Inspection on 13/04/07 for Benham Nursing Home

This inspection was carried out on 13th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Benham Nursing Home 08/05/08

Benham Nursing Home 31/07/06

Benham Nursing Home 26/01/06

Benham Nursing Home 16/08/05

Benham Nursing Home 23/09/04

Benham Nursing Home 04/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Benham Nursing Home 217-219 Spital Road Bromborough Wirral CH62 2AF Lead Inspector Julie King Unannounced Inspection 13th April 2007 08:10 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 Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Benham Nursing Home Address 217-219 Spital Road Bromborough Wirral CH62 2AF 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) 0151 334 8533 0151 334 8533 Mr Michael Richard McGowan Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 29 OP (N) and 1 named adult (N) under 65, 13 OP (PC) within an overall number of 43 11th January 2007 Date of last inspection Brief Description of the Service: Benham is a care home providing both personal and nursing care for up to 43 older people. It is located in Spital, Wirral and is close to the facilities of Bromborough. The home stands in its own grounds and is made up of two former dwelling that have been adapted and extended to provide accommodation in a mixture of single and double bedrooms and with communal lounge and dining room areas. A conservatory and a pleasant, welltended garden are situated at the rear of the building. Local amenities such as shops, cafes and a library are within a ten-minute walk and the home has its own minibus. Fees range from £352 to £408 according to whether personal care or nursing service required, and privately arranged fees by individual agreement. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit took place over 5 hours. The manager, Mrs Pat Perry, accompanied the inspector throughout the inspection period. Personal files of both residents and staff were inspected, and a full tour of the building took place, which included all communal areas and some resident’s bedrooms. Staff and residents were spoken with as regards their view about the care home. The care home was clean tidy, had no malodour, and had adequate staffing levels to care for the residents. What the service does well: What has improved since the last inspection? What they could do better: Care planning documentation and recording still needs more improvement, as does pre-admission assessments, some areas of mandatory training, risk assessments and quality assurance. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents assessed needs are being met, and the home is able to provide assurances to residents and their representatives that assessments will be a continuous process throughout the resident’s stay. EVIDENCE: Pre admission assessments provide a basic assessment of actual and potential needs of each prospective resident; thus allowing a care plan to be developed. The pre-admission assessments are in need of updating and expanding in order to fully provide a holistic view of each resident, and the recording made on all assessments requires more detail and clarity. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 9 These assessments are completed by the manager and include demographic details of the prospective service user – next of kin, past history both medical and psychological health, and evidence involvement of representatives as needed. The activities staff also have an input into establishing resident’s life interests and areas that can be continued upon admission into the home. Multidisciplinary healthcare team (MDT) input is evident in resident’s care files, and include reference to NHS outpatient’s appointments, opticians, dentistry, and district nurse (DN) input at the home as needed. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a care planning system in place for all residents. This provides staff with most of the information they need to meet the resident’s needs. EVIDENCE: It was evident that the resident’s needs are currently being met through examination of the care planning process and conversations with residents and staff. The care plans did not all evidence clear and concise recording of the daily care delivery, and some of the risk assessments and monthly reviews were below the required standard. A requirement was issued to update and expand, with clear detail, all residents care plans as soon as practicable. Individual care plans have been developed with each resident, and those seen were in process of being updated and reviewed with the involvement of the resident’s families as far as possible. Systems are in place to ensure Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 11 communication between the care home, the NHS and other professionals involved in the care of the residents. All this contributes to the safety and well being of the residents. Prior to this site visit, one of the specialist nurses was spoken to and asked for their professional opinion of care delivery at this care home. The specialist informed the inspector that they had no cause for concern, and was complementary about the care provided. Medications were examined as a routine part of this site visit, and were all found to be managed in accordance with current good practice guidelines. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Links with the local community are good, and support and enrich the resident’s lives. Meals in Benham are good, offering choice and variety, and cater for resident’s special dietary needs. EVIDENCE: Residents in the home are asked on admission about their lifestyle, choice of foods, and choices and preferences of the social activities they would like to participate in. The residents informed the inspector that they enjoyed the variety of food in the home, and were accompanied by the inspector for their three-course lunch. Visitors are allowed in the home at any reasonable time for day, residents may entertain their visitors, in the communal lounges, or in their own bedroom. The gardens are landscaped and are an ideal setting for residents to sit with their relatives, especially in the warmer months. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 13 The activities co-ordinators have organised numerous indoor games and activities, and involve resident’s families as much as possible. The less able-bodied residents are also catered for and included with regular one-to-one sessions, such as hand massage, talking about past-times, reading newspapers together, etc. Residents spoken to told the inspector how pleased they were having this additional opportunity to enrich their lives. It was recommended that all records of activities contain more detail and are kept within each resident’s care file. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaint and adult protection policy and procedure was in place that helps ensure the safety and welfare of residents. EVIDENCE: The residents, relatives and staff can access complaint policies and procedures as and if necessary. The procedure includes information on ‘whistle-blowing’, in accordance with current Department of Health guidelines. The CSCI has not received any complaints about this service since the previous inspection. Most of the staff have completed training in adult protection, with the remaining having training planned for the near future. However all staff do receive basic training in the protection of vulnerable adults during induction. Residents are enabled to exercise their right to vote, either via post or in person; and there is no religious or political persuasion in the home. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All of the resident’s rooms are personalized, providing an attractive and homely place to live. EVIDENCE: Benham has pleasant gardens to the rear of the property that are accessible to residents. A patio area with seating is also provided. All communal areas and bedrooms were examined, and all were highly personalised, with many residents bringing in their own furniture and personal possessions. The overall fabric of the building is of a good standard. There is an ongoing programme of redecoration, with all areas being done as needed. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 16 On the day of this unannounced site visit the home was clean and did not have any malodour, with many areas including corridors, bedrooms and bathrooms being recently refurbished. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a consistency of care within the home provided by permanent staff, which helps to offer safety and stability for the residents. EVIDENCE: References were seen in all staff personnel files, and CRB and POVA information was also evident. The manager and registered provider were able to inform the inspector of their knowledge regarding the recruitment and retention of staff. Some of the references seen on staff files were from friends, not the staff member’s last employer as required. This was discussed with the manager who is going to obtain the latest regulations and requirements regarding recruitment this within the next few days. Training and inductions, including specific training on the protection of vulnerable adults was seen for most staff. The manager has developed a training plan for all staff, accessing many external training providers. The range of training and development includes medication management, moving & handling, health & safety, pressure sore prevention and NVQ in Care. This improvement should continue to be built upon. The manager has also Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 18 established in-house “link people” to obtain additional information and training as needed. Their role extends to cascade new information to the remainder of the home’s staff Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. Quality in this area is good. This judgement has been made using available evidence including a visit to this service. This home benefits from a good manager and staff team, thus helping to improve the quality of care given to residents. EVIDENCE: The manager has completed her NVQ4 Registered Manager’s Award, and has, in conjunction with her staff team, made an ongoing improvement to this service. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 20 Staff morale is high, and staff spoken to said they feel valued and appreciated, and are happy coming to work. Policies and procedures are updated as needed, and both the manager and qualified staff were able to demonstrate their ongoing professional development. Records are kept in accordance with the Data Protection Act 1998, and audits were available for some, aspects of record keeping. The quality assurance needs further development to fully encompass residents, relatives and visiting professionals views about the standard of care delivered at Benham, and how to continue to improve the service. Required health and safety certificates and service contracts were in place, valid and up to date, but is strongly recommended that the registered person designates some named staff to receive training and assessment in the checking of bed rails. Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 3 X N/A 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 3 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES 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)(b) Requirement The registered person must keep the service users plan under review ensuring that regular evaluations of care detail the effectiveness or otherwise of the care prescribed. Previous timescale of 28/02/07 not met. The registered person must establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided at the care home including the quality of nursing where nursing is provided at the care home. Previous timescale of 31/03/07 not met. The registered person must ensure that all pre-admission assessments are fully completed to give a holistic plan of a prospective resident’s needs. The registered person must ensure that all staff complete suitable and sufficient training regarding the protection of DS0000020931.V335994.R01.S.doc Timescale for action 30/06/07 2. OP33 24(10 30/06/07 3. OP3 14 30/06/07 4. OP18 13(6) 30/06/07 Benham Nursing Home Version 5.2 Page 23 5. OP29 19 vulnerable adults. The registered person must obtain all the documents and records as specified under this regulation for all persons employed, including a reference from that person’s previous employer. 30/06/07 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 OP12 Good Practice Recommendations It is recommended that participation in social and recreational activities be documented on the daily report records within the individual care files. It is strongly recommended that the hours of the activities coordinator be reviewed and provision for specialist training in activities provision be provided. It is strongly recommended that designated staff complete suitable and sufficient training in the competent checking of bed rails. 2. OP12 3. OP38 Benham Nursing Home DS0000020931.V335994.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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