Inspection on 13/02/08 for Berwick Care Centre

This inspection was carried out on 13th February 2008.

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

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.

Other inspections for this house

Berwick Care Centre 22/05/09

Berwick Care Centre 09/04/09

Berwick Care Centre 03/12/08

Berwick Care Centre 07/02/07

Berwick Care Centre 21/12/05

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

CARE HOMES FOR OLDER PEOPLE Berwick Care Centre North Road Berwick Upon Tweed Northumberland TD15 1PL Lead Inspector Suzanne McKean Key Unannounced Inspection 13th February 2008 10:00 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 Berwick Care Centre DS0000066367.V358928.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. Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Berwick Care Centre Address North Road Berwick Upon Tweed Northumberland TD15 1PL 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) 01289 331117 01289 302473 berwick@fshc.co.uk www.fshc.co.uk Four Seasons (DFK) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Mrs Dilys Griffiths Care Home 60 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (3), Old age, of places not falling within any other category (54), Physical disability (3) Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Should any of the persons occupying the PD beds leave the home, CSCI must be notified immediately, at which time those beds will revert back to the category of OP. 7th February 2007 Date of last inspection Brief Description of the Service: Berwick Care Home is a purpose built two-storey building on the outskirts of Berwick town. It is of traditional brick and apex roof design. The car parking is provided to the front of the building with a level access into the front of the home. There are gardens to the rear of the premises where there are paved areas with seating provided. The home has good views of the sea. The town of Berwick is within walking distance of the home and there are public transport routes. Berwick Care is registered to provide care to older people, and is able to accommodate those who have been assessed as requiring nursing care. The home charges fees of between £417.57 and £419.08 per week depending upon the needs and requirements of the individual residents. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The home provides information about the service through the service user guide. A copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home. Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Before the visit: We looked at: • Information we have received since the last visit on 7th February 2007. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 13th February 2008 by two inspectors. During the visit we: • Talked with people who use the service, relatives, staff, the manager & visitors. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe & comfortable. • Surveyed a selection of residents, relatives and professionals who visit the care home. We told the manager and the deputy manger what we found. What the service does well: The Manager works hard to maintain the quality of the service and has a good relationship with the people living in the home, relatives and visiting professionals. The home provides good care for its residents including a number of which who have complex nursing needs. The home staff liaises well with National Health Service specialist health care professionals to do so. Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 6 The home is comfortable, well decorated and furnished. The residents and relatives are positive about the care being provided they were particularly complementary about the way they were treated by the staff in a friendly and caring way. The staff are well trained, they were knowledgeable about the needs of the residents and provide care in a friendly and professional way. 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. Berwick Care Centre DS0000066367.V358928.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 Berwick Care Centre DS0000066367.V358928.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 and 6. (Intermediate care is not provided) Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People moving into the home can be confident that the their needs can be met and that the appropriate equipment will be made available for them. EVIDENCE: All prospective residents or their representatives are given the opportunity to visit the home to meet other service users and staff prior to their admission. Although in practice it is usual for only the family to visit the home before admission particularly when the people planning to move into the home is in hospital. Care plans contained good information that was collected by either the manager or senior staff before the resident was admitted. This had been Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 9 gathered from the resident their families or representatives and any professionals caring for the individual prior to the placement being considered. The people living in the home were complementary about the way they were admitted and how they were made to feel welcome. Relatives spoken to said that they had looked around the home prior to the agreement to the placement and had spoken to the manager or senior staff during this visit. Berwick Care Centre DS0000066367.V358928.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home receive good well planned and recorded care and their needs are met in a private and respectful way. EVIDENCE: Care plans were up to date and in very good detail showing that they residents needs had been assessed and plans made as to how they can be met. They were written in a way, which allows the staff using them to plan the care they give. A variety of research based assessment tools are used, and the care plans are reviewed fully at least monthly. The manager monitors the care plans to ensure the standards are maintained. The home is registered to provide nursing care and the home has the necessary equipment to provide for the needs of the current residents. This Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 11 included a number of intermittent pressure-relieving mattresses and patient hoists. A skin integrity assessment tool is used to reduce the risk of residents developing pressure damage and they are assessed formally for their nutritional status. Records show that staff take necessary action to increase the residents calorie intake if they begin to loose weight. Residents are weighed regularly. No unexplained weight loss was noted in the care plans looked at. The Manager is also responsible for completing a weekly status report in which she identifies a number of statistics so that the regional manager is kept aware of the care issues in the home. This includes the number of residents loosing weight and the number of people with wounds and includes information