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Inspection on 29/11/06 for Benslow Nursing Home

Also see our care home review for Benslow Nursing Home for more information

This inspection was carried out on 29th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

The manager sets a high standard and is pro-active in monitoring the way that the residents are cared for. Feedback from residents and family members was positive and care staff were described as being `like a family`. The menu is varied and nutritious and several residents said they enjoyed the meals. One resident said `the food here is really tasty`. Another resident said `the night staff never mind bringing me a cuppa when I can`t sleep`. This helpful and friendly approach was observed during the inspection. The home was clean and in good decorative order.

What has improved since the last inspection?

Requirements from the previous inspection have been addressed. There has been a focus on team building and morale has improved since the last key inspection. A key-worker system has been implemented and a rota has been introduced which means that staff are assigned to work in a specified area of the home. A few residents said previously, they did not always like to use the call bell because they felt staff may be on another floor level; this new system reassures residents that someone is close at hand.

What the care home could do better:

There are various activities and events which the residents take part in and enjoy. However, some residents said they would also like the chance to do different things such as continue with some of the interests or domestic life they had before moving into the home. A more person-centred approach towards activities would ensure that each resident`s lifestyle experienced in the home matched their individual expectations and satisfied their recreational interests.

CARE HOMES FOR OLDER PEOPLE Benslow Nursing Home Benslow Rise Hitchin Hertfordshire SG4 9QY Lead Inspector Patricia Rogan Key Unannounced Inspection 29th November - 18th December 2006 13:00 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 Benslow Nursing Home DS0000019288.V325008.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. Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Benslow Nursing Home Address Benslow Rise Hitchin Hertfordshire SG4 9QY 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) 01462 459773 Benslow Management Company Limited Mrs Sandra Tyers Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered numbers shall remain at 33 subject to the continued occupancy by a married couple. When one permanently leaves, for any reason, numbers will reduce to 32 12th July 2006 Date of last inspection Brief Description of the Service: Benslow Nursing Home is a care home providing personal care and nursing care with accommodation for 33 older people. It is owned by Benslow Management Company Limited, which is a private company. It was first registered under the Registered Homes Act (1984) in January 1996. The home is situated in a quiet residential neighbourhood just over a mile from the centre of Hitchin. It consists of a three storey building and the interior is decorated to a high standard. All the home’s bedrooms have en-suite facilities. There are three double bedrooms, one of which is below the standard size. It is occupied by choice by a married couple, and it is a condition of registration that the room should revert to single occupancy if either of the couple permanently leaves the home for any reason. There is a passenger lift between the floors. The home has a garden at the side, accessed through the front door, with lawn and shrubs, a patio and sheltered sitting places. The fees range from approximately £480 - £600 but this is variable according to assessed care needs and should always be subject to an individual service contract agreed by the resident or their representative, if the service providers before a resident moves into the home. Ancillary, fee payable services such as hairdressing or chiropody are itemised in the contract. Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of all the key standards and the overall quality of this service is good. The inspection took place on two days and included a visit to the premises to meet service users and staff and additional meetings with some family members and professionals who are in contact with the home. Time was also spent observing the interaction between staff and the residents and inspecting record keeping and file management. What the service does well: What has improved since the last inspection? What they could do better: There are various activities and events which the residents take part in and enjoy. However, some residents said they would also like the chance to do different things such as continue with some of the interests or domestic life they had before moving into the home. A more person-centred approach towards activities would ensure that each residents lifestyle experienced in the home matched their individual expectations and satisfied their recreational interests. Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Benslow Nursing Home DS0000019288.V325008.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 Benslow Nursing Home DS0000019288.V325008.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): 3 (standard 6 is not relevant to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. No prospective resident moves into the home without having had an assessment of needs carried out by a senior member of staff. The prospective resident and their family member or representative is involved in this assessment. Information is also gathered from the person making the referral. EVIDENCE: Five case files were inspected and all held a copy of the initial referral and the subsequent assessment, which was carried out by an experienced member of the senior team. All assessments were signed by the resident or their representative. The assessments were in depth and recorded both the nursing and care needs and individual likes and dislikes. The five residents whose files were examined were asked about their experience when the assessment was carried out and all said they were given time to express their views and were told about what sort of assistance would be provided. Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Every resident has an individualised plan of care. There is a comprehensive medication administration policy and there is a protocol should any resident wish to take responsibility for their own medication. There is an effective system of monitoring each residents health care needs and contact with the GP and other medical professionals is good. Residents said they felt they were treated with respect and were given privacy when needed. EVIDENCE: Five care plans were inspected and these were person-centred and had been amended as needs had changed. Qualified nurses are on duty at all times. The input of a general practitioner or other allied professional had been recorded and acted upon if changes had been made. Only staff fully trained in medication administration and recording are allowed to give medication. Case files and other confidential records were stored in the managers office. Residents said they were treated with respect and felt staff had an understanding of the need for privacy when care is being provided. Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 Page 10 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are varied activities and celebrations of birthdays and other events throughout the year. Some residents felt these did not reflect their own preferences. Contact with families and friends and the wider community is encouraged. Meals are nutritious and served in pleasing surroundings. EVIDENCE: Residents were generally satisfied with the activities available and almost all enjoyed visits from local choirs or other entertainers. There should be further exploration into how the activities can be developed to reflect the individual residents interests and abilities. Some residents said they did not like the layout in the lounge and would much prefer to sit around a kitchen table sometimes, having a chat and a cuppa. The exercise to music was enjoyed by many of the residents although the music was rather loud for those nearest the music. Two residents said they would prefer to exercise by wrapping up against the cold and walking around the garden. A few residents had given up their hobbies or interests once they moved into the home because they had not thought they would be able to continue. Families said they found staff were very welcoming and helpful and they were encouraged to visit as often as they wished and all said they had attended events in the home. Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 Page 11 For those residents who follow a faith, there is at least one member of the clergy who visits the home and spends time with residents. If a resident wants to speak to a representative of a specific denomination or wants to take part in worship, the manager would ensure this was made possible. Residents said they enjoyed the meals and there was always a choice. The dining room is well laid out. If residents prefer to eat in their rooms, meals will be taken to them. Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All the residents and relatives who were asked, said they felt confident that their complaints would be listened to and acted upon. Staff have had training in the protection of vulnerable adults and there is a complaints procedure and whistle blowing policy in place. Complaints are recorded in detail and the investigation, the outcome and any decisions made are also recorded. EVIDENCE: All residents and family members are made aware of the complaints procedure when they move into the home. The staff are expected to keep the manager informed at the earliest possible moment if any concerns are expressed so that residents can feel confident that they are supported if they wish to make a complaint. An independent advocate is available for any resident who would like to have this support. When a complaint or concern has been expressed, this is recorded and in addition to an investigation to resolve the matter, the appropriate authorities are kept informed as required. There is a good relationship with the local community police and several residents said they liked the local police occasionally popping in because it reminded them of the days when they saw an officer on the beat. Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is accessible, safe and meets residents needs in a comfortable, clean and homely way. A programme of maintenance and fabric renewal is ongoing. Fire safety and environmental procedures are in place. EVIDENCE: There was a recently updated programme of routine maintenance and decoration of the premises. This is audited regularly and if any repairs are needed, this is arranged. The home is inspected periodically by the fire service and by environmental health to ensure compliance with regulations. Several residents and visitors said they thought the home was nicely decorated and that it has always been clean and tidy. Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The skill mix of staff reflect the needs of the residents. There are no staff shortages. The recruitment policies include reference checks and a check by the Criminal Records Bureau. There is a training programme for all staff relevant to the post they hold. Supervision is regular and is recorded. EVIDENCE: There is a qualified nurse on duty at all times. The assistant manager is a qualified nurse and observes clinical practice. An inspection of staff files showed there had been a Criminal Records Bureau check and a follow-up of references in every file. The correct procedures had been followed for staff who had nursing qualifications to ensure these were current. All staff have induction training when they begin working in the home and they are accompanied by a member of staff until they are considered competent to work alone. All staff have further training as learning needs are identified. Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is experienced and the home is well run for the benefit of the residents. Quality assurance audits are carried out and are incorporated in regular resident and staff meetings. Procedures are in place regarding financial transactions and residents money. The manager ensures as far as is reasonably practicable the health, safety and welfare of residents and staff. EVIDENCE: Many residents, visitors and members of staff spoke favourably about the manager and there were several comments about the improvement in staff morale. The manager has a good working relationship with the deputy manager and the key working and other systems, which have been implemented, have proved to be effective. All residents have access to a lockable drawer. When a resident moves into the home, an inventory is Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 Page 16 carried out, listing every item brought into the home. This is done in the presence of the resident and the residents family or representative. If a member of staff is asked to make a minor purchase or has a service such as hairdressing, there are procedures in place to record and receipt the transaction. The manager ensures compliance with relevant legislation regarding the health, welfare and safety of residents and staff by keeping copies of up to date information, by carrying out regular risk assessments and by involving outside agencies as appropriate. Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 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 3 x x n/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 Page 18 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 OP12 Regulation 16(2)n Requirement Further consultation with residents about the programme of activities is needed to ensure that residents are enabled to pursue individual interests in relation to recreation and fitness. Timescale for action 28/02/07 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 Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Benslow Nursing Home DS0000019288.V325008.R01.S.doc Version 5.2 Page 20 - 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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