Inspection on 16/08/05 for Benham Nursing Home

This inspection was carried out on 16th August 2005.

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

Benham Nursing Home 08/05/08

Benham Nursing Home 13/04/07

Benham Nursing Home 31/07/06

Benham Nursing Home 26/01/06

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 Les Hill Unannounced Tuesday, 16 August 2005 09.30 th 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 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 F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 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 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 N Care home with Nursing 43 Category(ies) of OP Old Age 43 registration, with number of places Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 29 OP (N) and 1 named adult (N) under 65, 13 OP (PC) within an overall number of 43 Date of last inspection 23rd September 2004 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, well tended 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. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Benham care Home was undertaken on Tuesday 17th August 2005 over a period of 4 hours and involved the examination of some records, a tour of the building and conversation with seven residents, one visitor to the home and four staff. The inspection was part of the Commissions requirement to visit and report on each registered care home on two occasions each year. What the service does well: What has improved since the last inspection? The homeowner has evaluated the level of nursing staff required at the home. Staff told the inspector that they were receiving supervision on a regular basis. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 Page 6 The inspector was told that residents meetings are being held. 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. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, 4, 5 and 6. Residents and their representatives know that the home will meet their needs. EVIDENCE: The home’s statement of purpose and service user guide were examined during the CSCI inspection on 23rd September 2004 and found to contain all the appropriate information to enable prospective residents and their families to make a decision about whether the home could meet their needs. At the time of this inspection the documents were being amended to ensure the information is relevant and up to date. All of the residents are provided with a contract/terms and conditions of residence that are updated in accordance with the annual increase in fees. The manager of the home completes a pre-admission assessment on all prospective residents to ensure that the home is equipped to meet their needs. The documents are maintained separately to the day-to-day care files in the home. However, once the resident is admitted a working assessment document is produced to identify the main areas of need for staff to address. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 Page 9 From discussions with staff on duty at the home, from the examination of records and from discussion with some of the residents, the inspector was satisfied that the home is able to meet the needs of residents currently accommodated at Benham. Staff at the home invite prospective residents and their families/friends to visit the home and to spend some time there before making a decision to move in and offer a two-month trial period of residence before they make a decision to stay. The home is not contracted to provide intermediate care. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10 and 11. The health and personal care needs of residents are set out in individual care plans and were being met. EVIDENCE: The home uses a “Cardex” system for maintaining individual records. Five care files were examined during the inspection. They contained a copy of the home’s assessment and care plans for each of the individual resident’s identified needs. The inspector was informed that the new manager at the home is in the process of reviewing and updating the care plans to ensure they remain appropriate and give clear instructions to staff about the ways in which each area of need is to be supported. There was evidence from signatures on the documents that care plans were being reviewed and where a revision to the plan had been necessary, it was rewritten out in detail below the original record so that staff could note the changes that had been made. Risk assessments are in place for residents who are susceptible to pressure sores and the home follows appropriate skin mapping and evidence gathering Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 Page 11 to identify the progress of healing. The PCT Tissue Viability Nurse is contacted for advice as necessary. The home uses the services of local GP’s and arranges for optician and dental support as necessary. The continence adviser undertakes an assessment of residents who are incontinent but there is a considerable time delay before the resident is provided with the necessary equipment. A sample check of the home’s medicines was undertaken. Wherever possible tablets are provided in “blister packs” to aid the management of medicines in the home. The check confirmed that most of the medicines were being managed satisfactorily. However, for one controlled medicine, although the numbers of tablets was correct, the records didn’t permit a clear audit trail. The staff on duty said that they would ensure the records were amended appropriately. Two of the homes residents hold their own medicines that they keep in a locked drawer in their bedroom. Although