Inspection on 03/12/08 for Berwick Care Centre

This inspection was carried out on 3rd December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Berwick Care Centre 22/05/09

Berwick Care Centre 09/04/09

Berwick Care Centre 13/02/08

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 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Berwick Care Centre North Road Berwick Upon Tweed Northumberland TD15 1PL     The quality rating for this care home is:   two star good 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: Anne UrwinBrown     Date: 0 3 1 2 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. that people have said are important to them: They reflect the things 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 27 Information about the care home Name of care home: Address: Berwick Care Centre North Road Berwick Upon Tweed Northumberland TD15 1PL 01289331117 01289302473 berwick@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Four Seasons (DFK) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Name of registered manager (if applicable) Mrs Dilys Griffiths Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: 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. Date of last inspection Brief description of the care home 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 Care Homes for Older People Page 4 of 27 care home 60 Over 65 3 54 0 0 0 3 Brief description of the care home 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 £556.57 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. Care Homes for Older People Page 5 of 27 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: two star good 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 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out Before the visit we looked at: Information we have received since the last visit. How the service dealt with any complaints & concerns since the last visit. Care Homes for Older People Page 6 of 27 Any changes to how the home is run. The providers 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 date 3rd December 2008. The visit lasted seven hours. During the visit we: Talked with people who use the service, relatives, staff and the manager. 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. 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. Care Homes for Older People Page 8 of 27 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 9 of 27 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 10 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People moving into the home are confident their needs can be met in an appropriate environment by the staff. Evidence: The Statement of Purpose has been updated since the last inspection. Good information is available for people about the service provided. Three people confirmed that they had received sufficient information about the service before deciding to come to live there. Individual records had good pre admission assessments in place that are used to inform the care planning process. Areas identified with the regulations were covered in the assessments. New forms have recently been introduced and these are very comprehensive. Care management assessments were also in place for those people placed by the local authority. The relatives of one person being admitted on the day of Care Homes for Older People Page 11 of 27 Evidence: the inspection said that the pre admission visit had gone very well and they were very satisfied with the way that the manager and her staff supported them through the admission process. They said that their relative had enjoyed the visit he made to the home and was very much looking forward to living in the home. One resident said that he had enough information to make an informed choice before coming to live in the home. Intermediate care is not provided at Berwick Care Centre. Care Homes for Older People Page 12 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home receive good quality care that is organised to suit their individual needs in a way that respects their privacy and dignity. Evidence: Good care plans were in place for individuals identifying their needs and how these are met by staff. Assessment tools are used to regularly review changing needs and these feed into regular reviews of the care plans. There was evidence available to show that peoples changing needs are identified and met. Staff demonstrated during the inspection a good knowledge of peoples individual needs. During the inspection four people living in the home said that staff were very good and knew what they needed help with and ensured that support was available for them. Seven relatives spoke very positively about the quality of care provided at Berwick Care Centre and all said that they found the Manager and her staff very approachable and responsive to any issues they raised. Health care needs are clearly identified within care plans and peoples nursing needs Care Homes for Older People Page 13 of 27 Evidence: are met by having access to appropriate equipment and support. Intermittent pressure relieving mattresses, hoists and other aids are available as necessary to meet individuals needs. Tissue viability assessments are carried out regularly and the incidence of problems arising was very low. People have access to chiropody, dental, optical and audiology services as necessary to their health and well being. There was evidence from individual plans of good systems for monitoring nutritional intake and any unexplained weight loss is identified at an early stage and action taken. Good policies and procedures underpin practice with regard to administration of medicines. Records were available to show ordering, administration and disposal of medicines complies with good practice. The arrangements for the storage of medicines are satisfactory. Four Seasons Health Care have in place good systems for carrying out regular audits of the medicines administration and records of these were available for inspection. Policies and procedures are in place to ensure that staff are made aware of the need to respect the dignity and privacy of people living in the home. These areas are covered within induction training for new staff as well as confidentiality, equality and diversity. Staff were observed knocking on