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Inspection on 12/06/07 for Bennfield House Nursing Home

Also see our care home review for Bennfield House Nursing Home for more information

This inspection was carried out on 12th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Excellent assessments ensure people who live at the home were receiving appropriate care, from staff who are well trained and motivated. Relative`s, visitors and health professionals all praised the home and said the care was excellent. The atmosphere within the home was calm and people appeared to be relaxed, indicating they were happy with how they were cared for. The home had a stable staff group who had worked at the home for a number of years. They were motivated, enthusiastic and well trained, and relatives and CSCI professional surveys received confirmed that the service was excellent. The team is led by a registered manager/provider, who encourages staff to be involved in promoting an excellent service. Mealtimes and social integration were well managed which was important to ensure the wellbeing of people who use the service. The review of nutritional assessments had helped to identify where supplements were required.

What has improved since the last inspection?

The registered providers continue to improve the environment, by adding new communal facilities (conservatory) which had involved moving the laundry to another area of the building. New boilers have been installed to improve heating and hot water systems around the home. Redecoration and refurbishment continues as rooms become vacant, or as needed. Staff had attained the required level of NVQ Level 2 qualified and a number had attained, or working towards NVQ Level 3 qualifications.

What the care home could do better:

The staff at the home have worked hard to maintain the quality of care provided to those who choose to live at the home, and continue to meet all standards assessed. Some amendments are needed to the Statement of Purpose to reflect the additional bedroom and conservatory.

