CARE HOMES FOR OLDER PEOPLE
Benkhill Lodge - North Yorkshire County Council Benkill Lodge 38 Benkhill Drive Bedale North Yorkshire DL8 2ED Lead Inspector
Denise Rouse Unannounced Inspection 20th December 2005 10.35a 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 Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 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. Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Benkhill Lodge - North Yorkshire County Council Address Benkill Lodge 38 Benkhill Drive Bedale North Yorkshire DL8 2ED 01677 422 407 01677 427426 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) North Yorkshire County Council Miss Amanda Jane Whitehouse Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st April 2005 Brief Description of the Service: Benkhill Lodge is a care home for 35 older people aged over 65 years who do not have any specialist requirements. The home was purpose built approximately 35 years ago and is located close to the centre of the busy market town of Bedale. All bedrooms are intended for single occupancy and those on the upper floor are accessible via passenger lift Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 4 hours and was carried out by one inspector, following half a day’s preparation. Gill Parkin Team Manager was available to assist in the inspection process. The registered manager was not at the home at the time of the inspection. A tour of the premises was completed, which included both bedroom and communal areas. A number of service users and staff were spoken with. The view of a visiting professional was also sought. Some records were inspected, including staff rotas, service users care profiles including care plans and risk assessments. Records of complaints, staff training, service users personal allowance accounts and controlled medications were also examined. Maintainace records for the home were also observed. The inspection concluded with a partial feedback session, involving Gill Parkin, Team Manager and Denise Rouse, Regulatory Inspector. What the service does well: What has improved since the last inspection?
Care staff are undertaking a distance-learning course “Safe Handling of Medications” via York University. Care staff are observed giving out medications by the registered manager to ensure they are competent. A controlled drugs register has been commenced. The registered manager has achieved the National Vocational Qualification Level 4. Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 6 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. Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 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 Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 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): None of these standards were inspected. EVIDENCE: Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7 8 9 10 The service users health and personal care needs are recorded; however further detailed information is required to ensure that full and appropriate care can be provided. EVIDENCE: Staff were seen knocking on doors prior to entering service users rooms. The service users stated that they were treated with dignity and respect. One Service user stated, “ the staff are very good, they look after me.” Service users care profiles examined confirmed that contact with optician’s chiropodists and other care professionals took place. The local General Practitioner attends the home every Tuesday he stated, “ The staff are genuinely excellent, very caring staff, and the level of communication is good.” Special equipment to prevent pressure sores was provided. There were stand aids and hoists available for service users who required them. One service user had recently had an accident that was recorded correctly, but his care profile did not contain an updated risk assessment. Other care plans inspected contained basic information about service users needs, but this was
Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 10 not detailed enough to ensure comprehensive and full care could be given. The Team Manager stated “ Further details regarding individual service users care are given to staff verbally at report.” This information must be documented. Training for care staff relating to medications had been commenced, a member of staff stated, “The course is very good, I have learnt a lot.” A controlled drugs register has been implemented and the balances were correct and up to date. The cabinets utilized for this purpose require adaptation, to ensure they comply with current legislation. The registered manager has other responsibilities, which take her away from the home. Her office is situated in a bungalow on the site. Although staff assured the Inspector that regular contact was made with the registered manager regarding all aspects service users care and the day to day running of the home, some concerns were raised. The team manager stated, “ The registered manager does not usually work shifts in the home, but due to staff shortage over Christmas she is working two shifts.” A visiting professional expressed “ the management structure is difficult to understand, the manager is not here a lot of the time.” There were two team managers taking charge of the home, a third was not able to fulfil shifts at present. Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected. EVIDENCE: Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 12 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): Standard 16 Service users can be confident that their complaints or concerns would be investigated and appropriate action taken to resolve any issues. EVIDENCE: There have been no complaints received since March 2004. There was a complaints procedure in place at the home. Information relating to complaints received was recorded. The date, and name of complainant was recorded. An outline of the issue raised, investigation process and outcome was adequately documented. The response of the service user to the outcome of the complaint was also recorded. Service users spoken with stated they would speak to the person in charge of the shift or the manager if they had any concerns. Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 13 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): None of these standards were inspected. EVIDENCE: Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 14 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): Standard 27 30 Service users needs are met, by adequate numbers of suitably trained staff, however some further training is required. EVIDENCE: The skill mix and numbers of staff were adequate for the needs of the service users on the day of the inspection. An off duty rota was in operation which indicated there were more staff on duty during the daytime, this was to cover peak times of activity. Staff are trained in relation to fire procedures, food hygiene, first aid and Back care. Newly appointed care staff undertakes induction and foundation training. The documentation observed relating to this did not include the start dates for the individual members of staff. Night staff undertake fire training twice a year, in view of the fact there are fewer staff on duty at night, training to this group of staff should be increased. There were no training records for kitchen and domestic staff relation to the Control of Substances Hazardous to Health (COSHH). This should be provided and recorded. Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 15 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): Standard 35 38 Service user health, safety and financial interests are safeguarded by the homes policies and procedures. EVIDENCE: Service users financial interests are protected by the homes policies and procedures. Several service users personal allowance balances were checked and found to be correct. Each service users personal monies were stored separately and locked away safely. The home also had records of other valuables stored; three entries’ were checked and found to be correct. Records pertaining to the maintenance of the building were examined; some were faxed to the Commission for Social Care Inspection the morning after the unannounced inspection. All documentation and relevant maintenance were
Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 16 satisfactory. The recordings of water temperatures were not available at the time of the inspection; two water temperatures in service user bedrooms were checked. One of these in a room that was unoccupied was slightly higher than the 43 degrees centigrade limit. This was pointed out to Gill Parkin, Team Manager .The contractors were contacted and they attended the home the day after the inspection to rectify this. Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 17 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 1 Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? No 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 (1) (2) Requirement The Registered Manager must ensure that all service users care plans and risk assessments contain adequate detailed information to ensure their needs are met. Risk assessments and care plans must be reviewed at least monthly, and when service users needs change. The Registered Manager must ensure controlled drugs administrated by staff are stored in a metal cupboard, which complies with the Misuse of Drugs (safe Custody) Regulations 1973. The Registered Manager must ensure that water temperatures are maintained at around 43 degree centigrade. Timescale for action 20/12/05 2 OP8 13 (2) 31/01/06 3 OP38 13 (4) (a) 20/12/05 Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 19 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 OP30 Good Practice Recommendations Staff using washing and cleaning solutions should receive training pertaining to the Control of Substances Hazardous to Health (COSHH). This should be recorded. Staff who are on night duty should undertake fire training on a three monthly basis. Benkhill Lodge - North Yorkshire County Council DS0000034358.V266978.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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