This inspection was carried out on 21st April 2005.
CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.
CARE HOMES FOR OLDER PEOPLE
Benkhill Lodge 38 Benkhill Drive Bedale North Yorkshire DL8 2ED Lead Inspector
David Martin Unannounced 21st April 2005 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. Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Benkhill Lodge Address 38 Benkhill Drive, Bedale, North Yorkshire DL8 2ED 01677 422407 01677 427426 benkhill.lodge-nyccss@btinternet.com North Yorkshire County Council 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) Amanda Whitehouse Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 16/09/04 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 J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of 4 hours on 21 April 2005. The home did not know the inspection was going to take place. It started at 09:30. The plan for the inspection was to check whether the home had met previous requirements and recommendations; to talk with service users about living in the home; to meet with care and kitchen staff and the home’s management team; and to look at records. What the service does well: What has improved since the last inspection? What they could do better:
The Team Managers said that they were not always confident about the admission process and would like to look at current practice to see where improvements could be made. Whilst the administration of medication is generally good there is action that could be taken to make practice safer for service users including the introduction of a ‘Controlled Drugs Register’ and training for staff. The home is well-managed but the manager has yet to obtain an NVQ4 in care. Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 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. Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 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 Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 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) 3 The assessment of service users is managed well ensuring that individual care needs can be met within the service. EVIDENCE: A referral for a placement in the home includes a care management plan that contains information about a services user’s health and social care needs. The plans are usually completed in sufficient detail for the management team to decide whether the home could meet identified needs. A pre-admission assessment pro-forma has been developed which assists in the decision making process. A service user recently admitted to the home said she understood the assessment and review process and was aware that she could decide whether the home was right for her. The team managers said that they were not always confident about making the right decisions as to whether the home could meet a prospective service user’s needs. They have discussed with the registered manager proposals to review the admission process to identify where improvements could be made. They would like to include a day’s assessment in the home itself to enable them to observe how a prospective service user manages in the ‘new’ environment.
Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 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 standard(s) 7 & 9 Individual health and personal care needs are well met but improvements are required to ensure the administration of medicines continues to be carried out safely. EVIDENCE: A service user plan has been developed for each service user that identifies needs associated with health, personal and social care. This ensures that staff are clear about what is required of them in meeting a service user’s needs. Each plan sets out the tasks that a service user can manage without help and those where support is required from staff and other health care professionals. Many service users were very positive about the manner in which staff members helped them with day-to-day tasks. A visiting District Nurse said the standard of care provided by staff was good and that staff referred service users to the district nurses at an early stage. The administration of medicines is generally carried out safely and within current guidance on good practice. An area where improvements could be made, however, concerns controlled drugs. A ‘controlled drugs register’ is required to ensure that drugs falling within this category can be properly accounted for and administered safely. To maintain good practice standards, a
Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 Page 10 recommendation was made in the last inspection report that staff responsible for medication should undertake training that included a test of competence. This is still required. Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 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 standard(s) 12 -15 The recreational and social needs of service users are well catered for which enables service users to make daily choices and promotes independence. EVIDENCE: There was good practice relating to the promotion of independence and social contact with people outside the home. Service users said that they are able to see their relatives and friends and this was also observed. An activities organiser was in the home on the morning of inspection and was engaged in discussion and a craft session with service users. Service users were able choose whether or not they wish to be involved. One service user said she was able to take a taxi to town and to catch a bus if she wished to go further afield. Staff said they had time to talk with service users. Interdenominational services are held in the home enabling service users to fulfil any religious needs. Without exception, service users said that the food was good. Observation of the lunchtime meal provided evidence that service users were able to make choices about the meals they wished to eat. The meal was unhurried. Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 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 standard(s) 18 There are well-established systems for safeguarding service users which helps in their protection from abuse. EVIDENCE: The home had in place policies and procedures for the protection of vulnerable adults from abuse. This provides a good reference point for staff to report any concerns accurately and promptly. Staff were able to give a clear account as to action they would take. There were modules in the NVQ2 training package which helped staff understand issues of abuse. There were procedures in place regarding the recruitment of staff and there was evidence that adequate vetting of prospective staff takes place. This is good practice as it recognises the importance of recruiting appropriately qualified and experienced staff as a means of helping safeguarding service users from abuse. Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 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 standard(s) 19 & 26 The home was clean and well-maintained providing service users with a safe and pleasant environment. EVIDENCE: Benkhill Lodge was a well-maintained home providing a safe and comfortable environment. Décor throughout was in good condition and the manager is able to arrange for ongoing maintenance to be carried out as budgets allow. Improvements to the ground floor male toilets have been identified and work is due to commence soon. Bedrooms reflected the individual taste of service users and service users confirmed that they can bring their favourite possessions. This helps service users cope with the move from home to a care home. There were no outstanding requirements from the previous inspection report. Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 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 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) 28 - 30 The recruitment of staff is taken seriously which contributes to the ongoing safety of service users. EVIDENCE: The home had staff files in place which provided evidence that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references and Criminal Record Bureau (CRB) checks. New staff have been appointed but have yet to start work because CRB clearance had yet to come through. County Care is committed to having a trained workforce and more than half the staff at Benkhill Lodge have completed NVQ2 training. Staff said they found the training helpful in improving their day-to-day practice. Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 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 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 - 33 Benkhill Lodge is well-managed and this helps staff to remain well motivated and committed to meeting the needs of service users. EVIDENCE: Staff said that the management team are readily available which enables discussion of any practice issues as they arise. They feel that the managers are knowledgeable and are good at providing information about up-dates and changes in policy and procedures. Staff receive supervision every 6 weeks or so and said that this provides an opportunity to resolve any work related issues. Whilst there was evidence to indicate that the home was well-managed, the manager has yet to complete the NVQ4 in care. Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 Page 16 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 2 3 3 x x x x x Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 Page 17 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 9 Regulation 13 Requirement A controlled drugs register should be maintained. Timescale for action 1 May 2005 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. 2. Refer to Standard 9 31 Good Practice Recommendations Staff who administer medecines should complete training that includes a test of competency. The manager should complete NVQ4 training in care. Benkhill Lodge J53_J04_S34358_Benkhill Lodge_V222459_2100405_stage4.doc Version 1.30 Page 18 Commission for Social Care Inspection 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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