about their current state. The staff support the residents to stay in the home when they are unwell by providing a higher level of care e.g. getting fluids through a drip (sub cutaneous) and with assistance from the specialist nursing services. Residents are provided with services available to the wider community for example chiropody, dentistry and other therapeutic services according to assessed need. Care plans include good information regarding the cultural and religious needs of residents on an individual basis. This is evident in both the social and health care needs. Dietary needs are identified and met for those residents who have requirements specific to their beliefs. The medicine records and systems were good; these were completed, staff are aware of the need to manage the medication systems effectively. Staff were seen knocking on bedroom doors prior to entering and residents interviewed confirmed that this was usual practice. They also said that they felt that they were offered privacy during personal care. Residents were complementary about the way they are supported by the staff an example of the comments were “the girls are always helpful and they are lovely”. Any examinations by medical or nursing staff are carried on in the resident room. Berwick Care Centre DS0000066367.V358928.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 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A good range of publicised activities is made available for people to help them to live satisfying and fulfilled lives. People living in the home are supported to make choices and maintain relationships with those people they value in their lives. EVIDENCE: Some residents described how they are encouraged to take control of their daily routines in simple but important ways including the time they get up, what and when they eat and how they spend their time. Staff confirmed that they encourage resident to make these choices. The home employs an activities co-ordinator, who is offers the residents differing opportunities according to their needs and abilities. The activities offered include some in the home and visits into the community. The home has a mini bus. Bingo, dominoes and crafts are particularly popular with the current relatives. Two residents asked said “I take part in some of the things Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 13 going on, when I feel like it” and a relative said “my mother likes the activities they arrange”. The records of the activities provided are detailed, and there is a social assessment. The staff confirmed that residents are able to choose whether or not they are involved. Due to the dependency level of some of the residents a number of the activities offered are less active and provided on a more one to one basis. The outside areas are pleasant and residents enjoy sitting out in the summer. The food being served is nutritious and well presented, and the residents said that they were happy with what was available and that they could have as much as they liked to eat. A resident said that although she sometimes did not feel like eating “every effort is made to tempt a non existent appetite. Residents receive visitors in their own rooms or the lounges and a number of relatives visit and are involved in the day-to-day life of the home. During the visit a number of relatives were visiting and they were all positive about the care their relative received and the way they were treated by the staff. Berwick Care Centre DS0000066367.V358928.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints procedures are good and people using the service know how to raise concerns. Safeguarding procedures are in place, which reduce the risk of harm to residents. EVIDENCE: The complaints policy is in the service user guide and is displayed in the home. Two residents were asked specifically about how they would make a complaint if they wished to do so. They were both clear about the complaints procedure and said that they would not be worried about speaking to a member of staff if they had any concerns. All residents spoken to during the visit said that they knew Mrs Griffith’s, the Manager, and would speak to her when she tours the home as she frequently did or were happy to speak to the staff when there were small issues they needed to have resolved. The company have good complaint documentation, which is followed by the manager, and she records concerns in line with these. Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 15 The home has policies and procedures in relation to the prevention of abuse and whistle blowing; the staff has had training in these areas of practice either by external trainers or using the in-house training packs. The protection of vulnerable adults is included in the induction programme and the ongoing in house training programmes. Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 16 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 well maintained and suitably decorated, with particularly personalised and comfortable bedrooms. It is kept clean and safe for the residents to live in. EVIDENCE: The home is purpose built and in its own land which has access to a car park to the front of the home. It has a large landscaped area to the side and the back of the home, which is mainly lawned but has shrubs and is planted with colourful plants in the summer. The rear of the home has a view to the sea over part of Berwick. The entrance into the home is level and although access is through a usually closed door this is a very busy area and there is a bell to request access if assistance is needed. Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 17 The accommodation is provided on two floors with lift access to the first floor at the front of the building by the entrance. All of the resident areas have level access and there are no steps or ramps once in the home. The home is generally well decorated although there is a now some remedial decoration needed on walls and door entrances (most likely due to wheelchair damage) and some bedrooms. Two bathroom areas had some damage to the decoration following a minor flood and these were to be re-decorated in the week of the visit. There have continued to be ongoing improvements to the decoration of communal areas. These are now pleasant rooms. During the visit each of the lounges had three or four residents sitting comfortably and enjoying the space and each other’s company. One of the relatives said that she had noticed that there had been a lot of changes to the home when the manager was recently away she said that she was happy now that she was back as she had “confidence in her”. The service user bedrooms are pleasantly furnished and were particularly well personalised to the taste of the occupant, they were comfortable and warm. The home has a redecoration programme. This is followed and the records of this are completed to reflect the progress. The