Inspection on 28/09/06 for Bempton Old Rectory

This inspection was carried out on 28th September 2006.

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

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

Other inspections for this house

Bempton Old Rectory 13/10/09

Bempton Old Rectory 15/10/08

Bempton Old Rectory 20/01/06

Bempton Old Rectory 18/10/05

Bempton Old Rectory 08/03/05

Bempton Old Rectory 27/10/04

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Hawkhills

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

CARE HOMES FOR OLDER PEOPLE Bempton Old Rectory Vicarage Lane Bempton Bridlington East Riding Of Yorks YO15 1HF Lead Inspector Mavis Pickard Key Unannounced Inspection 28th September 2006 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 Bempton Old Rectory DS0000019648.V314229.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. Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bempton Old Rectory Address Vicarage Lane Bempton Bridlington East Riding Of Yorks YO15 1HF 01262 850072 F/P01262 850072 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) Mrs Dorothy Hunter Mrs Dorothy Hunter Care Home 17 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (17) of places Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th January 2006 Brief Description of the Service: Bempton Old Rectory is situated within the small village of Bempton, near the costal resort of Bridlington. The home is registered to care for a maximum of 17 older people who may or may not have a dementia type illness. The premises, a grade two listed building is set in its own grounds and has been extended and refurbished to provide residents with a homely and comfortable environment. Some resident’s private accommodation is on the first floor and a chair lift is provided. The service would accommodate anyone who has mobility needs in ground floor accommodation. The village has a number of local amenities including pub, village shops as well as limited public transport to Bridlington. The home has a dining room and lounge both of which are large enough to accommodate all residents. Information received from the home on 11 August 2006 states that the current fees are £347.00 to £420.00 per week. Additional charges are made for hairdressing, chiropody, and the beautician. Information about the services provided are made available in the home’s Statement of Purpose, Service Users Guide and through published inspection reports available from the home. The Commission for Social Care Inspection CSCI] has copies of the summary of recent reports available at www.csci.org.uk The full report can be obtained by contacting CSCI customer services on 08450150120. Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The provider Mrs Dorothy Hunter also manages the service and is present in the home each weekend. The service employs a management team of a business manager and care administrator who makes sure that the day-to-day management of the service and support for residents, families and staff is provided. The outcomes for residents were evidenced from speaking with residents, their families and other visitors to the home during this visit and from the examination of the care records of 3 residents. Further information about the service was obtained speaking with staff who work at the home and from the outcomes of surveys undertaken prior to the site visit. People surveyed included care managers and health professionals and other people who visit the home and have an interest in the service and its residents. Accumulated evidence was also provided by past inspection reports and other details about the service stored within the Commission for Social Care Inspection [CSCI] records. It was found that the service is running well and that a high level of care and support is provided to people accommodated. What the service does well: The service provides a clean, homely environment that is sufficiently staffed by competent and knowledgeable people. Relatives spoken with said that they are satisfied with the care that their loved ones receive and that staff make sure that everyone is cared for well. A resident said, “its fine here and the food is good” another resident said “its lovely here” their relative added “ we couldn’t think of anywhere better”. The atmosphere is homely, calm and relaxed and visitors are welcomed. Staff and residents are seen to be respectful of each other. The home has achieved ‘The Investors in People’, ‘Positive about Disabled People’ and ‘Heart Beat’ awards. Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 6 Residents and staff are encouraged to take part in life long learning experiences. The outcomes for residents they say, is that they enjoy the experience and that they feel safe. The home has a system of monitoring its quality that residents and families take part in. People can bring personal possessions to the home and can have their visitors at any time. The home makes sure that checks are done when employing staff, so that residents are safe. 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. Bempton Old Rectory DS0000019648.V314229.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 Bempton Old Rectory DS0000019648.V314229.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. [6] The service does not provide intermediate care facilities. Quality in this outcome area is good. This judgement has been made using available evidence about the service including a site visit. No resident is accommodated without a comprehensive assessment of their needs and prospective residents and/or their representatives are provided with the information they need to make an informed choice about moving in. EVIDENCE: The care files of 2 recently admitted people were examined. 3 residents were spoken with along with the family of 2 of the residents. The information found is that prospective residents are assessed for their care by the provider/manager Mrs Hunter, a qualified nurse. People said that they had been provided with all the information they needed to make a decision about being admitted to the home, they had been asked about their needs and what they require. Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 9 People said that they had seen the written assessment when it was completed and had agreed that it was accurate. All case files contain a copy of the resident’s contract that has been signed by the resident or their representative. The service does not provide intermediate care. Bempton Old Rectory DS0000019648.V314229.