Inspection on 10/02/09 for Benamy House

This inspection was carried out on 10th February 2009.

CSCI found this care home to be providing an Good service.

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

Benamy House 06/02/07

Benamy House 21/02/06

Benamy House 18/10/05

Benamy House 08/02/05

Benamy House 25/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Benamy House 25 Candlish Terrace Seaham Durham SR7 7LG two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kathy Bell Date: 1 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Benamy House 25 Candlish Terrace Seaham Durham SR7 7LG 01915813039 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Gail Smith,Mr Russell Smith Name of registered manager (if applicable) Mr Russell Smith Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 5 5 care home 5 learning disability Additional conditions: The category LD(E) is only available for those people already living at the home before reaching the age of 65 years. Date of last inspection 0 5 0 2 2 0 0 7 A bit about the care home Benamy is owned by Gail and Russell Smith and Mr Smith is the registered manager. The Smiths have described their services as having an extended family approach. Residents relatives are supported as well if appropriate. The home is registered for adults with learning disabilities over the age of 18 but can only have residents above the age of 65 if they have been living in the home before they reached 65. Five men are living in the home at the moment. The premises are a large, detached end terraced house near Seaham town centre. All the bedrooms are single and the home has a large lounge/activities room and a conservatory for eating and activities. The home is decorated and furnished in a domestic style. The owners of the home preferred not to provide information on the weekly charges in this report, but this information is available on request from the home. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home This inspection took place during one day in February 2009. We had arranged the date a few days beforehand, to make sure people would be in the building. During the visit we met all the people who live in the home and talked with two members of staff as well as Mr and Mrs Smith. We looked at records and after the inspection we talked to the relatives of two of the people who live in the home. The manager sent us a report (the AQAA). This report gives their view of what the home is doing well and what it could do better. We used this information when we did the inspection. In the last report we may have told the home to improve what they do. We call this making Requirements or Recommendations. If the home hasnt done what we told them to, but this doesnt affect peoples safety, we may not tell them to do it again. But, in future, if we have to tell a home a second time, we will probably take action to make them do what we say. They go out to leisure activities in the local area, like anyone else does. What has got better from the last inspection What the care home could do better Mr Smith must discuss with care managers when they are satisfied it is safe to leave anyone in the building without staff. Written instructions to staff about personal care should not be on display in communal areas, to respect peoples privacy and dignity. All of the staff who have not already done this, should do training in safeguarding adults to make sure they are aware of what is abuse and what they should do if they suspect it. Mr Smith should discuss with people, their relatives and care managers, whether they are comfortable with the physical contact between staff and people who live in the home. Mr Smith must make sure that he takes action to meet requirements made by CSCI. As part of the system to make sure the quality of the care they provide continues to be good, the Smiths should find out the views of all the relatives, the people who live in the home, care managers and health professionals. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Kathy Bell St. Nicholas Building St. Nicholas Street Newcastle upon Tyne NE1 1NB 019 1233 3300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The Smiths find out about people before they move into the home, so they can be sure they will meet their needs. Evidence: We looked at the records for the last person who had moved into the home, which was almost 2 years ago. Mr and Mrs Smith had obtained an assessment from a care manager, which described his needs. They also obtained information themselves. Before he moved in, he started spending time with the other residents, going out on social activities etc. This helped him get to know the other residents and also was an opportunity for the Smiths to find out if he would get on with them. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staff are given the information they need to provide each person with the care they need. But more care is needed to consider peoples privacy and dignity when the Smiths decide how this information is available to staff. People can make choices in their daily lives and are encouraged to do this. People are protected from harm as far as possible, while taking part in everyday household tasks. But the Smiths have not always discussed with care managers, as they should have done, decisions about whether people can spend time in the house without staff. Evidence: Each person has a care plan which explains any help they need with their personal care, how they communicate, any problems with mobility, and the activities they like. There is also a 24-hour plan which explains what staff need to do for people through the course of the day. This is particularly valuable for any new staff. But because Mrs Smith is keen to be sure that staff are doing what they should, when she is not there to supervise them, there are a number of reminders pinned up in the home. Some of these contain information about personal care and this should not be available for anyone to read. Also, there is a risk that information may be overlooked when it is with other reminders on the noticeboard. We saw many examples of how people living in the home can make choices. A member of staff explained how they take turns in choosing the main meals, which has to be something everyone likes, and staff just try and encourage variety and healthy options. She described the different leisure activities people like. The daily records showed how Mrs Smith saw it was something to