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Inspection on 21/02/06 for Benedict House Nursing Home

Also see our care home review for Benedict House Nursing Home for more information

This inspection was carried out on 21st February 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This is a pleasant home to visit, with a friendly atmosphere, efficient staff, and well maintained premises. The management team are committed to keeping a high standard of care, and ensure that nursing and care staff are able to update their training and develop new skills and competencies.

What has improved since the last inspection?

Internal alterations to the building included altering a shared room on the ground floor into a single en-suite room. This had enabled the adjacent Manager`s office to be extended, enabling more private space for interviews and talking with relatives/visitors. An unused bathroom on the ground floor was in the process of being altered into a sluice room, with a separate disabled toilet in the next room. The addition of a sluice room on the ground floor will mean that staff no longer have to take commodes to other floors for cleaning, and this is much better for infection control. A new format for care plans had been commenced some months previously, and there was ongoing progress to put all care plans into this new format. The Inspector gave an extended timescale for completing these, in order to give sufficient time for the Manager and nursing staff to complete these without rushing. The management team had ensured that other requirements and recommendations given at the last inspection had been met.

What the care home could do better:

No additional requirements or recommendations were given. The home was running smoothly and efficiently.

CARE HOMES FOR OLDER PEOPLE Benedict House Nursing Home 63 Copers Cope Road Beckenham Kent BR3 1NJ Lead Inspector Mrs Susan Hall Unannounced Inspection 21st February 2006 10:15 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 Benedict House Nursing Home DS0000010127.V283511.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. Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Benedict House Nursing Home Address 63 Copers Cope Road Beckenham Kent BR3 1NJ 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) 020 8663 3954 020 8658 1337 Sunglade Care Ltd Vacant Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing Notice issued 17 January 2000 Date of last inspection 25th October 2005 Brief Description of the Service: Benedict House is a large detached building situated in a residential area of Beckenham. It is near to local town facilities, and is easily reached by public transport. The home is an older building, and is suitable for the nursing care of older people. The home’s owner lives in the vicinity, but he does not oversee day-to-day control of the home. Management is carried out by andmedia care. Accommodation is on four floors (lower ground, ground, first and second floors), and there are bedrooms situated on each floor. Access to all floors is facilitated by a passenger lift. There is a mixture of single and shared rooms, and some have en-suite toilet facilities. There are communal areas on the ground floor and lower ground floor, as well as smaller quiet areas on the first and second floors. The activities room on the lower ground floor leads out through patio doors to a small garden, which is enhanced by a patio area and tubs of flowers. Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out between 10.15 a.m. - 1.30p.m. The Manager was on duty and assisted the Inspector by showing her some alterations to the building, and locating some documentation. The Inspector met and chatted with several staff and service users while looking around the building. These included care staff, maintenance and nursing staff. The premises were very clean, and there were no offensive smells. The home is well decorated, and has good quality furniture and furnishings. There is a phased programme of internal alterations to increase the number of en-suite single rooms, to add an additional sluice room, and to fit a new bathroom. The Inspector had previously carried out an inspection visit in October 2005, and did not assess all of the National Minimum Standards at this visit. For a comprehensive view of the home it would be advisable to read this report in conjunction with the previous one. What the service does well: What has improved since the last inspection? Internal alterations to the building included altering a shared room on the ground floor into a single en-suite room. This had enabled the adjacent Manager’s office to be extended, enabling more private space for interviews and talking with relatives/visitors. An unused bathroom on the ground floor was in the process of being altered into a sluice room, with a separate disabled toilet in the next room. The addition of a sluice room on the ground floor will mean that staff no longer have to take commodes to other floors for cleaning, and this is much better for infection control. A new format for care plans had been commenced some months previously, and there was ongoing progress to put all care plans into this new format. The Inspector gave an extended timescale for completing these, in order to give Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 6 sufficient time for the Manager and nursing staff to complete these without rushing. The management team had ensured that other requirements and recommendations given at the last inspection had been met. 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. Benedict House Nursing Home DS0000010127.V283511.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 Benedict House Nursing Home DS0000010127.V283511.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 The Statement of Purpose and Service Users’ Guide are well produced, and contain all the necessary information to enable service users and relatives to make a choice about living in the home. EVIDENCE: The Statement of Purpose is set out in sections for easy reading, and includes all the required information from Schedule 1 of the Care Homes Regulations. The Service Users’ Guide is a comprehensive document which explains the philosophy of care, and gives details of staffing, visiting hours, terms and conditions of residency (e.g. smoking, use of alcohol, management of laundry, insurance data) and fee structure. It includes the complaints procedure, and has information about meal times, availability of social activities, and service users’ rights to make decisions about their treatment in a confidential environment. Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 – 10 Care plans include detailed information, enabling staff to give effective care to service users. Health and medication needs are met, and service users are treated with respect and dignity. EVIDENCE: The Inspector saw that service users were well groomed, and appropriately dressed for the time of year. They are assisted with getting up or going to bed at their preferred time wherever possible, and are able to sit where they wish, in private or with others. The Inspector viewed 4 care plans, of which 2 were in the new format and 2 in the old format. These all contained good levels of information. Pre-admission assessments are followed with further assessments on admission, and this data was very concise, and included updated health information, and personal, family, and social history. Risk assessments are completed for risk of falls, and for risks associated with wandering, infection, skin deterioration and orientation (e.g. hearing the fire alarm). Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 10 Other assessments are carried out for any wound care, risk of pressure sores, mobility needs and nutrition. These contained sufficient details – for example, mobility assessments specify if a hoist is needed, and which hoist and sling should be used. Care plans include specific details – such as: a plan for personal hygiene needs stated that a male service user preferred a bath to a shower, required medicated shampoo for hair washing, and preferred an electric razor. Other care plans cover aspects of daily living such as social and spiritual interests; nutritional needs and food preferences; sleep pattern; pressure area care; management of incontinence; pain management; confusion and orientation; communication ability and wound care. The Inspector read a care plan for a service user who required wound care, and this was well documented. The plan showed the treatment to be given, and the state of the wound at each dressing change. A Tissue Viability Nurse from the Primary Care Trust had visited on several occasions at the home’s request to give updated advice about the dressings to be used. Care plans in the old format contained the same amount of good information, but are less easy to follow. Nursing staff are working with the Manager to gradually put all plans into the new format. The Inspector sees this as an important task for the benefit of both staff and service users. The timescale of the previously given requirement has been extended, so that staff have sufficient time to carry out this work. Both nurses and care staff write a daily report for each service user, and take part in daily handovers to discuss the best ways to give the most effective care. The Inspector had been informed of a medication error during the previous month, and was pleased to see that this situation had been handled well, and properly reported and investigated. The home has good policies and procedures in place for the protection of service users. A requirement concerning the disposal of unused medication had been followed up, and a contract has been arranged for the proper disposal. Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 Service users are able to choose their lifestyles within the limits of their nursing needs. Opportunities for social activities are available, and visitors are welcome at any time. EVIDENCE: Many service users have high nursing needs, and are unable to carry out their previous levels of activities. The home provides opportunity to join in with other service users for singing and entertainment afternoons, birthday parties, in-house church services, and activities such as reminiscence and indoor games. A weekly activities programme is displayed on the home’s notice board, and service users are also kept informed by care staff. Bingo was particularly popular at the time of the inspection, and having coffee mornings together. Relatives are invited to take part if they are visiting. A visiting company had carried out a sensory workshop, and many service users had really enjoyed this. Residents’ meetings are held to discuss and plan future activities, and there is an Activities Fund to pay for new equipment/ entertainers. This was commenced with a raffle, and provides the opportunity for service users to decide how they want to raise future funds, and spend the proceeds. The Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 12 Manager produces a short newsletter each month, to keep service users and relatives informed about any changes to the home, new staff, and planned activities. Visitors are welcome at any time, so long as it fits in with the service users’ wishes. Service users are able to bring in their own personal possessions, and items of furniture as agreed with the Manager. The Manager has arranged links with Bromley Advocacy Services for any service users who require this support. Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 13 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): 16,17 The home has a clear complaints procedure in place. Service users’ legal rights are protected. EVIDENCE: The Inspector viewed the complaints log, and there had been no formal complaints since the last inspection. The Manager spends time talking to service users each day, and is quick to take action for any concerns raised by service users or visitors. The complaints procedure is easily accessible, and is included in each Service Users’ Guide, which is given to service users when they move into the home. Service users are encouraged to continue to take part in legal processes. Postal votes are arranged for the majority of service users at their request, although some prefer to attend polling stations in person when there is an election, and they are assisted in doing this. Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 14 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 - 26 The premises are well maintained, and clean and tidy. There is an ongoing phased plan of alterations to improve the property still further. EVIDENCE: The Manager took the Inspector to view each floor, and to see the improvements which had been carried out since the previous inspection. A few bedrooms were viewed, and bathrooms, toilets, sluice facilities and communal areas. The home was very clean, and there were no offensive smells in any areas. The home is already suitably fitted with wide corridors and a passenger lift, so that wheelchair access is available for any floor. Outdoor scaffolding had been removed since the previous inspection. This had been fitted for work on the roof – which had been completed, and for the completion of double-glazing to all rooms. Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 15 Alterations on the ground floor included changing a shared room into a single en-suite room. This work had been carried out to a high quality, and the room was pleasantly decorated and furnished. There are plans to alter other shared rooms during the next year. Building work is carried out with the minimum of disruption to the home. A ground floor sluice room was in the process of being fitted, using an unused bathroom space. This will assist in the management of infection control, as staff will no longer need to take commodes for cleaning to other floors. A bathroom on the first floor was being altered to include a “ Malibu” bath, which is easier for service users and staff to use in place of the existing bath. A new fire door had been fitted on the lower ground floor as an additional safety precaution between bedrooms and kitchen/laundry facilities. There was also an upgrading system in progress for fitting magnetic fire releases to each bedroom door. The home is suitably equipped with nursing beds, grab rails, assisted baths and hoists. The Manager said that the management team were looking to provide another hoist in place of a current manual hoist, and this was currently under discussion. All hoists had been recently serviced. New furniture had been purchased for some bedrooms, and this was of good quality. A newly decorated vacant bedroom was viewed, and this was very smart. Each room is colour co-ordinated with paintwork, carpet and soft furnishings. Each room has 2 sets of matching duvet covers and bed linen, so that the rooms always look pleasant. Some service users prefer to have their own duvet covers/curtains, and the staff ensure that these are clearly labelled for their use only. There is a laundry assistant on duty each day – including weekends, and these staff check that clothes and bed linen are properly labelled. The home has 3 lounges, and small quiet areas with armchairs on each floor. Activities for larger groups are carried out in the main lounge on the ground floor. There is an additional activities room on the lower ground floor, and this leads on to the patio, and out into the garden. Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 16 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 - 29 The home maintains good staffing levels, and promotes ongoing training for care staff and nurses. Recruitment procedures are well managed. EVIDENCE: The home had maintained the same staffing levels, to ensure that care staff are available on each floor during day and night shifts. There are 2 nurses for day shifts, and 1 at night times, as well as care staff. Nursing staff have good opportunities to meet their own training needs, and to increase their skills and competencies. The Inspector was informed that 3 nurses had completed training to change a “PEG” tube for gastric feeding, and nurses also have the opportunity to keep updated with skills such as venepuncture and wound care. Healthcare assistants are encouraged to study for NVQ 2 or 3, and 6 more had enrolled to commence this during 2006. 5 had already completed this training, and 3 were being trained. When these have all completed training, the home will have a ratio above 50 of care staff trained to this level. The home has good recruitment procedures in place, and a previous requirement to ensure all staff files include a staff photograph had been met. Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 17 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): 32,33,38 The Manager provides good leadership in the home, and promotes a culture of enabling staff to work well together. Service users and relatives are able to express their views and know they will be listened to. The home is run in such a way as to promote the health and safety of service users and staff. EVIDENCE: Regular staff meetings are held to give staff the opportunity to discuss ongoing situations, and to make decisions together about different aspects of care. The Manager has consistently provided good leadership, and is available to talk with staff, service users or relatives on most days. Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 18 Staff complete mandatory training during the induction period and the first few months of employment. The Administrator retains a staff training matrix to ensure that all staff keep updated with training. Accidents are recorded in accordance with Health and Safety legislation. Additional fire precautions were being put in place with a fire door on the lower ground floor, and magnetic door releases for bedrooms. These are over and above the fire officer’s requirements, and show a commitment to ensuring the home is as safe as possible for staff and service users. Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 19 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X X X X 3 Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? 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 (2) Requirement Ongoing requirement to complete all care plans in the new format. (Previous requirement with extended timescale). Timescale for action 31/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations To consider making space for a more suitable clinical room in long-term planning for the home. Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Benedict House Nursing Home DS0000010127.V283511.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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