CARE HOMES FOR OLDER PEOPLE Bennfield House Nursing Home 65 King Edward Rd Thorne Doncaster South Yorkshire DN8 4DE Lead Inspector Valerie Hoyle Key Unannounced Inspection 12th June 2007 09:00 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 Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bennfield House Nursing Home Address 65 King Edward Rd Thorne Doncaster South Yorkshire DN8 4DE 01405 812663 01405 817071 NONE 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) Mrs Anne Penelope Bennett Mr David Bennett Mrs Anne Penelope Bennett Care Home 26 Category(ies) of Dementia (26), Dementia - over 65 years of age registration, with number (26), Mental disorder, excluding learning of places disability or dementia (26), Mental Disorder, excluding learning disability or dementia - over 65 years of age (26) Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2006 Brief Description of the Service: Bennfield House is an adapted building with an added extension located in the residential area of Thorne. It is situated on a main road and has easy access to local transport and shops. The home cares for people with dementia and nursing needs. The house provides accommodation on two levels. It has several lounge areas that people can access and a relaxation area with sensory equipment. A new conservatory makes an excellent additional space for the benefit of people who use the service. Bedroom facilities are provided on both floors in 22 single and 2 double bedroom facilities. There is a small secure garden area that is accessed via the lounge, and there are plans to develop an additional patio area in the near future. Dining is provided either in the dining room or the lounge. The home provides information to people and their relatives prior to admission into the home. Service Users Guides are available in all bedrooms or on request from the manager. The last published inspection report is available on request and a copy is available in entrance for visitors to read. Information gained on the 12th June 2007 indicates the current fees range from £477.50 per week plus the registered Nursing Care Contribution (RNCC paid directly to the home from the PCT). Additional charges include private massage therapy £5 - £10, hairdressing from £2.50, and newspapers and transport. Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over 6 hours, this included a partial inspection of the building. Three peoples care plans and supporting documentation were examined. One person who uses the service and four staff were spoken to during the visit, their views are included throughout the report. Occupancy at the home remains high with only one vacant bed, which had been allocated to some one awaiting placement. The manager said there was a waiting list for placement at the home. Five CSCI service users questionnaires were sent to the home and four surveys were returned. The surveys had been completed by relatives, as service users had limited capacity due to their diagnosis of dementia. Three professional CSCI surveys were returned and two relatives were spoken to during the inspection. The information has been collated and their views are contained within this report. The registered manager was present throughout this visit and assisted with the inspection process. The registered manager had completed and returned the pre-inspection questionnaire and the information gained is included in this report. What the service does well: Excellent assessments ensure people who live at the home were receiving appropriate care, from staff who are well trained and motivated. Relative’s, visitors and health professionals all praised the home and said the care was excellent. The atmosphere within the home was calm and people appeared to be relaxed, indicating they were happy with how they were cared for. The home had a stable staff group who had worked at the home for a number of years. They were motivated, enthusiastic and well trained, and relatives and CSCI professional surveys received confirmed that the service was excellent. The team is led by a registered manager/provider, who encourages staff to be involved in promoting an excellent service. Mealtimes and social integration were well managed which was important to ensure the wellbeing of people who use the service. The review of nutritional assessments had helped to identify where supplements were required. Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were assessed before moving into the home to ensure their needs can be met. EVIDENCE: All new people receive a full comprehensive needs assessment before admission this is carried out by manager or responsible person who have the required skills and competencies. The service is highly efficient in obtaining a summary of any assessment undertaken by the placing authority, and insists on receiving a copy of the care plan before admission. Staff confirmed that information contained in the assessment was essential to understand what they needed to do to ensure people’s needs were met. Three assessments were examined and they focused on achieving positive outcomes for people who use the service. Before agreeing admission the Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 9 manager and staff carefully consider the needs assessment for each individual prospective person and the capacity of the home to meet their needs. Prospective people who use services were given the opportunity to spend time in the home, before making final decisions about where to live. One relative said he had visited a number of homes before selecting Bennfield as the best home to meet his mums care needs. All CSCI surveys received confirmed that people who use the service were provided with sufficient information about the service before moving into the home. The Statement of Purpose should be reviewed, as it did not reflect the additional bedroom and communal facilities, which had changed since the last inspection at the home. Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provide staff with sufficient information to meet the needs of people who use the service. Arrangements for dealing with health issues are met with support from health professionals. Medication policies and procedures were well managed ensuring the safe administration of medication. EVIDENCE: Three care plans were examined; these were well written and provided sufficient information to enable staff to meet the needs of the people who use the service. The care plans include regular evaluations, and daily records assess the individual’s progress. Comprehensive risk assessments ensure people can maintain their independence, while remaining safe. All CSCI surveys received confirmed that people’s needs were always met by staff that are well trained. Surveys said that staff always listen to people who use the Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 11 service, and relatives said staff were excellent, well trained and always provided a good service. Records examined and discussion with the staff confirmed people’s healthcare needs were met. The manager said doctors provide a good service, and staff were trained to recognise health problems and report them to the nurse in charge of the shift. An audit of medication stocks and records were examined and were found to be correct ensuring the health and safety of people who use the service. Nurses had responsibility for administering medications, they had attended training to update their knowledge, to ensure medicines were administered safely. The local pharmacist is contracted to undertake periodic checks to ensure the stock levels are maintained and procedures are followed. Medication was stored securely, there were separate, locked rooms for storing medication that contain a locked fridge and a controlled drugs cabinet. Throughout this visit staff were seen interacting with people who use the service in a kind manner, they spent time talking to people and were observed knocking on bedroom doors before entering. All people were referred to by their first name and this was agreed in the care plans examined. CSCI service user surveys received confirmed that staff always treated people who use the service with respect and maintain their dignity at all times. Relatives praised staff and said nothing was ever too much trouble, to ensure their family was cared for in a kind sensitive manner. Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities are organised which are appropriate to the needs of the people who use the service. Mealtimes were well managed and people were encouraged to make choices and control over their own lives. People who use the service can maintain contact with family and friends, and have good opportunities to maintain links with the local community. EVIDENCE: There was a warm and friendly atmosphere on entering the home and a sense of wellbeing throughout the home. Staff are commended for creating a pleasant ambiance in the lounges. Activities are arranged that are suitable to stimulate service users with dementia. There was a member of staff who had responsibility for organising activities. Activities were usually organised around a monthly entertainer. Recent entertainment included a Victorian coffee morning, Mothers day and Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 13 Easter party. She said plans were well underway for a person’s 100th Birthday party to include a garden party, with lots of entertainment for all ages. The snooze lounge contains photographs of recent entertainment and these were changed at regular intervals. There was a calm environment throughout this visit with some service users spending time in their bedrooms, while others spent time in the quiet lounge. A partial tour of the building found many examples of how service users are encouraged to bring in personal items to help them feel at home. Visiting relatives said they were always made to feel welcome and staff were very caring. They also said that they were confident in staff’s ability to provide the care needed for their relative. The cook gave examples of the menus provided and said alternatives were always available. Mealtimes were well managed by staff that have a good understanding of peoples dietary needs. The cook said nutritional assessments had been undertaken to ensure people receive additional supplements where needed. Staff were seen giving assistance in an unobtrusive way, and meals served to people in their bedrooms were accompanied with a drink. Due to peoples limited capacity most people were unable to use the dining facilities, although relatives had been consulted to ensure peoples best interests were maintained. One relative said he called every day to assist with feeding his relative, which made him feel involved in the care of his loved one. He said staff always offered drinks and meals during his visit, which made him feel welcome. Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can access the complaints procedures and the manager ensures any concerns are recorded and investigated appropriately. Adult protection policies, procedures and training of staff promote the protection of service users from abuse. EVIDENCE: There was a complaints procedure that was available to people who use the service and visitors. The procedure was also referred to in the service users guide, identifying the stages to follow; this includes the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection is included in the procedure, although the address needs to state the CSCI Sheffield office details. Examination of the complaints records show that there were no complaints recorded since the last visit to the home. Relatives said they were confident that the manager or the responsible person would deal with any concerns they may have. There was a comprehensive Adult Abuse and Whistleblowing policy and staff follow the procedures to those standards. The registered manager would investigate fully any allegations of abuse and would follow the necessary procedures if any were substantiated. The registered manager holds discussions with staff to talk over issues and how to recognise different forms of abuse. Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are provided with a clean, comfortable environment, and there were sufficient staff to maintain good hygiene standards. EVIDENCE: A partial tour of the building found excellent standards of cleanliness and hygiene. Staff were commended for their efforts to make the environment smell and look fresh. A new conservatory enhances the communal areas available for people who uses the service, and the refurbishment and redecoration programme ensures bedrooms and lounges are of a good standard. New boilers had been fitted, which will ensure water is sent to bedrooms at a consistent temperature. The Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 16 registered provider has plans to create a shower room, which will be beneficial to those people who find it difficult to access other bathing facilities. Plans were also underway to create a new paved area, which will be used for people to sit out in the summer. Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff had the skills and knowledge to fulfil their roles within the home; a stable staff group ensures continuity of care by staff that knows the people who use the service. Recruitment policies are followed ensuring the safety and protection of people who live at the home. EVIDENCE: Training records examined confirmed the staff have the required skills and competencies to deliver a good service to people who live at the home. Discussion with the manager and staff confirms that there was a stable staff group who had worked at the home for a good number of years. Staff say they enjoy working at the home, and feel supported. There was a robust induction and probationary package, which is service specific. The manager only confirms permanent employment when satisfied that competence and progress has been shown to be satisfactory against their high standards. One new member of staff said she enjoyed working at the home and recent training had helped her understand the needs of people with dementia. Other staff said that the atmosphere within the home was relaxed and everyone worked hard to ensure people were well looked after. Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 18 Staff rotas and observation during this visit show there were sufficient staff to meet the needs of people who live at the home. Staff were deployed to work on the two floors of the home, which ensures people are safe and well looked after. Staff had the required skills to meet the needs of people, and they are commended for meeting the requirement of 50 NVQ level two qualified staff. A number of staff are progressing with or completed NVQ level three There were robust recruitment and selection procedures that ensure people who use the service are safe and protected. A number of staff recruitment files were examined, and there was evidence that all the required employment checks have been undertaken prior to commencing work at the home. Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were protected by sound management practises, and their views were actively sought to improve the service, although not by formal quality surveys due to their limited capacity. The financial interests of people were safeguarded, and good health and safety procedures ensured they are protected. EVIDENCE: The registered manager/provider has a wealth of experience and knowledge and was able to demonstrate her ability to manage the home. She had achieved the required management and care qualifications and she is a qualified nurse. She operated an open door policy to ensure she was accessible Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 20 to staff and people that use the service. Relatives and staff spoke highly of the manager and said she was very caring. Staff and group meetings ensured that staff were informed about training opportunities and the day to day running of the home, they were also encouraged to be involved in decision making. People who use the service were unable to manage their own finances due to capacity. A number of peoples financial records were examined, the records were accurate and there are clear auditing procedures to ensure peoples monies are managed in their best interests. Quality systems are in place, and the home continues to be registered with ISOQAR and continues to perform to their requirements, Staff should be commended for their efforts in attaining excellence. The views of people who use the service were difficult to gain using a survey due to their limited capacity; therefore staff discuss the quality of care provided with visitors and relatives. Completed relative surveys were examined and all describe the service as excellent. Accident reports were analysed by the manager to ensure risk assessments are developed where required. Maintenance and service records examined were up to date and current to the services provided. The manager has the required Health and Safety policies and procedures and displays the relevant notices. Fire safety procedures are in place and service records were examined and were current, ensuring the safety of service users. The manager had undertaken a period of consultation with regards to the forthcoming legislation about smoking in public places. Risk assessments had been completed to enable people who use the service to smoke in their bedroom. They had enforced a no smoking ban for all staff. Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bennfield House Nursing Home DS0000015850.V329255.R01.S.doc Version 5.2 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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