the staff were satisfied that the medicines were safe and the residents were deemed to be capable of managing the medicines there was no written risk assessment on file. Risk assessments should be undertaken whenever a resident manages their own medicines and reviewed on a regular basis to ensure that the process remains safe. The home has made arrangements to change the supplying pharmacist so that access to important drugs can be achieved at weekends and bank holidays. The home’s underpinning values that include the maintenance of privacy and dignity are posted in the main entrance to the home. During an escorted tour of the building, the member of staff assisting the inspector knocked on bedroom doors before entering and introduced the inspector to each of the residents they met. Each of the residents who spoke with the inspector was complementary about the home and the staff. One of the residents told the inspector, “This is my home, and the staff very kindly help me to live here”. The home has a number of shared rooms. Mobile screens were evidenced in each of these rooms and the inspector was told that they are used to protect the privacy of residents when personal care tasks are being undertaken. The care plans seen during the inspection identified particular firms of undertakers that the residents or their families had specified should be used at the appropriate time. The information confirmed that this area of the work with residents was being explored. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 and 15. The home’s newly appointed activities organiser is approaching her role with sensitivity and is responding to the needs of residents. Residents are supported to make contact with family and friends. Food provided in the home is of good quality. EVIDENCE: The inspector met with the home’s activities organiser who had recently been appointed to work in the home for 10 hours each week. She had produced project plan for her work that involved getting to know the residents and finding out from them what kind of activities they would enjoy. Realistically she had decided that she would undertake one-to-one, or small group activities to start with so that residents could feel that they were able to make choices about engaging with her and others in the home. If residents then indicated a wish to participate in larger group activities she would take the necessary steps to arrange appropriate opportunities for them to do so. The home does have its own minibus and small groups of residents are taken out to visit places of interest. Entertainers are brought in to the home from time to time and the traditional games of Bingo are organised. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 Page 13 The home operates an open visiting arrangement. Residents can choose to meet with their relatives, friends or visiting professionals in the privacy of their own room or in one of the communal areas. Residents told the inspector that they are able to make choices about their everyday lives, what times they get up and go to bed, what to wear, what to eat and how to spend their day. All of the residents who spoke with the inspector were complimentary about the home and the staff. Residents were also complimentary about the food served in the home. They said that the variety, quality and quantity were all very good. The home has a four-week menu that identifies the meals enjoyed by residents and the opportunity for choice. Residents who don’t like, or don’t wish to take the main meal on offer are provided with an alternative meal of their choice. Special diets are catered for. Dining tables were laid out with tablecloths, napkins and individual place settings. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17 and 18. Residents are listened to and are protected from abuse. EVIDENCE: The home has a complaints procedure in place that is contained in the service users guide. There have been no complaints made to the home or to CSCI since the previous CSCI inspection in September 2004. All of the residents are listed on the Electoral Register and have the opportunity to vote in national and local elections. The home has adult protection policies and procedures in place and has a copy of Wirral’s adult protection procedures. Senior managers and staff are aware of the POVA Regulations. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26. Residents live in a safe, well-maintained environment. EVIDENCE: Benham Care Home with Nursing is situated in Spital Wirral close to the shopping complex at Bromborough and to local amenities. It was created from the adaptation and extension of two former private dwellings to provide places for 43 older people. At the time of this inspection the home’s electric wiring circuits and lighting were being upgraded. Off road car parking is provided at the front and pleasant well-kept gardens are maintained at the back of the home. The home is well decorated, carpeted and furnished in a homely style. Accommodation is provided on three floors with lift and stair access. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 Page 16 The home has two dining rooms, four lounges and a conservatory. The conservatory is the designated smoking room. Lighting throughout the home is domestic in character. Bedrooms throughout the home are decorated and furnished to a good standard. Some of the rooms are shared but prospective residents are advised before admission if the vacancies are in shared rooms. Residents can request to be moved to a single room when one becomes available. Movable screens are provided to ensure privacy in double rooms. Residents are encouraged to bring small items of furniture (fire regulations permitting) and other important possessions to personalise their room. All of the bedrooms in the residential care area of the home have an en-suite WC and wash hand-basin and a bath or shower. Many of the bedrooms in the nursing care areas have an en-suite WC and wash hand-basin. There are adapted bathrooms and accessible WC’s throughout the home. Specialist equipment is provided to support staff and residents where necessary and the home has its own hoists and pressure relieving mattresses. A resident’s callsystem is installed in all bedrooms, bathrooms and communal areas. Thermostatic valves do not control hot water delivered to wash hand-basins in resident’s bedrooms. However, the temperature of hot water to baths and showers is controlled in this way. On the day of this inspection the temperature was above the recommended limit and this was probably due to either the work being carried out on the electric wiring systems or to preliminary work being carried out on the homes boilers. The homeowner told the inspector that he would resolve the matter. On the day of this inspection the home was clean and well cared for and there were no offensive odours present anywhere in the building. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 28. Appropriate staffing levels were being maintained. EVIDENCE: The home employs a manager, 7 registered nurses and 28 care staff. Staff rotas ensure that from Monday to Friday during the week there is the Manager, who is an RGN another RGN and seven care staff on duty. At night there is an RGN and two care staff on wakeful duty and a member of staff sleeping in. Separate cooks and domestics are employed to work in the home. The homeowner told the inspector that staffing levels are monitored and that additional care staff are brought in when necessary. The homeowner is also monitoring the dependency levels of residents requiring nursing care and will adjust the levels of trained nurses when necessary. At the time of this inspection only one resident in a nursing care bed required high levels of nursing support. The home is approved to provide “Adaptation Training” for nurses and two overseas nurses were going through the adaptation process at the time of the inspection. The home does not normally use agency staff but had needed to engage an agency nurse for the day of this inspection. It was clear that the adaptation nurse was well acquainted with the needs of the residents and was supporting the nurse and the inspector through the inspection of the nursing care areas of the home. The home does have its own “bank staff” who help out when necessary. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 Page 18 Ten of the homes care staff have a qualification at NVQ level 2 or above and two of the “bank staff” are also qualified. A further 4 staff are expected to complete the NVQ award by the end of August 2005. Other care staff are being encouraged to take up training that will need to an NVQ award in care at level 2 or above. Once confirmation of the awards has been given to staff currently in training, the home will have achieved the 50 standard for care staff with an award at NVQ level 2 or above. The home’s recruitment and selection processes and its staff training arrangements will be examined at the next announced inspection. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 and 38. The home is run in the best interests of residents. EVIDENCE: The home has a new manager who was appointed in February 2005 and who is awaiting completion of the registration process from CSCI. The manager was on annual leave at the time of this inspection and so it was not possible to fully gauge the impact she has had upon the home. However, residents and staff who spoke with the inspector said that the new manager was knowledgeable about the care and support of older people and was approachable. The inspector was informed that resident’s meetings had been held but staff were unable to locate the notes that had been taken. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 Page 20 Records inspected confirmed that the fire alarms and emergency lighting were tested weekly and a fire drill held been undertaken in March 2005. The homes boilers had been tested on 03/08/05. As reported earlier the homes electrical wiring and lighting systems were being updated. More detailed inspection of the homes management processes will be undertaken at the next announced inspection when the manager will be present. Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x x x 3 Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 Page 22 No 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 OP9 Regulation 13(2) Requirement The homes manager must ensure that a risk assessment is undertaken whever residents manage their own medicines. The homes manager must ensure that the audit trail for all medicines is clear. The homeowner must ensure that the temperature of hot water delivered to residents bathrooms is controlled to avoid scalding. Timescale for action 31/08/05 2. 3. OP9 OP25 13(2) 13(4) 31/08/05 31/08/05 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 None Good Practice Recommendations Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Liverpool Area Office 3rd Floor, 10 Duke Street Liverpool L1 5AS 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 Benham Nursing Home F52 F02 S20931 Benham V244573 160805 Stage 4.doc Version 1.40 Page 24 - 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. 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