Inspection on 26/01/06 for Benham Nursing Home

This inspection was carried out on 26th January 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 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 13/04/07

Benham Nursing Home 31/07/06

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 Les Hill Announced Inspection 26th January 2006 09:30 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.V273585.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. Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 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 Mr Glenn Bullock Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 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 16th August 2005 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. Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection of Benham Nursing Home was undertaken on Thursday 26th January 2006 over a period of four hours. It involved the examination of records, a tour of the building, discussion with the homeowner and manager, and talking with six residents. The home’s manager had completed a pre-inspection questionnaire that assisted the process. The inspection was part of the Commission’s responsibility to visit and report on each registered care home on two occasions every year. What the service does well: What has improved since the last inspection? What they could do better: Requirements have been made to improve the recording of medicines given out in the home and to ensure information about staff is kept as per national Minimum Standards. A further requirement has been made to ensure the temperature of hot water is monitored and controlled. Please contact the provider for advice of actions taken in response to this Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Benham Nursing Home DS0000020931.V273585.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 Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6 Residents and their representatives know that the home will meet their needs. EVIDENCE: The home’s statement of purpose and its service user guide were being updated at the time of this inspection. The new document should include all matters identified in Schedule 1 of the National Minimum Standards, Care Homes for Older People. 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 DS0000020931.V273585.R01.S.doc Version 5.1 Page 9 From an examination of records, from observations during the inspection and from discussion with some of the residents in the home, the inspector was satisfied that Benham is able to meet the needs of residents currently accommodated. Prospective residents and their families/friends are invited to visit the home and to spend some time there before making a decision to move in. A twomonth trial period of residence is offered before they make a decision to stay. The home is not contracted to provide intermediate Care. Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 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. Four 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. Some of the care plans had been re-written to provide staff with more detailed guidance on the support required. There was evidence from signatures on the documents that care plans were being reviewed and where a revision to the plan is necessary, it is rewritten out in detail below the original record so that staff can note the changes that have been made. Where changes are not required a note from the review is recorded in the day-to-day notes for the resident. Risk assessments are in place for residents who are susceptible to pressure sores and the home follows appropriate skin mapping and evidence gathering to identify the progress of healing. The PCT Tissue Viability Nurse is contacted Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 Page 11 for advice as necessary. One resident had a pressure sore, from a stay in hospital, which was being treated. 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. It was noted that a number of MAR sheets had hand written entries that were not easy to read. Staff should be reminded that all entries onto a MAR sheet should be printed legibly and signed by two members of staff. It was also noted that some of the MAR sheets had not been completed on one particular night shift (identified to the manager) and the medicines to be taken were not in the “blister” pack. A “homely remedy” list confirmed by the appropriate GP was held for each of the residents. Two of the homes residents hold their own medicines that they keep in a locked drawer in their bedroom. Staff were satisfied that the medicines were safe and the residents were deemed to be capable of managing them. Written risk assessment were held with the MAR sheets. The home has changed its supplying pharmacist and can now access important medicines 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 manager 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, “You won’t find anything wrong here the home is very good and the staff are very kind”. 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 DS0000020931.V273585.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 A range of activity is provided in the home. Residents are encouraged and supported to maintain contact with family and friends. Food provide at the home is of a good quality. EVIDENCE: The inspector met with the home’s activities organiser who appointed a short time before the previous inspection. She was undertaking some one-to-one and small group activities as well as engaging the larger group. She had also made a link with a local school and had arranged for some older pupils to do a Duke of Edinburgh Award programme and for others to help with activities and entertaining the residents. The home has its own minibus and small groups of residents are taken out to visit places of interest, usually during the summer months. Entertainers are brought in to the home from time to time. A local parish priest visits residents who have indicated their wish to take communion and staff will contact clergy of other denominations and faiths if requested to do so. Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 Page 13 The home operates an open visiting arrangement. Residents can choose to meet with their relatives, friends or any 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 DS0000020931.V273585.R01.S.doc Version 5.1 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 the following standard(s): 16, 17 and 18 Residents are listened to and are protected from abuse. EVIDENCE: The home has a complaints procedure in place. Only one concern had been raised with the home since the CSCI inspection in August 2005 and the matter had been dealt with appropriately. All of the residents are listed on the Electoral Register and have the opportunity to vote in local and national elections. The home has adult protection policies and procedures in place that link with the local authority’s own procedures for the reporting of concerns. Senior staff are aware of the POVA regulations and training is planned to inform all staff of the ways in which the regulations are applied. Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 Residents live in a safe and well-maintained environment. EVIDENCE: Benham Care Home with Nursing is situated in Bromborough Wirral close to the village centre, a large shopping complex and local amenities. It was created from the adaptation and extension of two former private dwellings to provide places for 43 older people. The home’s electric wiring circuits and lighting had been upgraded and new hot water boilers installed. Plans were in place to renew carpeting in several areas of the home. The manager told the inspector that a CCTV camera positioned on the dining room wall had been disconnected when the homeowner became aware of the Commissions views on the use of surveillance equipment to monitor residents. A wall mounted TV in the front lounge of the home is only viewable by a small number of residents. Consideration should be given to its position so that it is available to more of the residents who use this room. Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 Page 16 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. 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. Hot water delivered to baths and wash hand-basins in resident’s bedrooms. Is controlled from the boiler. However, on the day of this inspection hot water delivered to a wash hand-basin in one of the WC’s exceeded the recommended temperature. The temperature of hot water delivered to one of the baths was at an acceptable level. The home’s manager should ensure that hot water is safe and that risk assessments are undertaken where there is a concern about any resident’s ability to manage or control its use. It is recommended that thermostatic valves control the temperature of hot water delivered to baths and showers. On the day of this inspection the home was clean and well cared for and there were no offensive odours present in general areas of the building. Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Appropriate staffing levels are being maintained. Staff records should be upgraded. EVIDENCE: The home employs a manager, 7 registered nurses and 27 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 home is registered to provide adaptation training for overseas nurses. The manager told the inspector that staffing levels are monitored and that additional care staff are brought in when necessary. The dependency levels of residents requiring nursing care are also monitored and during previous inspections the homeowner has indicated that he will adjust the levels of trained nurses should this become necessary. The home does not normally use agency staff but has its own “bank staff” that help out when necessary. Eight of the homes care staff have a qualification at NVQ level 2 or above and two of the “bank staff” are also qualified. The home’s overseas staff that are completing adaptation training are regarded as having the equivalent of NVQ Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 Page 18 at level 3. Other care staff are being encouraged to take up training that will need to an NVQ award in care at level 2 or above. The home’s recruitment and selection processes were examined through sample staff files. Four files were selected. An application form had been completed but one of the files contained only one reference. Confirmation of identity documents was more evident on the files of overseas staff. CRB clearances had been obtained although one had been accepted from a previous employment. The home’s manager must ensure that all the documents identified in Schedule 4 of the National Minimum Standards, Care Homes for Older People are in place for all staff employed to work at Benham. Induction training is provided for new staff and refresher training is available in moving and handling, first aid, food hygiene and fire safety. The manager is arranging training in dementia care and in palliative care for the qualified nurses and will provide training in POVA for all staff. Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38. The home is run in the best interests of residents. EVIDENCE: The home’s manager was appointed in February 2005 and is awaiting completion of the registration process from CSCI. The homeowner lives on-site, the previous manager works as a deputy manager in the home and the homes administrator has been in post for some considerable time. All are well known to the residents and their families. Residents who spoke with the inspector were complimentary about the support they receive. None of the CSCI’s feedback forms for residents and relatives had been returned. Appropriate insurance arrangements are in place. Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 Page 20 The Commission is not aware of any matters that would affect the ongoing operation of Benham. Staff at the home do not manage any money on behalf of the residents. Accounts are made out for newspapers, hairdressing, chiropody etc and given to residents or their relatives as agreed in advance. Arrangements were in place for the regular and formal supervision of staff. The manager told the inspector that it is her intention to cascade the arrangements by using trained nurses as part of the supervision process. Notes from supervision sessions were located on staff files seen during the inspection. All records examined during the inspection (except those referred to in standards 9 and 29) were being maintained to a good standard. Records confirmed that the fire alarms and emergency lighting were tested weekly and a fire drill’s were being held. Catering staff maintain records of the temperatures of fridges and freezers and the temperatures of food during the cooking processes. Staff have thermometers to check the temperature of hot water but more frequent checking should be undertaken as identified earlier in this report. Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 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 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 Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 2 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 3 3 3 3 3 3 3 Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 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. 2. Standard OP9 OP25 Regulation 13(2) 13(4) Requirement The manager must ensure that records of medicines given out in the home are kept appropriately. The homeowner must ensure that the temperature of hot water delivered to resident’s bathrooms is controlled to avoid scalding. The home’s manager must ensure that staff records are maintained as per Schedule 4 of the National Minimum Standards. Timescale for action 26/01/06 28/02/06 3. OP29 17(2) 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Benham Nursing Home DS0000020931.V273585.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 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 DS0000020931.V273585.R01.S.doc Version 5.1 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. 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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