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 11 Quality in this outcome area is good. This judgement has been made using available evidence about the service including a site visit. All residents have a care plan that sets out the support and care to be provided. People’s care needs are met, their views are respected and they are supported to make decisions about how they wish to live their lives. EVIDENCE: The care files of 2 people were examined and found to contain all the information required to support care staff to provide appropriate and individual care. Residents care plans had been generated from the assessment and reviewed regularly. People said that they and their relatives had seen their plan and agreed with it. Care plans contain details of the resident’s health and personal care needs however although these areas of care are recognised and action taken to ensure that all support is provided and that medical and nursing support is Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 11 sought whenever necessary. Staff said that its the daily lives of the residents that is paramount, that all people are treated as individuals and make decisions about how they want to live their lives. People spoken with said that it’s this aspect of life at Bempton Old Rectory that is most important. A resident said, “ People come here to live, they don’t come here to die” The service and its staff are committed to ‘life long learning’ for residents and staff. Residents are supported to be able to understand and be part of any areas of learning that staff undertakes i.e. fire training, infection control, computer knowledge, moving and handling etc, if they want to. The result is that even people who have progressed dementia have absorbed and retained enough of this fun based training to ensure that they remain safe in an emergency. Within the residents file it is recorded if people wish or do not wish to be responsible for their own medication. If they don’t, the service will take responsibility. The home uses a monitored dosage system and any staff who administer medication have undertaken an accredited course. The care administrator is responsible for overseeing all aspects of the ordering, receipt, administration and disposal of medication. Throughout the day it was observed that there is an atmosphere of mutual respect within the service and that staff ensure residents dignity is preserved. Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence about the service including a site visit. Residents and their representatives know that people accommodated are supported to have control over their lives and are provided with interests, activities and life style that meet their expectations. EVIDENCE: Members of this resident community are encouraged to reach their potential by joining staff in life long learning opportunities. Residents are provided with fun based learning in respect to all aspects of safety. The themes include fire safety, health and safety, safe moving and many more. The outcome for residents is that they are empowered to remain safe in their environment. Those residents with dementia type illnesses evidence that they have absorbed and retained sufficient information to support personal and communal safety. Success of this innovative approach can be measured by improvements in the relationship and understanding between the residents, relatives and members Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 13 of staff. The staff team have a holistic approach and the manager stressed the value of fun and laughter in the home above the needs of some other issues. Several residents and/or relatives and friends were spoken with all were very complementary about the services provided and about the fact that the service recognises residents strengths first and not weaknesses. It is clear that the service is dynamic and that all residents whatever their ability are tailored for. A relative commented that their loved one is less anxious and more relaxed since moving to the home and that they can see a vast improvement in them. It is clear that relatives are encouraged to invest their time and become truly involved in the community. Staff spoken with were clear that the service is for residents, they lead what happens within the home, that “staff enter the world of the resident” not the reverse. The meals are of a high standard. Food preferences, allergies and medical dietary needs are recorded on individual care records. People are asked what they like and catered for accordingly. All said they found the meals to be excellent. Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence about the service including a site visit. The service follows its own complaints policies and procedures. Residents are safe. EVIDENCE: The home has a comprehensive complaints policy and procedures. Service users and members of staff said that they would have no hesitation in raising any concern with the manager or with any of the senior staff in the knowledge that their concerns would be treated seriously. There has been 1 complaint raised with the Commission since the last inspection. The details of the concerns were around the assessment, admission and discharge of a resident. A random site visit was undertaken to see if any of the Care Homes Regulations 2001 [and amendments] had being breeched. It was found that there were. The service has since put new systems in place to ensure that it follows appropriate guidelines regarding assessment and the giving of notice. The provider/ manager a qualified nurse now undertakes all assessments. Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 15 Complaints procedures and policies that meet current standards are being followed. The service ensures that their recruitment procedures are followed and makes available policies and procedures and local guidance for the safeguarding of residents. Staff has attended training about safeguarding adults and when spoken with understand their responsibilities in regard to safety and protection. Bempton Old Rectory DS0000019648.V314229.