12 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. Daily records show that resident’s health and welfare is being monitored. Accidents records seen at this visit were detailed and showed what action had been taken; they are regularly audited by the manager. Risk assessments were in place to ensure that’s staff are able to work safely with residents and there is moving and handling guidance in each residents bedroom. The home has a medication policy, self-administration of medication and a homely remedies policy, which were observed during the visit. Resident’s individual medication is kept in lockable cabinets in their rooms. Registered nurses access and administer medication on behalf of the residents. Additional supplies of medication are stored in locked cupboards and a medicines refrigerator in a lockable office. Records for receipt and disposal of medicine are recorded in a book. Administration is recorded on medication administration record (MAR) charts which were observed to be completed clearly up to the day of the visit for those four residents who were part of the case tracking exercise. Staff were observed to interact with resident during the visit. They were observed to treat residents as individuals, adjusting their approach to maintain individual levels of independence. They spoke to residents in a meaningful, caring manner. Visitors to the home who spoke with the inspector were complementary about the staff and how they provide care for residents. Comments made led the inspector to conclude that although the majority of residents have high nursing needs the staff recognise the need to maintain privacy and dignity. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The routines of the home are planned around the resident’s needs and wishes so that there is some flexibility in the service. Residents are encouraged to maintain contact with their family and friends so that they so that they can satisfy their social and emotional needs. Activities are offered and residents who are able are encouraged to take part. Home cooked food is provided to a good standard with choices of alternatives available. Outcomes for residents are good. EVIDENCE: Beggars Roost normally provides nursing care for residents who need high levels of nursing care and the routines of the home are focused in meeting these needs. Some residents are nursed in bed whilst others who are well enough to get up are assisted to interact with other residents in the lounge and conservatory. There are residents who choose to stay in their rooms and not take part in activities. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 14 A hairdresser was present on the day of this visit to enable residents to have their hair attended to professionally. Those residents visiting the hairdresser looked as if they were enjoying the experience. The home does provide activities and occasional entertainment for residents. Information provided prior to the visit reports that this includes: Movement to music, weekly activities, seasonal parties and visiting singers. The visitors book records that there are regular visitors to the home and feedback from the three visitors at the home during the visit, reported that they were always made to feel welcome. One relative visiting a resident in the privacy of the bedroom said that they had been visiting for five years. That they were always made to feel welcome and that they felt that they were kept informed about the care of their relative living at the home. They commented that the resident, which they visited although confined to bed, always “looked well cared for”. Food is considered to be of a good standard by residents who are able to express their opinion to the inspector. Staff spoken with during the mealtime said “we have a good cook”. The cook is part of the team and is aware of the dietary needs of residents. On the day of the visit the main meal of the day was braised beef in a red wine sauce, accompanied by buttered carrots, peas and creamed potatoes. This was followed by apricot meringue or there was fresh fruit for those residents who have a diabetic diet Menus observed during this visit showed variety and choice at each mealtime. Residents are consulted with each morning to discuss the options for the meals during each day. One residents spoken with in her bedroom at lunch time told the inspector that they were “ having an omelette as an alternative to the braised beef in red wine”. On the day of the visit 10 residents needed to be assisted to eat their main meals. The process for this is well organised and the inspector observed residents being assisted both in the lounge and in bedrooms. The process was not rushed. Residents who were able, dictated the pace and staff were encouraged them to maintain some level of independence. The inspector noted that there was very little waste went back to the kitchen. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 15 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): 16,18 The complaints procedure enables those using the service to have the confidence that their complaint will be responded to within a maximum of 28 days. The homes adult protection procedure is now clear and residents are protected by arrangements in place to protect residents from being placed at risk of harm or abuse. Outcomes for residents are good. EVIDENCE: The complaints procedure is on display in the home and a copy is included in the Statement of Purpose and Service User Guide. There have been no complaints made to the manager or provider since the last visit to the home by the inspector and no complaints made to CSCI. Since the last visit to Beggars Roost the provider and manager have updated its own policies and procedures to safeguard residents from abuse. They are now clear and follow the West Sussex Multi Agency Adult Protection procedures. All staff have now been trained in using the procedures have attended training in recognising and responding to adult protection matters. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 16 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 residents have a comfortable, homely, well maintained environment to live in. Bedrooms are comfortable and meet the needs of the residents. Residents are encouraged to contribute to making their bedrooms their own by having their own personal possessions around them. EVIDENCE: During this visit to the home the inspector visited the majority of private accommodation and all communal accommodation. The home was observed to be well maintained and clean and a refurbishment of the home continues. Since the last visit to the home a major building project has commenced. The planned extension expected to be completed by the end of November will Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 17 include seven new bedrooms, each with en suite shower facilities. There will also be an assisted bath with overhead hoist and a parker bath. Alterations to the existing home will then commence, providing a ramped corridor to the five existing rooms, which are currently only accessible via a short flight of steps. A further two rooms will be fitted with en suite shower rooms. The existing sluice facilities are to be replaced and the laundry room is to be refurbished. There are no plans to increase the occupancy of the home after completion of the extension. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The staffing numbers are set at level, which allows residents assessed needs to be met. Recruitment procedures safeguard and protect residents at the home. The staff-training programme provides staff with the majority of skills, which they need to do their job, and enables them to provide a reasonably safe environment for residents. Outcomes for residents are good EVIDENCE: Staffing rotas observed prior to the visit show that sufficient staff are employed with the appropriate skill mix to meet the needs of residents over the 24-hour period. There were positive comments made by visitors to the home during the visit. One visitor said, “the nursing staff are lovely, they cant do enough”. This person also said that they thought that there were enough staff and that when they visit their relative a care assistant or nurse is “always popping in and out to check that they are alright”. Another visitor said “they are very pleased because the staff keep them informed and they listen to what relatives have to say to help”. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 19 The home had its own recruitment procedure, which was observed at this visit, and the records of four members of staff were examined to see if the procedure is being followed. Recruitment records have improved and now include identification of the person employed but records showed that in practice the homes recruitment process is not always being followed to ensure that satisfactory references are in place and new staff have a POVA First clearance before starting work. Information provided by the manager of the home prior to the visit about the qualifications of staff show that there are twenty-two nursing and care staff working at the home. Eight staff including the manager are registered nurses and nine care assistants (72 ) working at the home have an N.V.Q qualification. The manager told the inspector that other care assistants were waiting to start an N.V.Q. The training programme at the home has been extended since the last visit to the home to include Adult Protection training for all staff. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 20 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): 31,32,33,35,37,38 The home is well managed providing leadership and guidance for staff. The views of resident’s families and friends are not formally being sought to measure how successful the home is at meeting its aims and objectives and the statement of purpose of 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. Outcomes for residents are good EVIDENCE: Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 21 The manager has the required experience to manage the home but does not have a formal management qualification. However she has researched opportunities to acquire a qualification and is waiting to commence a management course. Visitors, staff and residents feel that the manager is competent and runs the home in the best interests of the residents. No evidence could be provided at this visit to demonstrate that a formal quality assurance system in use at the home, which seeks the views of residents and measures its success in meeting the aims and objectives and statement of purpose of the home. 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. No health and safety issues were identified at this visit unless mentioned in other areas of this report. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 22 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 1 X 3 X X 3 Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 23 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 OP33 Regulation 24 Requirement A formal quality assurance system must be established in Timescale for action 01/03/07 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 OP29 Good Practice Recommendations The homes recruitment policy should be followed with regard to references and POVA first checks. Beggars Roost Nursing Home DS0000024116.V302754.R01.S.doc Version 5.2 Page 24 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.V302754.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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