bedroom doors before entering and were respectful of peoples dignity when speaking to them. It was clear from speaking with people living in the home and from relatives that they are happy with the way that staff interact with them. Care Homes for Older People Page 14 of 27 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. People are encouraged and supported to make choices about their routines and lifestyle. Social, emotional, cultural and recreational needs are met in a way that suits individuals. Evidence: Peoples routines and lifestyle are organised to suit their individual needs and records are available to confirm this. Five people spoken with said that they were able to make decisions about their day to day life. One person said I am able to do things when I want to, I can get up and go to bed when I want to. I can have meals in my room or go to the dining room when I feel like it. A programme of activities is in place and these are arranged by the activities co-ordinator. She organises group events and one to one sessions that suit peoples needs. People living in the home said that they enjoyed the activities. On the day of the inspection there was a cheese and wine party and relatives also attended. During this event people living in the home said they really enjoyed these type of events when they had the chance to get together with their families and friends from the local community. Relatives said that they feel satisfied that the way staff support people reflects their wishes about their routines and lifestyle. There was evidence from individual plans that the staff support people to Care Homes for Older People Page 15 of 27 Evidence: keep in touch with relatives and friends in the community. Appropriate opportunities are provided for people living in the home to exercise choice and control over their lives. This was evident from records and from talking with individuals. Equality and diversity principles are reflected in staff guidance and staff showed that they were aware of the need to respect individuals privacy, dignity and cultural identity. People are encouraged to retain control of their financial affairs for as long as possible. Rooms are personalised to reflect individuals interests and taste with most people bringing in items of furniture when they move into the home. During the inspection one family were helping a person who was moving in to organise his room to suit his taste and needs with items from his previous home. Menus show that a good variety of food is available. There are alternatives available at each mealtime. People said that the food is good, well cooked and that there is plenty available. The kitchen is in need of redecoration and this was highlighted in the last inspection report. It was also needing cleaned, the deep fat fryer is leaking and the cooker is not working properly. During this visit the Environmental Health Officer visited. He made recommendations relating to the need for more attention to be given to cleaning the kitchen, the cooker should be replaced if parts cannot be sourced, the fat fryer needs repaired or replaced and the walls need redecorated or wet wall panels installed. The kitchen staff have completed food hygiene training. Arrangements for the storage of food was satisfactory. Care Homes for Older People Page 16 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the good systems in place for dealing with complaints and safeguarding matters. Evidence: The complaints procedure is available in the service user guide and copies are displayed in the home. Three people living in the home said that they were aware of the complaints procedures and would feel able to talk to the manager or the staff if they had any concerns. Relatives also said that if they wished to make a complaint they were sure that the manager or the staff would take seriously any issues. One relative said the manager and her staff are wonderful and they are always very kind and considerate. They make sure that I am kept informed about my mothers care and they always make time to talk to me if I have any concerns about my mothers condition. No complaints have been made, but good records are kept of complaints and any investigation. Staff know how to assist a person wanting to make a complaint. Policies and procedures are in place for dealing with allegations of abuse and for whistle blowing. Staff were aware of the procedure to be followed in the event of an allegation being made. Staff have an ongoing training programme that includes dealing with abuse. Care Homes for Older People Page 17 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable, well maintained and decorated home that suits their needs. Evidence: The home is situated in its own grounds in a residential area of Berwick. It is purpose built and has car parking to the front of the building and a large landscaped area to the side and rear of the building. This area is mainly lawned with some attractive shrubs and there are views to the sea. Accommodation is provided on two floors and there is a shaft lift fitted for ease of access. Good systems are in place to record maintenance work being carried out. Systems are in place for recording servicing and repairs of equipment. The accommodation is generally well maintained, decorated and furnished. Since the last inspection the dining room has been refurbished and carpets and curtains have been replaced. The sitting areas are spacious, comfortably furnished and well decorated. Since the last inspection a conservatory has been fitted to rear of the building and has attractive views to the sea. This area is generally used during the day. Residents said that the home is comfortable and that there are plenty of places to sit quietly or to enjoy the company of others depending on how they are feeling. Care Homes for Older People Page 18 of 27 Evidence: Bathrooms and toilets are fitted with appropriate aids and equipment to suit the needs of the people living in the home. During the inspection the hot water in two bathrooms and one toilet was very hot and could present a hazard to people living in the home. This matter was listed in the maintenance book for attention. Signs warning that water was very hot were put up during the inspection. Bedrooms are decorated as part of