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 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence about the service including a site visit. Residents live in a safe, well maintained, clean environment, with their own possessions about them. EVIDENCE: The home provides comfortable, homely and attractive accommodation for all residents. The business manager said and residents and families spoken with confirmed that there is no part of the home that is restricted. Relatives and if safe, residents are encouraged to visit all parts of the home including laundry and kitchen areas to see how the home is run and/or to use its facilities. Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 17 The inside and outside of the home is well maintained and there is a refurbishment and maintenance programme in place. Furnishings and décor are comfortable, domestic in nature and of good quality. All of the bedrooms in the home have en-suite facilities and communal bathrooms have been adapted for residents who have mobility problems. The home has secure well-maintained gardens for service users to enjoy. Residents and their families are encouraged to personalise resident’s private rooms with pictures, photographs and small items of furniture that they have brought from home. The home is clean and fresh smelling throughout. Where it is necessary staff are provided with protective clothing and gloves. However the emphasis is on a domestic and homely environment so this is kept to the minimum required. The home has hygienic, clean and tidy, well equipped and well managed laundry and kitchen areas. The overall feel of the home is that of a large domestic well maintained home where all people are welcome. Bempton Old Rectory DS0000019648.V314229.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 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence about the service including a site visit. Resident’s needs are met by sufficient trained and competent staff and they are protected by the home’s recruitment policy and practices. EVIDENCE: The site visit and the rota forwarded to the Commission previously showed that there are sufficient staff on duty to meet resident’s needs. Staff working in the home present as an impressive, competent, coherent and knowledgeable group who understand and practice holistic care and support for residents. The home is a pleasant and happy place to spend time. Residents, relatives and other people spoken to say it’s the staff that makes it so. Staffing levels are high presently as the home which is registered to accommodate 17 people is accommodating just 9. The business manager said that although the home is quiet presently the provider doesn’t lower staff levels because it gives scope for extra support and because it may result in the service loosing current staff who are valued. Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 19 The home has robust recruitment policies and procedures in place. The recruitment files of 2 recently recruited staff were examined and found to be maintained in line with current legislation and with the homes own policies and procedures. The Criminal Records Bureau [CRB] and Protection of Vulnerable Adults [POVA] checks for those records examined are compete. These now checked by the Commission can be destroyed in line with the Data Protection Act. All staff on duty were spoken with informally and 2 carers were spoken with privately. They said that they enjoyed working at the home and that it is a personally fulfilling experience. Staff said that the service is robust in its training programme and that they have learned lots of things, more than what they might have expected in a care environment. Both people said that residents are included in all training opportunities, given ‘bite size’ pieces in a way that is fun and that it benefits them on many levels including safety and enjoyment of life. All staff receives a thorough induction into the home and regular and on going supervision where notes record outcomes for staff. Bempton Old Rectory DS0000019648.V314229.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): 31,33,35 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence about the service including a site visit. The service is safe and effectively managed. Residents, their representatives, staff and visiting professionals understand the management structures of the service, which is run in the best interests of people accommodated. EVIDENCE: The service is owned and managed by Mrs Dorothy Hunter who is a qualified nurse. The management structure of the service is that Mrs Hunter manages the service and is present in the home weekend days thus undertaking a hands on management role for approximately 16 hrs a week. However she is available at other times by telephone or by appointment and she undertakes all the initial assessments for prospective residents. Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 21 The service employs a business manager and care administrator both of who are present in the home 5 days each week usual office hours. The business manager has overall responsibility for the day-to-day running of the service including among other duties, staff recruitment and training, policy management, quality assurance and ensuring that the premises are safe and maintained appropriately. The care administrator is responsible for overseeing the care of people accommodated including all aspects of medication and in liaising with health professionals about resident care. The results of the quality assurance surveys are published and available for any interested party to examine. The home has a policy of continual self monitoring and has a proactive approach to improving the quality of service through consultation and regular review. The home does not become involved in service users’ finances. Staff spoken with said that they have regular supervision that looks at all aspects of care, the purpose of the home and any training needs. A range of health and safety records and documents were examined. All were up to date and accurate. Bempton Old Rectory DS0000019648.V314229.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 X 3 3 3 3 Bempton Old Rectory DS0000019648.V314229.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. 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 Bempton Old Rectory DS0000019648.V314229.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Bempton Old Rectory DS0000019648.V314229.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!