work done was organised to take into account the priority of the residents with minimum disruption. There are now two areas, which are now in significant need of redecoration. These are the kitchen and the first floor treatment room. This is particularly significant as they are areas, which are important in reducing the risk of infection. The laundry area is small and is equipped with appropriate equipment. The area was well organised. Residents were dressed in clean and well-laundered clothing. Although there are occasionally problems with ensuring that clothing does not become mislaid the residents said that they were satisfied with the service. There are good records in place to show that the home is being maintained well. The handyman is aware of his responsibilities and the records were up to date and detailed. There are contracts in place for the services to the home for both routine maintenance and emergency repairs. The on suites are equipped with disposable paper towels, liquid soap, and waste bins which would assist in control of infection. Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 18 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. There are sufficient numbers of appropriately skilled staff at such times to meet the needs of the people living in the home. EVIDENCE: The manager ensures that the staffing rota identifies sufficient numbers of staff of appropriate skill mix to meet the needs of the residents. There were staff on duty during the visit in line with the rota. A qualified nurse is allocated to each floor and the manager is not included in the numbers unless there is only one nurse on duty. The staff receive training in line with the company policy and statutory requirements for fire training, moving and handling, first aid, food handling and hygiene and a plan is in place to address this on an ongoing basis. The record of training was particularly well kept and is used by the manager to monitor the training programme. Any additional training opportunities are allocated depending upon the individual staff member’s role, previous experience and qualifications. These records show that the Manager maintains the training programme to ensure Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 19 that the staff are equipped with any specialist skills and competencies necessary to care for the residents in the home. The staff recruitment and selection records all contained a completed application form, two written references, a completed CRB check and contained the evidence of the equal opportunities policy being followed. All staff commences employment on a trial basis and undertakes an induction period depending upon their previous experience and qualifications. There are records of staff meetings in which a relevant selection of issues around training and quality of the care being provided are discussed. Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 20 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 37. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has good arrangements in place to ensure that safety, welfare and quality of life of the people living in the home is maintained. EVIDENCE: Mrs Griffiths is registered with the Commission for Social Care Inspection as the Manager. She has worked in this role since September 1993 and is a qualified nurse experienced in both nursing and management. Since qualifying she has obtained a degree in health studies and has completed training in teaching. There is now a new deputy Ms Garland who is working with Mrs Griffiths to manage the home. Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 21 Mrs Griffiths and the senior staff of the home continually monitor the views and wishes of the residents by speaking to them on a daily basis. The manager arranges resident and resident meetings. The records of these are available. The meetings are varied and for those who do attend they can offer them the chance not only to discuss any changes occurring but also to become involved in the planning of the social activities. Staff meetings are carried out frequently and the records showed that the content of the meetings cover a broad spectrum of issues. These show that there is good attention to individual aspects of providing care. The range of topics demonstrates the commitment to providing a very high quality service. During the visit there were a number of relatives in the home, some of whom were spoken to about their views of how the home is managed. They were without exception very positive about the way Mrs Griffiths communicates with them and the staff and were complementary about her management style. One expressed her concerns that there had been changes when the manger was away for a short time. However she said that she now felt confident of the standards since her return in November 2007. Another said that they felt confident about how their relative was being cared for and said, “ it is nice to know that I can leave my mother and be sure she is well looked after”. Relatives were all happy with the way they were listened to by the Manager and when going around the home it was noticeable that all of the residents and their families knew Mrs Griffiths and were obviously relaxed and open with her. Regular reviews of individual residents care are arranged either by the Social Services departments or by the home. These offer the opportunity to seek the resident and relative views as well as review the care. The personal records kept in the home of residents who are receiving assistance to manage their finances were examined. They are detailed, logical and appropriate. Receipts were in place for purchases made on behalf of residents and signatures of either two staff or one and the service user were in place. The company undertakes internal audits and this includes the resident’s personal finances. The home has good systems for looking after the homes equipment and ensuring that the premises are safe and well maintained. Good records are kept by the handyman of the checks made. Records are in place to prove that the home has contracts for the premises and equipment safety and service certificates are kept. Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 22 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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 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 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. 1. Refer to Standard OP19 Good Practice Recommendations The kitchen and treatment room are now in need of redecoration and refurbishment to make sure the staff have a area to work in which is easy to keep clean and organised and reduce the risk of cross infection. Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Berwick Care Centre DS0000066367.V358928.R01.S.doc Version 5.2 Page 25 - 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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