a rolling programme. Rooms are well furnished and appointed. Five people living in the home said their rooms were very comfortable and they had been able to bring things in to make it feel more homely. The laundry is well organised and equipped with washing machines with sluice programmes. Residents clothing was clean and well laundered and good systems were in place to return washing promptly. No concerns about the laundry service were mentioned. Staff have had infection control training. Care Homes for Older People Page 19 of 27 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. There are sufficient appropriately skilled and trained staff to meet the needs of the people living in the home. Evidence: There were appropriate numbers of staff at all times to support the needs, activities and aspirations of people living in the home. There is an appropriate skill mix of nurses and care staff provided and this was confirmed from staff rotas, talking to staff and people living in the home. There was evidence from the manager and senior staff that they have a good understanding of the flexibility needed to ensure staffing is adequate to meet peoples needs. Good communication systems are in place to ensure consistency and person centred approach is supported. Good induction training is provided for new staff. Support is provided by existing staff and one person said that she had received good support when she first started working at Berwick Care Centre. Staff training is well organised and targeted. Good records are kept to show training planned and undertaken. Staff said that they received plenty of training opportunities and mandatory training is up to date or organised. Care Homes for Older People Page 20 of 27 Evidence: Seven people living in the home spoke highly of the support they received from the manager and her staff. One person said The staff are very good, they know what I need help with and come when I want them. Relatives also said that they were very satisfied with the care provided to their family members. One person said that her mother received excellent care and she was very satisfied with the way staff communicate with her and the rest of her family. She said The manager is wonderful and I am very happy with the support provided at the home from all the staff who are all so kind. Staff recruitment procedures are well developed and followed to ensure that people using the service are well protected. The recruitment procedures take account of equality and diversity principles. The interview and selection process is based on identified criteria within individual job descriptions. Staff records showed that reference and other checks are carried out prior to new staff starting work in the home. Records seen showed that all elements of recruitment are clearly recorded and required information is always received before the employee starts work. Staff training is well organised and planned. All staff receive relevant training opportunities that is focussed on delivering better outcomes for people living in the home. Care Homes for Older People Page 21 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a well managed home and are encouraged to put forward their views. Evidence: The manager is a registered nurse and is experienced and well qualified. She is supported by an experienced and settled senior staff team. The people living in the home and relatives all spoke positively about the support they receive from the manager and her staff. They said that they were satisfied that they could speak to the manager and senior staff about any concerns they may have and that there were plenty of opportunities to put forward their views about the service. There are regular resident and relative meetings. Good systems are in place for auditing the quality of the service. People are asked for their views by questionnaires and this information is used in planning any changes to the delivery of the service. Copies of reports prepared by the line manager were Care Homes for Older People Page 22 of 27 Evidence: available for inspection and these provided good information about the quality of the service and actions taken to address any issues identified. There are regular staff meetings and staff have regular supervision and issues identified are followed up. Staff said that they felt well supported and able to put forward their views about the service. Good recording systems were in place and record keeping was of a high standard. Records are kept securely in accordance with the requirements of current legislation. Records of accidents are kept and there are systems in place for monitoring the incidence of accidents. There was evidence of good risk assessments and of systems for regular reviews of any assessments. Good systems are in place for dealing with money held on behalf of people living in the home. Records are well kept and any money held is securely stored. Good records are kept of fire alarm testing and servicing. Health and safety policies and procedures underpin good staff practice and are regularly reviewed. Risk assessments are in place. Staff training in health and safety is provided. Individual training records reflect this. Care Homes for Older People Page 23 of 27 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 24 of 27 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 15 16 The issues identified by the 28/02/2009 Environmental Health Officer must be addressed: a more effective cleaning routine must be introduced, redecoration/fitting of washable wall panels must be completed, the cooker and deep fat fryer must be repaired or replaced. This will ensure that adequate facilities and equipment are available so that the production of meals is not affected by the environment. 2 25 23 The hot water system must be checked to ensure that thermostats are in good working order. This will ensure that hot water is provided at an appropriate temperature to safeguard people from scalds. 31/01/2009 Care Homes for Older People Page 25 of 27 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 Care Homes for Older People Page 26 of 27 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 © (2009) 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. 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