Inspection on 12/10/05 for Benton House Nursing Home

This inspection was carried out on 12th October 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Benton House Nursing Home 01/10/08

Benton House Nursing Home 06/02/08

Benton House Nursing Home 12/03/07

Benton House Nursing Home 19/04/06

Benton House Nursing Home 14/04/05

Benton House Nursing Home 08/12/04

Benton House Nursing Home 14/09/04

Benton House Nursing Home 07/02/04

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Benton House Nursing Home Benton House Gattison Lane Rossington Doncaster South Yorkshire DN11 0NQ Lead Inspector Ian Hall Unannounced Inspection 24th October 2005 08:45 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 Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Benton House Nursing Home Address Benton House Gattison Lane Rossington Doncaster South Yorkshire DN11 0NQ 01302 864979 01302 863435 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) Union Healthcare (North) Limited Susan Carol Bennett Care Home 36 Category(ies) of Dementia - over 65 years of age (36), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (36) Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That Mrs Bennett acquires the relevant management qualification in line with the National Minimum Standards (Older People) That Mrs Bennett acquires training on mental health nursing. A maximum of three persons between the age of 60 years and 65 years may be accommodated to receive Nursing Care or Residential Care, be accommodated in the categories DE(E) and MD(E) within the total of 36 registered beds. 14th April 2005 Date of last inspection Brief Description of the Service: Benton House Care Home is situated in the village of Rossington near Doncaster. It is within reach of local shops, a post office, church and other local amenities. The home is registered to provide both nursing and personal care for up to 36 service users in the category of older people with dementia and mental disorder. Benton House is an extended detached house. It provides its accommodation on two floors. There is a passenger lift to facilitate access between floors. The communal areas are located on the ground floor and comprise two lounges, a smoker’s room and a dining room. The kitchen and laundry facilities and office are also found on the ground floor. There is a garden at the rear of the building with limited parking available at the front of the building. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6.5 hours and was the second of the cycle of inspections for the year 2005/6 and followed a risk assessment carried out with the CSCI risk assessment tool. The focus of the inspection was to meet both service users and visitors to the home to gain an insight into daily life for residents. The officer met with members of the on duty staff team and toured the site. Three residents care files were “case tracked” and the associated records checked. What the service does well: What has improved since the last inspection? What they could do better: The home’s owners have made little progress towards updating, refurbishing and redecorating the home. The outside lamp was broken, exterior woodwork and paintwork is in need of cleaning and maintenance. Broken and worn furniture and fitments were identified throughout the premises. Many door handles did not function. The main lounge area is equipped with tired looking armchairs a number of which emanate an unpleasant odour. The area requires Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 6 redecoration and cleaning/ renewal of carpet. A number of armchairs lacked seating cushions. A number of bedrooms had been personalised with the help of staff. Bathrooms, toilets and corridors required redecoration, provision of suitable floor coverings, aids/adaptations, domestic lighting and homely touches. There has been some redecoration and provision of carpets and furniture. The laundry area is cramped, poorly ventilated, unheated and had an unsuitable floor covering that requires risk assessment. The maintenance, refurbishment and redecoration need to be prioritised and demonstrated within an annual action plan. 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. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5, 6. Examination of case files and discussions with relatives and residents demonstrate their involvement in choosing to live at Benton House. During the officers discussion with management it was evident that the needs of existing residents are considered throughout the assessment process before a decision to admit another resident is taken. EVIDENCE: Residents and their advocates confirmed that they had discussed the care and service provision before admission to Benton House. The case files examined contained individual copies of care assessments, care plans and written contracts that stated both terms and conditions of residence. Intermediate care is not provided at the home, however respite care is provided by negotiation. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Staff was focussed upon meeting the needs of both residents and their families. Relatives were observed to visit freely and continue to assist with care of their loved ones. Family members spoken to confirm their involvement in the planning and provision of social, physical and psychological care and provision. The home facilitates access to the whole range of health care professionals and health care facilities. Staff was observed to interact with residents skilfully, professionally and with obvious empathy for each individual. EVIDENCE: The officer inspected care records of 3 residents; they contained individual “needs” assessments with plans of “care” for staff to follow and meet each individuals needs. These records were correctly maintained; they described how each resident responded to the care package and any necessary changes that were made. These were monitored at regular intervals; some plans had been amended within the timescale in response to changing needs. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 10 None of the residents was responsible for their own medication although this facility is available. Staff was observed administering medications and providing appropriate support to residents. Service users and visitors stressed that staff were always keen and willing to help them. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. The homes manager and her team have worked hard to build links with the local community. Records demonstrate the provision of both choice and a balanced diet. EVIDENCE: Visitors to the home confirmed that they were able to visit at any reasonable time, with shift workers visit at any other time by appointment. Well-behaved pets were able to visit be arrangement. The home employs an activities coordinator. There is a specific activities room where work with service users was being conducted during the inspection. Activities were organised on either a one to one or small group basis. Residents were observed to be looking at newspapers listening to music and watching television. None of the residents currently leave the home unless accompanied by members of their family or staff. The religious and cultural needs of service users from ethnic minorities are well documented and records show how these can inform basic lifestyle issues such as diet and dress, and how staff, sometimes in conjunction with families act to meet these. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 12 Nourishing fluids and snacks were readily available throughout the day. There was a choice of midday meal, staff was observed to encourage and assist with meals as needed. Mealtimes were unhurried with extra portions available as required. Specialist diets are available for those requiring this service. The dietician has assisted with compiling the menu. Meals were taken in a well-decorated and well-furnished dining room. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. Staff spoken to was confident and competent to respond to concerns or complaints effectively. EVIDENCE: Residents and staff stated that they had no concerns or complaints about care or services provided. They confirmed that they had regular and easy access to the home’s manager and her deputy and that any small points raised were dealt with promptly. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Although improvements have been made to the decoration and furnishings throughout the last 12 months, substantial further improvements must be made. The company has failed to achieve required improvements to ensure that the environment meets minimum environmental standards for maintenance, decoration and safety. EVIDENCE: The Inspector toured the building with the home’s manager. There has been some redecoration and refurbishment of the home. The home continues to fail to meet minimum environmental standard as set out in the Care Standards Act 2000 and accompanying regulations. The premises, decoration, furnishings and soft furnishings appear generally tired and worn. There is a general air of lack of maintenance. An additional maintenance man has been employed. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 15 Deficiencies and defects were identified and discussed at the time of inspection. The main lounge area is equipped with tired looking armchairs a number of which emanate an unpleasant odour. The area requires redecoration and cleaning/ renewal of carpet. Bathing and toilet facilities lack aids and adaptations to ensure service user safety. Floor coverings are in need of review and in some areas replacement. These rooms are basic facilities and lack homely features and touches. Lighting requires review. Exposed pipe-work must be risk assessed to ensure there is no danger for service users. Hallway and corridor areas require redecoration, re-carpeting in some areas, and provision of handrails. Lighting in these areas is by fluorescent light fitments. This presents a stark appearance. This must be reviewed with domestic fitments provided. Many bedrooms require redecoration, re-carpeting, new soft furnishings, new beds and bedroom furniture. Many items of damaged and worn furniture were identified. There is a lack of armchairs and tables provided in bedrooms. The total amount bedding, pillows and bed linen provided must be reviewed. Many bedroom door handles were failing to function correctly. Identified bedroom doors had large gaps and did not seal effectively. A number of beds continue to lack headboards. The home’s owner must implement a programme to replace worn and tired mattresses. The manager has provided a range of colours and homely features to improve the appearance of the bedrooms. A number of families have assisted with personalisation of bedrooms with favourite items and memorabilia. The laundry floor covering has a slippery surface and requires risk assessment/replacement. The laundry is small and lacks effective ventilation for the summer or heating for the wintertime. A health and safety assessment must be undertaken. The outside light fitment was broken. External paintwork was in need of cleaning and maintenance. Access to the home via patio doors is a potential trip hazard and requires risk assessment to ensure service user safety. A number of paving stones are uneven and present a trip hazard. The home’s staff group works hard to maintain a clean and homely environment for service users. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. The staff team are keen to learn, develop their skills and knowledge base, this reflects within the personal care provision. Over 50 of the care staff had achieved NVQ 2 or/and NVQ 3 assessment and awards in care. EVIDENCE: The staff group without exception were well motivated and enthusiastic about their work. They confirmed that not only were they well supported in their work but actively encouraged and supported to develop personally. Staff has undertaken statutory training and updates i.e. moving and handling, fire prevention etc, and are involved in national vocational qualification training and medication administration training. The home’s manager follows the home’s policy for recruitment and induction of staff. Satisfactory references are obtained and statutory checks POVA and CRB were completed. The numbers of trained nurses, care workers and ancillary staff on duty were able to meet the needs of the service users. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 38. The home is well organised and managed with all statutory servicing and checks complete. The management teams enthusiasm and positive approach to elder care has clearly influenced the whole team and benefited the service users. EVIDENCE: Visitors to the home stated that they had ready and easy access to the homes management and that they felt confident in them. Staff stated here was always a senior member of staff on duty at the home with advice and support readily available. Responsibilities were shared between senior members of the team. