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Inspection on 23/01/09 for Derwentside Dementia Care Centre

Also see our care home review for Derwentside Dementia Care Centre for more information

This inspection was carried out on 23rd January 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.

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Benfield Villa Care Home 157 Durham Road Blackhill Consett Durham DH8 5TH     The quality rating for this care home is:   two star good service 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: Nicola Shaw     Date: 2 3 0 1 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. that people have said are important to them: They reflect the things 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 Older People 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. Care Homes for Older People Page 2 of 28 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Benfield Villa Care Home 157 Durham Road Blackhill Consett Durham DH8 5TH 01207581596 01207588956 lk@mentalhealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mental Health Care care home 30 Number of places (if applicable): Under 65 Over 65 0 30 dementia old age, not falling within any other category Additional conditions: 30 0 The maximum number of service users who can be accommodated is: 30 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 30 Dementia - Code DE, maximum number of places: 30 Date of last inspection Brief description of the care home Benfield Villa is a care home providing personal care and accommodation for up to 30 older people with dementia. The registered provider is Mental Health Care. The home is located on the main street in Blackhill, which is an area on the outskirts of Consett and is close to houses, shops, a pub and other amenities. It was first opened in 1990 and consists of a two-storey building from the Victorian period. There are gardens to the front and rear, an indoor courtyard and car parking facilities. Care Homes for Older People Page 4 of 28 Brief description of the care home The accommodation is split into two units with the first floor accommodating older people with dementia. There is a passenger lift for access. There are no en-suites facilities but an adequate number of bathrooms and toilets are provided. Each unit has spacious lounge and dining areas including a conservatory leading from the ground floor lounge. A hairdressing salon is located on the first floor. The current weekly fee is £390.50 for a residential bed and £411 for a dementia bed. Care Homes for Older People Page 5 of 28 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 Health and personal care Daily life and social activities Complaints and protection peterchart Environment Staffing Management and administration Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations-but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Before the inspection visit: Care Homes for Older People Page 6 of 28 We looked at: Information we have received since the last inspection on 25th January 2007. How the service has dealt with any complaints and concerns since the last visit. Any changes to how the service is run. The providers view of how well they care for people. The visit: An announced visit was made on 23 January 2009. During this visit we: Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had knowledge, skills and training to meet the needs of the people they care for. Had a look around the home. Talked to residents, staff and visitors. Checked what improvements had been made since the last visit. We told the manager what we found at the end of the visit. What the care home does well: What has improved since the last inspection? Care Homes for Older People Page 8 of 28 There have been some improvements to the environment, such as the provision of a sensory room for people with dementia to relax in. Some of the bedrooms have also been re-decorated. What they could do better: 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 admissions process ensures that people are adequately assessed prior to care being offered. This means that service users are offered the right type of care at the home. Evidence: For prospective residents, funded by the local authority, the manager obtains a copy of the needs assessment and care plan from the care manager so that she can decide whether Benfield Villa is able to meet their needs. Senior staff also arrange to visit the prospective residents, before they move into the home, so that they can complete their own pre-assessment information with them. Residents commented in surveys that they had been provided with enough information about the home so that they could decide if it was the right place for them. One Care Homes for Older People Page 11 of 28 Evidence: person said that they were able to test the home first by staying for two weeks respite care, before deciding to move in permanently. Care Homes for Older People Page 12 of 28 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. There is good information in the care plans about the health and personal care needs of the residents. This ensures that everyone receives care and support in a way that they prefer. Staff care practices preserve the dignity and privacy of the people who live here. And medication administration procedures protect the residents. Evidence: A range of standardized assessments are in place that lead to the care plans being developed. These cover a number of areas such as communication, mobility and falls prevention, eating and drinking and pressure area care. A copy of the care plan is held on the computer as well as a hard copy being available for staff and residents to read. There are guidelines in place for staff to follow for those residents who have needs in relation to their behaviour. In such situations the home works closely with the Care Homes for Older People Page 13 of 28 Evidence: community psychiatric services ensuring that the residents receive the support they need. The care plans we looked at provided good information about the residents health and personal care needs and the support needed of staff to meet their needs. They are evaluated monthly and up-dated if there had been any changes to a persons care needs. No-one has a pressure sore in this home. Residents weights are monitored monthly and there is a graph on the computer so any changes in weight can easily be seen. There are food and fluid charts which are used if anyone has needs in this area. There was lots of evidence of involvement of a range of other health care professionals such as physiotherapists, community psychiatric nurses, as well as district nurses. The manager has access to the falls clinic and if necessary, she said a referral would be made through the GP for a resident noted to be falling frequently. Medication is stored in a locked, secure room. Senior staff administer the medication and all have completed training in the safe handling of medication. There are photographs of the residents on the Medication Administration Records (MAR) which helps the staff when administering the medicines. Senior staff