Inspection on 21/12/05 for Berwick Care Centre

This inspection was carried out on 21st December 2005.

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

Berwick Care Centre 22/05/09

Berwick Care Centre 09/04/09

Berwick Care Centre 03/12/08

Berwick Care Centre 13/02/08

Berwick Care Centre 07/02/07

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 Janet Thompson Unannounced Inspection 11:30 21 December 2005 st 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 DS0000066367.V265828.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. DS0000066367.V265828.R01.S.doc Version 5.0 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 Four Seasons (DFK) Limited Mrs D Griffiths Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (56), Physical disability (3), Terminally ill (1) of places DS0000066367.V265828.R01.S.doc Version 5.0 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. 26th April 2005 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. Car parking is provided to the front of the building and gardens to the rear. The home offers good views of the sea. The town of Berwick is easily accessable and the home is situated on public transport routes. Berwick Care home can frail elderly peope, some of who require nursing care. DS0000066367.V265828.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place through the week. The inspection was unannounced. The manager of the home was present at the inspection. The inspector walked around the premises but did not conduct a full premises inspection. Residents care records were examined as well as records relating to staff training and accidents. Some relatives were spoken to during the inspection. A number of standards have not been met. However there was an improvement noted in that many standards have had some action taken to address them. What the service does well: What has improved since the last inspection? The home was cleaner than at the last inspection. There were no offensive smells. The atmosphere in the home has improved. The home now appears to be calm and relaxed. Some good efforts have been made to improve staff communication and standard of record keeping. Two new shower rooms are now in operation. These were well presented. Some redecoration of lounges and communal areas has taken place. These look much improved. DS0000066367.V265828.R01.S.doc Version 5.0 Page 6 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. DS0000066367.V265828.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 DS0000066367.V265828.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): 3. Standard 6 does not apply to this home. Service users needs are assessed prior to admission to the home. EVIDENCE: All residents are assessed prior to admission. Pre admission records were examined. They did contain enough information to identify resident’s needs. The preadmission records are used to form part of the admission assessment. Information from care managers, relatives and medical staff is taken account of in the assessment. DS0000066367.V265828.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 Care plans do not adequately reflect the health, personal and social care needs of residents. EVIDENCE: Four resident care plans were examined, one was case tracked. There was some lapse in document changeover to Four Seasons proforma. This made it difficult to assess the information that was current. One care plan had not been reassessed since July. The actual plan of care was inadequate. Information was written as “give all care”. This is not enough. Two plans had nothing written in the social diary since July. Some information written in the daily notes should be in the care plan. One plan was very good, it contained comprehensive information that was reviewed regularly and was well written. The records of food and fluid intake have improved. Different staff members audit them to ensure that all information is properly recorded. A requirement is outstanding regarding the standard of care planning. DS0000066367.V265828.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. The care records did not contain enough information about resident’s lifestyles or their social interests. Residents were helped to maintain contact with family and friends. Residents could exercise choice and control. Residents diet was adequate. EVIDENCE: Residents did have access to a range of social opportunities. There were a lot of activities planned for Christmas, some of which residents had already enjoyed. Resident’s social needs and abilities were not well recorded. Proper recording would assist staff to plan activities for individuals as well as large groups. Staff should ensure that social activities reflect individual choice, need and ability. Relatives and friends were observed visiting the home during the inspection. One group of people had stayed for lunch with a resident. They appeared happy and relaxed. The food on offer was well presented and looked appetising. The menu was satisfactory. Residents and relatives said they were happy with the food on offer. The inspector observed that staff did offer residents a choice on subjects such as where to sit, when to eat and what to wear. DS0000066367.V265828.R01.S.doc Version 5.0 Page 11 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): 18 Staff training does not fully protect residents from abuse. EVIDENCE: Adult Protection Procedures are available in the home. They do include local guidance. The manager and one staff member have received external training in Adult Abuse. Some other staff have not received training since 2003. DS0000066367.V265828.R01.S.doc Version 5.0 Page 12 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): 19.21 and 26. The home was not always well maintained. Toilet and bathing facilities were not adequate. The home was not fully hygienic. EVIDENCE: Two new showers have been provided. These were well decorated, pleasant rooms. The home was generally cleaner than at the last inspection. There were no offensive odours. Some bathrooms and toilets were still in need of redecoration. Walls were scuffed and stained. Some areas of bare plaster were noted, pipes were exposed and the general impression was not welcoming. Light pull cords in some bathing or toilet areas were grubby. These should be replaced and then kept clean. DS0000066367.V265828.R01.S.doc Version 5.0 Page 13 There was a large hole in the carpet of the ground floor lounge. This room was not in use and should not be used until the carpet is replaced. The carpet in the nurse’s office was worn and had black patches. It should be replaced. Dining room chairs are spindle style. They were worn and scuffed. They should be replaced with chairs with arms and skids to offer more support to the resident group and be easier for staff to move in and out. At the last inspection the tumble drier in the laundry was broken. It has been discarded but not replaced. This should be replaced. Sluice disinfector machines were not available. In care homes with nursing these must be provided. As there are nursing patients on both floors there must be a machine on each floor. There were waste bins with swing lids. These should be replaced with foot operated pedal bins. Throughout the home there were communal jugs, used for hair washing. This practice must stop as MRSA is colonised in scalps. There were a number of toiletry items left in bathrooms. These should be used for and returned to individuals only. Some hoisting equipment was not clean. The linen trolley was also dirty. DS0000066367.V265828.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Staff are not fully trained EVIDENCE: Staff have received recent training in Moving and Handling. One staff file was examined. It showed that the staff member had not received any training since 2004. Not all staff had received training in Adult Protection. Fire safety training was not up to date. The manager did not have an overview of staff training and was therefore unable to confirm which staff were due statutory training. A training and development plan was not available. DS0000066367.V265828.R01.S.doc Version 5.0 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 36 and 38. A fit competent manager runs the home. Staff are not appropriately supervised. The health and safety of residents and staff are not fully protected. DS0000066367.V265828.R01.S.doc Version 5.0 Page 16 EVIDENCE: The manager is a first level registered nurse. She has many years of experience in the management of care homes. The manager has had a period of long-term sickness. She has had a number of issues to address on her return, which has taken up a lot of time. The manager stated that she is now making changes to the home that will result in an improvement in systems. The inspector observed that staff residents and relatives demonstrated a lot of trust in the ability of the manager. Staff are expected to receive formal supervision six times per year. Supervision records were examined. These showed that registered nurses have received appropriate supervision. Care assistants have not yet received adequate amounts of supervision. There are a number of issues relating to health and safety shortfalls that have been identified in this report. These are primarily staff training and hygiene. The accident records contained an account of restraint. The manager had not signed the record to show that she overviews accidents and was not aware of the restraint. A requirement is outstanding regarding this. DS0000066367.V265828.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 X 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 2 X 2 X X X X 2 STAFFING Standard No Score 27 X 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 2 X 2 DS0000066367.V265828.R01.S.doc Version 5.0 Page 18 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 OP12OP7 Regulation 15 Requirement All care plans must be reviewed monthly. Care plans must reflect residents social needs as well as physical needs. (OUTSTANDING SINCE APRIL 2005) All staff must receive training in the Protection of Vulnerable Adults. Tidy all bathrooms. Redecorate all bathroom and toilet areas identified at the inspection. (OUTSTANDING SINCE APRIL 2005) Replace light pull cords or cover them with plastic. 4. OP19 16(2) Replace the lounge carpet. Replace the carpet in the nurse’s office. Replace the broken tumble drier in the laundry (OUTSTANDING SINCE APRIL 2005) DS0000066367.V265828.R01.S.doc Timescale for action 01/03/06 2. 3. OP18 OP21 13(6) 13(3) 23 01/04/06 01/04/06 01/05/06 5. OP38OP26 16, 13(3) 01/04/06 Version 5.0 Page 19 Provide a sluice disinfector machine on both floors of the home. (OUTSTANDING SINCE APRIL 2005) Remove communal items from bathrooms. Ensure that all medical equipment including hoists and trolleys are kept clean. Ensure that all staff are up to date with statutory training. Provide a staff training and development plan. Staff must receive appropriate formal supervision. (OUTSTANDING SINCE APRIL 2005) The Registered Manager must complete an overview of the number, type and incidents of accidents to residents. (OUTSTANDING SINCE APRIL 2005) 6. OP38OP30 18(1) 01/04/06 7. OP36 18(2) 01/04/06 8. OP38 17(1a) Sch 3 13(7) 01/02/06 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 Provide dining chairs with arms and skids. DS0000066367.V265828.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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. Extracts may not be used or reproduced without the express permission of CSCI DS0000066367.V265828.R01.S.doc Version 5.0 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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