Inspection on 03/09/08 for Benthorn Lodge

This inspection was carried out on 3rd September 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Benthorn Lodge 29/09/09

Benthorn Lodge 14/03/08

Benthorn Lodge 27/11/07

Benthorn Lodge 01/12/06

Benthorn Lodge 13/02/06

Benthorn Lodge 12/07/05

Benthorn Lodge 27/01/05

Benthorn Lodge 10/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Benthorn Lodge 48 Wellingborough Road Finedon Northants NN9 5JS     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Irene Miller     Date: 0 3 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Benthorn Lodge 48 Wellingborough Road Finedon Northants NN9 5JS 01933682057 Telephone number: Fax number: Email address: Provider web address: benthorn.lodge@ntlworld.com Name of registered provider(s): Name of registered manager (if applicable) Mrs Pam Bennett Type of registration: Number of places registered: Mr Frank Bennett,Mrs Pam Bennett care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: No person falling within the category DE(E) can be admitted where there are 18 persons in the category DE(E) already in the home. The Home will limit its services to the following service user categories: No person falling within the category Older Persons (OP) can be admitted where there are already 4 persons of category OP in the home. The total number of service users in the Home must not exceed 18. Date of last inspection Brief description of the care home Benthorn Lodge is a home providing personal care and support for 18 Older People, by reason of old age and dementia. Community healthcare professionals meet healthcare needs. The home is situated on a main road leading into the centre of Finedon and is within easy access of public transport and local shops. The home comprises of a threeCare Homes for Older People Page 4 of 25 Over 65 18 4 0 0 Brief description of the care home storey building of which the first two floors are used for resident?s accommodation. The original frontage of the house has been retained so that the home blends in with others in the road. There is off road parking at the side of the house, and a small paved garden to the front, which is accessible for residents. Accommodation is provided in both single and shared rooms, one of the single rooms has en suite facilities. A copy of the last inspection record is held in the homes office. Current fees are between £331.60- 348.55 per week. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The focus of all inspections undertaken by the Commission for Social Care Inspection (CSCI) are based upon seeking the outcomes for people using the service and their views of the services provided. This visit was unannounced and focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for older people. Care Homes for Older People Page 6 of 25 The care records of three people using the service were sample checked this involved looking through written information available on their care, such as their individual care plans (a care plan sets out how the home aims to meet the individual service users personal, healthcare, social and spiritual needs). During the course of the visit people using the service were consulted on how they view the care provided at the home, and discussions with staff gave an insight into the support and training provided at the home. Observations made during the visit gave an indication on the quality of staff interactions with people using the service. Records in relation to the homes management and administration systems, quality assurance, staffing and general policies and procedures were viewed. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this 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 choosing to use the service and their representatives have the information they need to make a decision about whether the home can meet their needs. Evidence: The Statement of Purpose was available which provides details on the range of services available at the home and information on staff qualifications and training records and the latest inspection report was held in the office. Within the care plans viewed their was records of assessment on the health and social needs of people choosing to use the service having been made prior to admission into the home. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care of people using the service is generally met, however greater attention to recording of accidents and medications would ensure that the health, safety and welfare is promoted and protected. Evidence: Within the care plans viewed their was section entitled the working care plan which gave a brief outline of the daily routines of the individuals. There were records within the care plans of the personal preferences in relation to how people wished to have their personal care delivered, this information identified the support required to enable the people using the service to maintain some independence. There were records of people having their nutritional needs monitored and records of weights being monitored and recorded on a monthly basis. Care Homes for Older People Page 11 of 25 Evidence: Within one of the care plans viewed there was instruction of a person requiring the use of pressure relieving equipment, however within this care plan there was no supporting documentation such as a risk assessment to identify the reason why the person required the use of the equipment. In discussion with the staff it was established that due to a reduction in mobility the use of the pressure relieving equipment had been introduced as a preventative measure to reduce the risk of the person developing pressure ulcers. Within the moving and handling profile for one person there was a record of aggression being shown towards staff and this appeared more frequently when the staff had to assist the person to mobilise. In this instance the risks to the person and the staff due to the behaviour had not been addressed within a written risk assessment. The moving and handling profiles were seen to be last been formally reviewed in April 2008. A risk assessment was viewed for one person registered as partially sighted the assessment identified the support required to enable the person to mobilise around the home and to continue in eating and drinking independently. Generally there was documentation to evidence that people had access to care and treatment from other healthcare professionals, such as the general practitioner, district nurse, community psychiatric nurse, chiropodist and optician. However within the daily notes section of two of the care plans viewed there was records of a person acquiring a skin tear to their leg, there was reference within the daily notes of the person having received treatment from the district nurse, there was a record of a person acquiring a bruise to their forehead, and of a person showing signs of dehydration. In these instances there was no records available to demonstrate what action had been taken to identify the possible cause of injury, first aid or medical treatment made available. People were observed receiving their medications over the lunchtime period, two staff undertake the responsibility to administer medications. One member of staff dispenses the tablets and hands them to an assistant to give to the person. During the medication round the assistant left the lounge to give medication to a person who was out of the lounge, the member of staff who was dispensing signed the medication administration record that the tablets had been given however they did not actually witness the assistant give the person their medication. The medication administration records (MAR) charts were viewed, and although two staff are involved in administering medications only one signature is recorded. Prior to this inspection a concern had been brought to the attention of CSCI over Care Homes for Older People Page 12 of 25 Evidence: medication practises at Benthorn Lodge which had prompted a safeguarding referral to be raised with the Northamptonshire Social Services Sustaining Adults Team and a second visit to Benthon Lodge on 11th September 2008. During this visit the medication storage and administration records were looked at in more depth and identified that there were some shortfalls in the medication storage and administration systems and arrangements were made for a focused medication inspection to be carried out by a CSCI Pharmacy Inspector. