Inspection on 19/05/06 for Bendigo Nursing Home

This inspection was carried out on 19th May 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

Bendigo Nursing Home 19/06/07

Bendigo Nursing Home 06/10/05

Similar services:

Springfield House

The Shelley

Thorndene

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Bendigo Nursing Home 22 Arundel Road Eastbourne East Sussex BN21 2EL Lead Inspector Kathy Flynn Key Unannounced Inspection 19th May 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bendigo Nursing Home Address 22 Arundel Road Eastbourne East Sussex BN21 2EL 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) 01323 642599 01323 431080 Kindcare (UK) Ltd Vacant Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability (25) of places Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That the maximum number of service users to be accommodated will be twenty-five (25). Service users must be aged sixty-five (65) years and over on admission. Service users may also have a physical disability. Date of last inspection 6th October 2005 Brief Description of the Service: Bendigo Nursing Home is registered to provide nursing care for up to 25 older people, over 65 years, or individuals with physical disabilities. Situated in a residential area of Eastbourne it is approximately 20 minutes walk from the town centre with its variety of shops and public transport facilities, with a library, GP surgeries and dental practices accessible. The home is a converted detached property, the kitchen, the staff room and storage facilities are in the basement with a further three floors containing a lounge, resident’s individual bedrooms, 19 single rooms and three double rooms, assisted bathrooms and toilets. There are uneven floors in some areas of the home, narrow corridors and steps that can restrict movements throughout the home, with some rooms only accessible by negotiating steps. There is a small passenger lift, which has been recently improved and can now be used by wheelchair users and staff. There is a large garden to the rear with an access slope at the side of the home for wheelchairs and is used when weather permits. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out on the 19th and 22nd May and took place over nine hours. The inspection included a tour of the home, a review of pre-admission assessments, care plans, accidents records, staff records and training, medication records, activities, policies and procedures and menus. The home is registered to provide nursing care for up to 25 residents. There were 16 residents at the home during the inspection and fees range from £405 to £625 per week. Fourteen of the residents were spoken with and all those who expressed an opinion were very positive about the care and support provided at the home. The acting manager, deputy manager, registered nurse on duty, care staff, cook and housekeeper were happy to discuss the care and support provided at the home. A pre-inspection questionnaire and ten residents surveys were sent to the home prior to the inspection, the questionnaire and nine completed surveys were returned. Ten comment cards were sent to relatives, six were returned as were the two sent to GP’s. The reader should aware that the Care Standards Act 2000 and the Care Homes Regulations 2001 use the term service user to describe those living in care home settings. However for the purposes of this report those living at Bendigo Nursing Home will be referred to as residents. What the service does well: The atmosphere at the home was relaxed and residents were able to choose where they spend their time, some in the lounge some in their own rooms. Communication between staff and residents was open and friendly, reflecting the staff’s awareness of residents needs. Residents spoken with who expressed an opinion said they are ‘very comfortable’, ‘very happy here’ with the staff providing ‘as much help’ as residents need. The meals provided at the home are nutritious and appealing, residents spoke very positively about the food, with one saying ‘it is excellent’. Choices are offered for each meal, drinks and snacks are available throughout the day. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 6 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. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service Users Guide provide sufficient information to enable prospective residents and relatives to decide if the home can provide the services they need. Contracts are provided for residents to explain the services that are offered at the home. Pre-admission assessments are completed prior to the offer of a place at the home to ensure that the home can meet prospective residents needs. EVIDENCE: The Statement of Purpose and Service Users Guide has been reviewed. It is now in booklet form and has been given to all residents. Sufficient information is available to enable prospective residents and their families to decide if the home provides the care and support they need. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 9 All residents are given contracts, which list the costs covered and the number of the room residents have agreed to take. The acting manager confirmed that she plays an active role in ensuring the home can meet the needs of residents and has introduced a pre-admission assessment form. The deputy manager and registered nurses complete these forms when assessing the needs of prospective residents and use the information collected to develop the care plans. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 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 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care planning system provides sufficient information for staff to enable them to provide appropriate care and support for residents. The systems for the administration of medication are satisfactory and there are arrangements in place to ensure that resident’s medication needs are met. Staff treated the residents with respect and encouraged them to play an active role in deciding the care and support they receive. EVIDENCE: The acting manager has done a considerable amount of work developing an effective care planning system. The care plans now include information about all aspects of the care needs of residents admitted to the home in recent months. Some residents have lived there for several years and there is limited information available, however staff are aware of their needs and are able to provide appropriate care. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 11 It was noted that some care plans are not reviewed on a regular basis and the recording of information is not complete, some risk assessments have not been completed and the information recorded is different in some daily records compared with wound care and pressure area charts. The acting manager had identified this as a training issue prior to the inspection and will be arranging relevant training for the registered nurses, with ongoing supervision to assess improvements. Residents have access to allied health professionals as required including the tissue viability nurse and chiropodist. Policies and procedures are in place for the receipt, storage and administration of medicines. The deputy manager has identified some concerns with medication at the home and a pharmacist has visited to discuss them and provide training if required. The acting manager discussed her plans to improve the clinical room to provide more storage and make better use of the space available. This will ensure that nurses no longer have to use the resident’s lounge when checking deliveries of medication. The atmosphere in the home was relaxed, residents were comfortable, communication between residents and the staff was friendly. Residents who expressed an opinion said that ‘staff are very good and help as much as I need’ and ‘I am very comfortable’. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents at the home would benefit from an improved programme of activities. The meals at the home are good offering variety and choice and catering for residents special dietary needs. The routines of the home are flexible this enables residents to have control over their lives and encourages them to make choices about all aspects of their day to day lives. EVIDENCE: Some activities are provided at the home. Weekly group singing and one to one sessions are arranged in addition to staff spending time with residents offering a manicure, playing games or just talking to them depending on what they want to do. Residents said that they choose how they spend their time, ‘I enjoy the morning while sitting in bed, I can see over Eastbourne’, ‘we have a nice talk when the activity person comes and I prefer to stay in my own room’. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 13 The acting manager has identified that additional activities should be available for residents to enjoy if they wish. The expectation is that one of the care staff will take responsibility for developing and introducing a programme based on the residents’ preferences and choices. Residents are encouraged to keep in contact with relatives and friends. Some continue to go out on trips with friends, one resident plans to attend the Air Show in August, and local groups, including the Multiple Sclerosis Society. Relatives and friends can visit at any time in line with resident’s preferences. There were no visitors at the home during the inspection. However the positive statements included in the comment cards and resident surveys were ‘staff proved very helpful and considerate’, ‘they are always caring and helpful’, ‘been very happy since he has been here’ while one stated that they were ‘very impressed’ with the home. The acting manager has a good understanding of the areas that need to improve at the home. Her concern is that some staff regard the work as tasks to be completed instead of caring and supporting residents to make choices. Training is to be provided with the expectation that this will be supported through ongoing supervision. However it was noted during the inspection that the routines at the home are flexible, residents who expressed an opinion said that they made choices about all aspects of their lives. One resident has a ground floor room and as a wheelchair user is assisted to use her room, the lounge or sit in the entrance hall if she wishes. Her placement was arranged on the understanding that she could keep her pet with assistance from staff, and is able to continue to have days out several times each week, a calendar is used to plan and record the activities. The meals provided for residents are nutritious and appealing, they are offered choices, the cook explained that the residents ‘can have what they want’, and a resident stated that the ‘food is excellent’. Residents were having a variety of meals at lunchtime, one had a sandwich and coffee, another pureed vegetables while most had fish, chips and peas followed by a choice of puddings. Staff working at the home all day can also able have meals and eat the same food as residents. The acting manager has reviewed the menus, fresh fruit and vegetables have been increased and now meet the governments recommended five portions a day. The nutritional assessment tool is used to identify any residents with special dietary needs, including monthly weights. However it was noted that some residents were not given salt, pepper and sauces with the meal, or offered them. The acting manager said that this is an ongoing issue, training has been provided for staff with regard to ensuring the Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 14 trays used for residents meals are laid appropriately and additional training will be arranged to ensure residents are offered condiments with meals. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system with some evidence that residents feel their views are listened to and acted upon. Staff demonstrated a good understanding of Adult Protection issues, which protect residents from abuse. EVIDENCE: Appropriate policies and procedures are in place for investigating complaints. One complaint was made to the Commission. This was referred to the acting manager of Bendigo Nursing Home who followed the homes procedures to investigate it. Issues concerning communication between the DGH and nursing homes were identified and action has been taken on both sides to address these. Residents who expressed an opinion said that the acting manager and staff listen to them when they have any problems and deal with them, although they also felt that they didn’t really have ‘anything to complain about’. Training in Adult Protection is provided for all staff. Those spoken with during the inspection were able to demonstrate an understanding of abuse and what action should be taken if they have any concerns. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 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 adequate. This judgement has been made using available evidence including a visit to this service. Recent investment has significantly improved the appearance of this home creating a comfortable and safe environment for residents and visitors. Systems for the control of infection are in place and protect residents, staff and visitors. EVIDENCE: An improvement programme is in place at the home to update all aspects of the building and its environment, and therefore improve the conditions in which the residents live. During the inspection it was clear that a considerable amount of work has been done. The entrance area was being updated, the internal communication system has been removed as it was thought to be inappropriate for a care home, the furniture is being replaced with modern and contemporary chairs Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 17 and tables, and the ceiling is being lowered with ceiling lights to make the entrance more attractive and welcoming. The furniture in the residents lounge has been replaced and the new curtains will be put up when the building work has been completed. The windows in resident’s rooms were being replaced with double glazed ones during the inspection, furniture is being updated, including bed tables and commodes and all rooms will be redecorated, curtains will be replaced, with residents choosing the colours for their own rooms. Residents who expressed an opinion spoke positively about the home, many have decorated their rooms with their own possessions, pictures and ornaments. Training is infection control is provided for all staff and those spoken with were able to demonstrate and understanding of the use of preventative measures including the use of gloves and aprons. Appropriate policies and procedures are in place. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 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 adequate. This judgement has been made using available evidence including a visit to this service. The staffing numbers and skill mix is appropriate to meet the assessed needs of residents. Thorough recruitment procedures help to ensure the safety and protection of residents. Appropriate training, including induction training, for the registered nurses and care staff would enable them to demonstrate a clear understanding of their roles. EVIDENCE: The staffing numbers were felt to be appropriate to meet the needs of residents at the home during the inspection. There were 16 residents at the home and the acting manager discussed the need to review the staffing levels if the number of residents increased to the registered number of 25. The home follows robust recruitment procedures, POVA/CRB checks are carried out and two references are requested by the acting manager prior to the offer of employment at the home. One member of staff is working under the direct supervision of experienced staff as a POVA first only has been completed, she was able to demonstrate an understanding of why this system is in place and how it protects residents. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 19 One member of the care staff team has NVQ Level 3, although the majority of staff employed as care staff are nurses who have trained in other countries. Discussions with the acting manager identified some confusion concerning what qualifications are equivalent to a NVQ and advice is to be sought to clarify this. Induction training is not in place for staff. The acting manager expects to develop this programme with the deputy manager within the next few weeks and introduce it for new staff to begin with, although all staff will be expected to complete it. A Staff Handbook has been developed and given to staff, it includes information about the care practices in the home, health and safety as well as the homes policies and procedures. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 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): 31,32,33,35,36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The acting manager has a clear development plan and vision for the home, which she has effectively communicated to the residents, staff and relatives. Residents views are sought on a regular basis and there is evidence that they are acted upon. The residents health and safety may be at risk if staff do not follow safe practices when providing care and support. EVIDENCE: The acting manager has been in place since January 2006 and an application will be made to for her register with the Commission as the manager of the home when the delays with CRB checks enable it to be processed. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 21 The management style at the home is open and inclusive, encouraging residents, relatives and staff to be involved in reviewing and developing the services offered at the home. A quality assurance and monitoring system is not yet in place at the home, although the acting manager has developed a system, which will be introduced when the building work has been completed at the home. Residents, visitors and staff are encouraged to discuss with the management and staff any concerns they may have regarding any aspect of the home, its environment and the care and support provided. The manager confirmed that the home does not take responsibility for resident’s finances. Informal supervision takes place as part of the management process at the home, however formal supervision is not provided although the acting manager and deputy manager confirmed that they are planning to start this within the next week. Training required by legislation including moving and handling and fire training is provided for all staff. The training is moving and handling is to be reviewed and updated to ensure staff are aware of the correct procedures using handling belts. Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 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 3 3 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 2 X 2 Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 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 OP7 Regulation 15 18 (1)(c)(i) Requirement Care plans to be reviewed on a regular basis, with the involvement of residents, all relevant information to be recorded and staff training to be provided for registered nurses. A minimum ratio of 50 care staff trained to NVQ Level 2 or equivalent. An induction programme in line with Skill for Care be developed and introduced. Quality assurance and monitoring system to be developed and introduced. A programme of formal supervision be developed and introduced. Training in manual handling to be reviewed and repeated for staff as required. Timescale for action 14/07/06 2 3 4 5 6 OP28 OP30 OP33 OP36 OP38 18 (1)(a) 18 (1)(a)(c) 24 18 (2) 13(3)(5) 04/12/06 04/08/06 07/08/07 14/07/06 14/07/06 Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 24 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 Bendigo Nursing Home DS0000065151.V289780.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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