order the medication from the prescriptions to ensure that residents are provided with the correct medication. There were no gaps on the MAR sheets, which we looked at which demonstrated that residents are receiving their prescribed medication. There is a small stock of controlled drugs. These are stored securely, and a random count of medication in stock balanced with the records. A medication review is carried out by the nurse practitioner each year. At this time they also check the residents blood pressure and weights. Staff were respectful in their approach towards the residents and ensured that their privacy was respected. Personal and intimate care tasks were carried out in the privacy of the residents own bedrooms. Staff referred to the residents by their preferred name and it was clear there was a good rapport between the staff and residents. Care Homes for Older People Page 14 of 28 Evidence: One relative said before my mam came to the home you could not have a conversation with her, now you can. They also said that staff always get in touch with a GP straight away if there is a problem and they would get in touch with me if mam has had a fall. A visitor to the home said staff have a lovely manner with the residents. Residents said they look after me very well. Care Homes for Older People Page 15 of 28 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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. Residents enjoy a variety of activities, and are able to maintain family and other contacts if they want to. This ensures residents have opportunities to lead a fulfilling lifestyle and do not become socially isolated. Residents are able to exercise control and choice over their lives, as far as is possible, which enables them to remain independent. Residents receive a varied menu, which promotes their general health and wellbeing. Evidence: The home has a dedicated activities co-ordinator and the range of activities available to residents is displayed on the notice board in the home. These include 1:1 chats, pampering sessions, a visiting pat dog and chair exercises. There are also trips out and in the summer the manager said she is hoping to arrange for day trips to places of interest such as the local medieval village. The activities co-ordinator completes a daily report and also carries out monthly evaluations of the activities she has provided. There is some information about the residents likes and dislikes and evidence of social Care Homes for Older People Page 16 of 28 Evidence: care plans being developed from this information. One resident said that they go out during the day for a short walk, weather permitting, their independence in this area is encouraged and supported by staff. Another resident visits the local Church. A church visitor comes to the home every week and was visiting the home on the day of our inspection. They give communion to the residents who request this. Children from the local school have also been invited into the home to talk to residents and the activities co-ordinator is arranging for a newspaper article to be published about one resident who is soon to reach the age of 100. Residents are offered a choice of where to have their meals and are able to spend time where they wish. Residents commented in surveys that they could do what they wanted to during the day. Throughout our visit friends and relatives were seen to freely come and go. During lunch we noticed that tables were nicely presented with napkins and table cloths. Those residents who needed support were offered this by staff. One relative commented that staff sit with mam as long as it takes and encourage her to eat. They said that the food always seemed nice with plenty of choices available. There is lots of home baking and when we visited freshly baked cheese and cherry scones were available for residents. There is also plenty of fresh fruit and vegetables available to choose from on the menu. The Menu is displayed on the menus board. It would be useful, to help those people who have dementia to make choices, if picture menus and/or written menus were also displayed on the tables. Care Homes for Older People Page 17 of 28 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 has a good complaints procedure so people know that their views will be listened to and acted upon. And staff training helps to ensure that the residents are protected from abuse. Evidence: The home has a complaints procedure and this is displayed in the entrance area of the home. The manager confirmed that this would be made available in different formats, such as Braille, if required. Relatives we spoke to said they have been provided with a copy of the complaints procedure and would have no hesitation in speaking to the manager if they had any concerns. Residents also said that they would have no hesitation in making a complaint. They also commented I have no complaints, I have no cause to complain, and I believe the response (to a complaint) would be appropriate to the situation, but to date I have had no reason to test this. We looked at the complaints book. There have been no complaints in the last year. There is also a compliments book, in which relatives have made many entries. Recent examples of these include, many many thanks for everything, and I dont tell you often enough, but I would like to thank you for all the lovely care. There have been no safeguarding referrals made in the last year. All staff have completed training in the protection of vulnerable adults and said that they would have Care Homes for Older People Page 18 of 28 Evidence: no hesitation in speaking to the manager if they had any concerns in this area. The manager and deputy have also completed deprivation of liberty safeguarding training. And plans are in place for all staff to complete this training. Care Homes for Older People Page 19 of 28 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the home is clean, residents to not benefit from a well maintained environment. The home offers a specialist service to people who have dementia, however, has not been adapted to meet the needs of this client group. Evidence: There have been some recent improvements to the environment, which have included the provision of a snoezelen room (this is a sensory room in which there are soft furnishings, fibre optic lights and soft music so people can relax), new none-slip flooring to some of the bedrooms and improvement to the gardens. There were no unpleasant odours when we visited and residents commented in surveys that the home was always or usually clean and fresh. Relatives said the home is always clean and any unpleasant odours are sorted straight away. They also commented that when their family members room was being re-decorated they were able to choose the colour. However, there are a number of areas of the home that need attention. Communal furniture throughout the home is old and worn with varnish chipped and fabric torn. Paintwork in the corridors is damaged as is the paint on grab rails. Wallpaper in the ground floor lounge is torn. Care Homes for Older People Page 20 of 28 