celebrate when, for the first time, one Evidence: person said they didnt want to do what other people were doing. We spoke to one person who lived in the home, with his mother, and they agreed that he is much more independent and able to make his own choices now. Mrs Smith explained how they had recognised that he found it difficult to express choices at first so they had come up with a phrase he found easier to say than simply saying, no, I dont want to. But some of the guidelines written for staff could lead to staff restricting choices. These refer to a 10 p.m. bedtime, but we were told that the intention was that people stayed up to an adult bedtime, unless they didnt want to, rather than staff sending them to bed earlier. Mr Smith said that they did generally expect people to go to their rooms about 10 oclock, and most people were tired by then, but people could sit and listen to music or watch TV in their rooms. Mr Smith had looked at whether people would come to harm by carrying out day-today tasks within the house, like washing-up or helping prepare meals. He had written down the safeguards needed to keep people safe as far as possible. Generally this meant that people could carry out tasks, but with staff supervision. There were also risk assessments which said that some people could be left in the house without staff. These showed which people could be left in the house together without staff. Mr Smith had recorded whether people would be able to get help in an emergency and if they would be at risk. These decisions must be discussed with care managers to make sure that everyone agrees this is a reasonable thing to do. The risk assessments had been reviewed recently, to make sure they were up-to-date and nothing had changed. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live in the home have been encouraged to learn new skills and gain independence in the home. They take part in a range of leisure activities, using facilities in the local community. They can maintain close relationships with their families. Staff recognise peoples rights to make choices and encourage them to take responsibility for day-to-day life in the home. People enjoy a varied diet, which takes into account individual needs. Evidence: People who live in the home are encouraged and expected to take part in preparing meals etc, as much as they can. Mrs Smith described how one person had started independently writing out a list for the shopping. Some people go to day placements arranged by care managers. They have an active lifestyle, going out to art classes, bowling, the local club etc. Two different holidays were arranged last year as people wanted to do completely different things. Within the house, people can listen to music or watch TV in their rooms. They have regular karaoke and music sessions. People with older parents have close contact with them, making the move into a care home easier. Also the Smiths provide practical support where necessary, including one relative in shopping trips. The Smiths put on her 90th birthday party for her in the home. Another relative confirmed that they visit the home every week to discuss anything they need to with the Smiths. Evidence: People who live in the home take turns in deciding what they will have to eat. But the staff encourage healthy eating and check peoples weight. Record showed they have been successful in helping overweight people to lose weight and in maintaining the weight of someone who was at risk of being too thin. Mrs Smith showed that she knew it was also important for meals to be enjoyable-it was very important to her that staff were good cooks as well as good carers. A relative said the meals are lovely. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who live in the home receive the personal and health care they need. Medication is looked after safely and people can look after their own medication if they can do this safely. Evidence: Very detailed care plans explain the help staff need to give each person with their personal care. A relative who commented felt that the staff always knew what to do, as it is all written down. Relatives said that they felt people were well cared for. Some people have difficulty communicating but two relatives said that this had improved since they had been in the home. There were detailed records of when people had seen the doctor or nurse which showed that any problems were followed up. People also had checkups at the dentist and optician and saw the chiropodist if necessary. The home does not have to look after much medication for people but they do keep proper records of medication they give to people. Staff have had training in looking after medication safely. One person is completely independent in ordering and taking his medication. The home uses a monitored dosage system. This means that the pharmacist fills up a box with different sections for each day of the week and time of day. Staff help some people have as much independence as possible by handing them the box with the medication in and supervising them taking out the pills from the right place. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People can be confident that any concerns will be responded to properly. They are protected from harm as far as possible but all staff must receive training in safeguarding adults. Evidence: The home has a satisfactory procedure for dealing with complaints but has not recorded any formal complaints in the last two years. Two relatives confirmed they meet with the Smiths every week. Both said that they can raise any small issues and always receive a satisfactory response. An allegation was made under safeguarding adults procedures last year. This was investigated and care managers found that there had been no abuse. Mr and Mrs Smith cooperated fully with this investigation. In a small home of this kind, sometimes relationships are less formal between staff and people who live in the home. This can include affectionate, but not improper, physical contact. Mr and Mrs Smith need to continue to take care that any physical contact is truly welcomed by each person as this can be misinterpreted. Durham County Councils contract section carried out an audit of the money looked after for people who live in the home last year. This found that money was properly accounted for and used appropriately. They made some recommendations to improve the system which have been complied with. The Smiths carry out all the necessary checks on new staff before they start work, to make sure there is nothing in their background which would mean they were unsuitable to work in a care home. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is a comfortable and safe place to live and is decorated and furnished in a domestic style. It seemed clean and hygienic on the day of inspection. Evidence: The home provides a single room for each person and everyone decorates their room to suit their individual interests. One bedroom has an ensuite toilet and one other has a wash hand basin. There is a bathroom upstairs and another shower room and toilet on the ground floor. Two of the bedrooms are on the ground floor. There is a large sittingroom/activity room and a conservatory room which is used for eating and activities. Mr Smith explained that they had improved the heating for the conservatory room when they found the original heating was not sufficient in winter. The building is comfortably furnished and decorated in a domestic style. Examples of art created by people who live in the home are on display. On the day of inspection it seemed clean. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There are enough, qualified staff on duty to meet the needs of people who live in the home. Most essential training has been given but all staff should receive training in safeguarding adults. The home checks new staff properly, making sure, as far as possible, that they are suitable to work in a care home. Evidence: Four of the six care staff have already achieved the National Vocational Qualification in care at level 2. This is the recognised qualification for care workers. The National Minimum Standards recommend that at least half of the care staff in a home have this qualification so Benamy is doing better than this. Staff seem to have the personal qualities needed for this work: a relative described them as really nice and said her son got on with them, like a house on fire. The rota showed that there is one person on duty through the day and evening and Mr and Mrs Smith both work from 10 a.m. to 10 p.m. on Saturdays and Sundays. On weekdays, three of the people who live in the home are at day placements for between two and four days a week. Risk assessments state that two people can be left at home without staff so if they choose not to go out with the others, this is not a problem. Mr and Mrs Smith take into account the preferences of people who live in the home when recruiting staff. The newest member of staff said that she had had her first interview, then met the people who live in the home before she had a final interview. Records showed that the Smiths had obtained references for her and a Criminal Records Bureau /Protection of Vulnerable Adults List check before she started work. By doing this they made sure there was nothing in her background which would mean she was not suitable to work in a care home. Evidence: Most of the staff have received the essential training they need to work safely. The newest member of staff is currently doing food hygiene training. Not all of the staff have received training in safeguarding adults. We saw the record of the induction received by the newest member of staff. She confirmed that she was working alongside Mr or Mrs Smith until they were all confident she could work alone. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is well managed in most ways but greater attention must be paid to requirements made by CSCI. The Smiths receive a lot of feedback from some relatives about the quality of care but have not asked for comments from other people involved with the care of people who live in the home. They need to do this to properly look at the quality of the care they provide. The home is maintained as a safe place to live and work. Evidence: Mr Smith is a nurse specialising in learning disabilities with many years of experience. He has also completed management qualifications. He has been running this home for a number of years and knows the people who live there well. But he has not met two requirements we made at the time of the last inspection. The Smiths have relied a lot on receiving informal, day-to-day feedback from relatives who are closely involved , to find out whether they are satisfied. Mrs Smith meets with the relatives of three of the people who live in the home every week. This is a good way of finding out their views and picking up any problems before they become serious. In the past they have carried out a survey of all the relatives, the people who live in the home, care managers and health professionals. They should do this again to make sure that they are getting all the information which will be useful to them in checking on the quality of the care they provide. Mr Smith confirmed that they have been carrying out the monthly checks which are required by law. We saw the records of regular maintenance checks, for the electrical installation of the building, portable electrical appliances and gas equipment. The building has a fire safety system suitable for the scale of the home and the Smiths followed the advice of Evidence: the fire officer on extra precautions when they increased the size of the home two years Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 1 9 13 Risk assessments about leaving people in the home on their own must include more details of the potential risks and how they can be minimised. The home must ask care managers if they agree that the risk can be taken. 31/03/2007 2 23 13 Staff must do training in adult protection. 01/06/2007 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 6 12 31/03/2009 Instructions to staff about personal care must only be contained within the care plans and not be displayed in communal areas. This is to respect the privacy and dignity of people who live in the home and to make sure that staff have the information they need. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 23 Mr Smith should discuss with people who live in the home, the care managers and relatives whether they are comfortable with the physical contact between people and staff. The Smiths should find out the views of people who live in the home, all the relatives involved care managers and 2 39 health professionals as part of the quality assurance system. Helpline: 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 We want people to be able to access this information. 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