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities for people using the service to engage in activities generally matches their needs and expectations. Evidence: People using the service were observed during the course of the visit to spend time within their bedrooms and the communal lounges. A small group of ladies were enjoying afternoon tea together within one of their own rooms, when asked if this was of their choosing the the ladies said they enjoyed spending time in each others company. One visitor said that they come to see their wife everyday and that the staff prepare them a meal, this person said that the staff were very friendly and welcoming and that the meals were lovely, observations of staff with visitors supported this comment. Opportunities are available for people to receive visits from the clergy, holy communion is offered each week and organised outings take place to visit a local Over 60s club and coffee morning. Care Homes for Older People Page 14 of 25 Evidence: Each of the communal lounges has a dining area, people using the service were observed receiving lunch, the atmosphere was relaxed and staff were observed to offer and provide support with tact and sensitivity to people who required more assistance to eat and drink. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Having a clear complaints procedure would ensure that people using the service and their representatives are fully aware of how to raise any concerns or complaints they may have. Evidence: The complaints procedure was on display within the front entrance notice board, the procedure would benefit from being simplified to include the stages and the timescale for the complaints process. The details of the person whom to address concerns or complaints was out of date. Since the last inspection one concern had been brought to the attention of CSCI, due to the nature of the concern a safeguarding referral was raised with the Northants Social Services Sustaining Adults Team, at the time of inspection an investigation into the concerns was still in process. Staff training had been provided on Safeguarding Adults and relatives spoken with during the visit had no concerns about the care provided at Benthorn Lodge saying that the staff are very approachable, caring and friendly. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The building is in need or repair and refurbishment as people using the service may be at risk of not being provided with a safe environment. Evidence: A limited tour of the building was carried out to include viewing some bedrooms, bathrooms and communal areas. The ceiling to the ground floor lounge had recently had flood damage around the bay window area there was some evidence that repairs had commenced. Some areas of the home had an unpleasant odour present this was especially noticeable in the corridor at the top of the stairs leading to the office area. The office area appeared cluttered there is a need generally for the home to be decluttered and building upkeep attended to. Within some of the bedrooms viewed there was evidence of them being personalised, although there was evidence that some work is needed to attend to redecoration, repairs and refurbishments. Care Homes for Older People Page 17 of 25 Evidence: Some work had taken place to provide an outdoor seating area to the front of the property, however the external of the property is in need of repair work. The parking facilities at the side of the building was is in need of attention to ensure that people visiting the service have a safe place to park their vehicles. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 supported by a staff team who are appropriately trained to meet their needs. Evidence: The staff recruitment files of three staff were viewed all contained evidence of Criminal records Bureau (CRB) checks and checks on the Protection of Vulnerable Adults Register (POVA). There was records of staff having received mandatory training to include fire safety, food hygiene, moving and handling, medication, and abuse awareness. In discussion with the registered manager and staff it was confirmed that most staff had received training in dementia care and that further training in this area was planned to take place. Staff receive regular one to one supervision and appraisal which is documented. In discussion with the staff on duty they all said that they enjoy working at the home, that there is a homely feel to it. Care Homes for Older People Page 19 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Until all of the people using the service have had their individual risks assessed and action plans put in place there is the potential that their needs may not be fully met. Evidence: Time was spent at the beginning of the visit looking at the requirements that were issued following the last key inspection of 14th march 2008, the person in charge explained that some of the care plans had the risk assessments completed and others were underway. Within the care plans viewed there was evidence that some work had taken place to improve on the risk assessments process, however further work is needed to ensure that individual risks assessments are in place for people using the service who may be at risk of their fluid and nutritional intake needs not being fully met, those who are immobile from developing pressure area ulcers, and those who display aggression and challenging behaviour. Care Homes for Older People Page 20 of 25 Evidence: Records were available of money held on behalf of the people using the service with records of individual itemised expenditures such as payment for chiropody, hairdresser, outings, and purchase of toiletries. The registered manager/providers Mr and Mrs Bennett were available for most of the visit. Care Homes for Older People Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 8 13 Accident and incidents must 12/12/2008 be recorded to evidence the care and treatment required. This will ensure that the health safety and welfare of people using the service is promoted and protected. 2 9 13 Prescribed medications for people using the service must be available at all times. This will prevent the risk of people running out of stocks of their prescribed medications. 12/12/2008 3 16 22 The complaints procedure must be reviewed and updated to ensure that information is clear and includes the stages and timescale for the complaints process. This will ensure that people using the service and their representatives are fully 12/12/2008 Care Homes for Older People Page 23 of 25 aware of the the stages and timescale for the complaints process. 4 19 23 A programme of routine building upkeep, maintenance and renewal of the fabric and decoration of the premises must be implemented. This is to ensure that people using the service are provided with a safe and well maintained home. 5 26 16 The premises must be kept free from unpleasant odours This is to ensure that people using the service are provided with a clean home that is free from unpleasant odours. 6 38 13 Risk assessments must be in 12/12/2008 place for people using the service which are based upon individual vulnerability. This will ensure that individual risks to people using the service are addressed and their safety needs met. 12/12/2008 12/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 26 A system of routine carpet cleaning should be in place to ensure that unpleasant odours are dealt with and eradicated as much as possible. Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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