Evidence: The environment for people living upstairs who have dementia is adequate. The lounge/dining room floor covering is badly marked and looks very unpleasant, corridors are bland, the flooring in bathrooms and toilets is heavily stained. There is very little to help people with dementia find their way around. For example, it is good practice in dementia care to have items which would be familiar to the individual on their door to help them find their own bedroom, grab rails and toilet seats should be bright contrasting colours to help people see them, consideration should be given to placing items of interest along corridors such as photographs of the area in years gone by to provide a point of interest. Some of the double glazed windows also need to be replaced as the seal is broken allowing for condensation to develop. We met with the manager and homes line manager after the inspection who have in place a plan to improve the environment, particularly for people with dementia. This includes changing the flooring in the dining room. The manager has also begun to research best practice in dementia care and when we visited work had begun to change the environment, for example, contrasting coloured grab rails along corridors. Staff have completed training in infection control. The manager is attending regular workshops in relation to this as part of a one year programme, to raise awareness of the issue and promote good practice. As a result of this signs have now been placed above wash hand basins reminding people to wash their hands. The manager has also carried out an observation of all staff washing their hands to ensure that this has been carried out effectively. Care Homes for Older People Page 21 of 28 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Staffing levels are sufficient, which ensures staff provide person centred care. Staff training is satisfactory and includes specialist training in order to meet the diverse needs of the residents. This ensures staff can effectively meet the care needs of people with dementia. Staff recruitment procedures fully protect the residents. Evidence: On duty when we visited was the manager, one senior and two care staff. There was also a cook and two domestic/laundry staff. We asked staff if they felt there was enough staff on duty to meet the needs of the residents and they said there is always plenty of staff. There is also a one hour handover period in the afternoon so that information about the residents health and personal care needs can be effectively shared between shifts. There has been a low turnover of staff, which is good for continuity of care. Eighteen out of twenty staff have completed the NVQ level 2 qualification in care. Staff we spoke to said that they had been offered the opportunity of completing the NVQ level 3 qualification in care. In addition to this the manager has arranged for regular internal Care Homes for Older People Page 22 of 28 Evidence: training. This has included awareness training about dementia and challenging behavior provided by the community psychiatric nurse, and training on nutrition, provided by the dietitian. Three staff will be attending training in palliative care. Staff said about training training is offered all of the time. We spoke to staff about training in the needs of people with dementia. They said that they had not received any yet but said that the manager was arranging distance learning training for them in relation to this. Staff said I like it here and theres good team work. Relatives spoke positively about the staff and there was clearly a good rapport between the residents and staff. Relatives said about staff welcoming, friendly,absolutely wonderful, always have a smile, and nothing is too much bother A visitor said staff are very pleasant, caring, lovely manner and very keen. Residents said in surveys staff could not be better, and the carers are very helpful. All new staff complete induction training. Staff files showed that the companys recruitment procedures are followed. This includes obtaining two written references and an Enhanced Criminal Records Bureau check to ensure that the prospective staff member is suitable. Care Homes for Older People Page 23 of 28 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. Good management systems ensure the health, safety and welfare of residents. There is a good quality assurance system. This is based on the views of residents, where they are able to communicate their wishes, so that they know their rights and views will be listened to. Evidence: The manager has worked for the company for a number of years and is an experienced manager. She has completed the Registered Managers Award, an NVQ level 4 qualification in care and continues to up-date her knowledge by attending other training such as palliative care, alongside her staff. Although the manager only has two hours per day dedicated management time she said that she found this to be sufficient. If she needed additional time she said she could request this from the company. Relatives said about the manager Lynne is lovely, couldnt wish for better. Care Homes for Older People Page 24 of 28 Evidence: A relative satisfaction questionnaire is used to obtain feedback about the service. These are sent out by Head Office each year and information from these used to improve the service. A summary of the outcome of these is prepared by the manager and sent to all of those people who took part. Feedback is also obtained from the complaints and compliments forms freely available in the home. We looked at how the home manages the residents personal allowance. Satisfactory records of these are maintained and receipts are obtained for any money deposited or withdrawn. The home carries out internal maintenance checks and has contractors to service equipment. A fire drill is carried out every month so that staff know exactly what to do if there is a fire. When we visited there was a safety gate, which had been fitted at the bottom of the staircase to prevent one resident from climbing up these. We were concerned about this as this was a fire exit and asked the manager to seek advice from the fire authority. The manager told us at the time of the inspection that the gate was no longer needed and would remove it straight away. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 26 of 28 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 Requirement Timescale for action 1 19 23 The environment must be 08/10/2009 adapted to meet the needs of the people who live here. This is to ensure the welfare and independence of residents is fully promoted. 2 19 23 All areas that residents have 08/10/2009 access to must be decorated and furnished to a reasonable standard. This is to ensure residents benefit from a well maintained place in which to live. 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 Requirement Timescale for action 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 15 It is recommended that a picture menu be developed to help people with dementia make choices about what to eat. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!