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 18 The manager to ensure policies monitors case files and the personnel files and procedures are adhered to and enable her to identify where improvements are needed in these areas. The manager has an effective system for meeting the training needs of staff to ensure they have the necessary skills to provide the care and service that the service users require. The manager Mrs Bennett is a qualified and experienced nurse and care home manager. Her role is complex and to continue to develop and improve the care and services provided at the home in accordance with the Care Standards Act 2000, she is required to be employed in addition to rota nurses and care staff. The company have failed to provide the additional management hours required to fulfil her role within her working hours. Many of her duties are being undertaken in her off duty time. The manager has worked hard to develop a culture of continuous improvement amongst the staff; they appear to have embraced this wholeheartedly and are contributing ideas and suggested improvements. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 19 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 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 N/A 18 N/A 2 2 3 2 2 2 2 2 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 3 3 N/A N/A 3 N/A 2 Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 20 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. 1 Standard OP19 Regulation Requirement Timescale for action 01/02/06 2 OP20 13, 16, 23 The registered person shall ensure that : a) all parts of the home to which the service users have access are so far as reasonably practicable free from hazards to their safety c) unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. 23(b) The registered person shall having regard to the number and needs of the service users : ensure that the premesis to be used as the care home are kept in a good state of repair both internally and externally. 23(o) external grounds which are suitable for, and safe for use by service usersare provided and appropriately maintained. The grounds of the home have uneven paved surfaces and entrances are not ramped. Previous requirement not met 30/06/05 13, 16, 23 The registered person shall 01/02/06 ensure that : a) all parts of the home to which DS0000015851.V253737.R01.S.doc Version 5.0 Benton House Nursing Home Page 21 3 OP21OP22 4 OP24 the service users have access are so far as reasonably practicable free from hazards to their safety c) unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. 23(p) ventilation, heating and lighting suitable for service users is provided in all parts of the home which are used by service users. Lighting at the home must be domestic in character, there is a lack of bedside lighting, poorly positioned bedroom lights, corridor lighting is fluorescent. Previous requirement not met 01/08/05 12, 13, 23 23 (d) (j) The registered person 01/02/06 shall having regard to the number and needs of service users ensure that: d) all parts of the home are kept clean and reasonably decorated. j) Provide at appropriate places sufficient numbers of lavatories, washbasins, baths and showers. Bathing and toilet facilities identified were in need of updating, refurbishment and redecoration. Aids and adaptations must be provided. Previous reqirement not met 01/08/05 13, 16, 23 23(2) The registered person shall 01/02/06 having regard to the number and needs of service users ensure that: (e) adequate private and communal accomodation is provided for service users. (h) the communal space provided for service users is suitable for the provision of social, cultural and religious activities appropriate to the circumstances of the service DS0000015851.V253737.R01.S.doc Version 5.0 Page 22 Benton House Nursing Home 5 OP25 6 OP26 users. 16(1) provide in rooms occupied by service users adequate furniture, bedding and other furnishings, including curtains and floor coverings, and equipment suitable to the needs of service users. (see standard 24 for complete list of basic requirements). Assist service users to personalise their rooms with homely features/items. Replace worn and damaged items of furniture and carpets. Remove/replace armchairs that have an unpleasant odour. Ensure adequate stores of pillows and bedding is available. Implement a programme for replacement of beds and mattresses. Previous timescale not met 01/10/05 01/02/06 13, 16, 23 The registered person shall having regard to the number and needs of the service users ensure that: ventilation, heating and lighting suitable for service users is provided in all parts of the home used by service users. : Lighting in service user accomodation to meet recognised standards (lux 150), is domestic in character and includes table-level lamp lighting. Redecorate and refurbish bedrooms, furniture, soft furnishings and floorcoverings. 13, 16, 23 The registered person shall 01/02/06 having regard to the number and needs of the service users ensure that equipment provided at the home for use by service users or persons who work at the home is maintained in good working order. (k) Necessary sluicing facilities are provided. The sluicing and laundry facilities DS0000015851.V253737.R01.S.doc Version 5.0 Page 23 Benton House Nursing Home 7 OP38 must be clean and tidy with an impermeable floor and wall surfaces that are readily cleanable. Protective clothing and hand washing facilities must be readily available. Previous requirement not met 01/10/05 13, 16, 23 The registered person shall 01/02/06 having regard to the number and needs of the service users ensure that equipment provided at the home for use by service users or persons who work at the home is maintained in good working order. (j) After consultation with the environmental health authority make suitable arrangements for maintaining satisfactory standards of hygiene at the home. (k) Necessary sluicing facilities are provided. - The sluicing and laundry facilities must be clean and tidy with an impermeable floor and wall surfaces that are readily cleanable. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP31 Good Practice Recommendations Ensure the home’s manager is employed in addition to nursing and care staff, is “off” the duty rota; to provide adequate managerial time to continue the development of care and services and staff for Benton House Care Home. Benton House Nursing Home DS0000015851.V253737.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 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. 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