Inspection on 07/02/07 for Berwick Care Centre

This inspection was carried out on 7th February 2007.

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 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 13/02/08

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 10:30 7th February 2007 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.V304595.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.V304595.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.V304595.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. 21st December 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. 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 £339.99 and £389.24 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.V304595.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over a total of six hours during one visit. Seven residents and four staff were spoken to at some length and others chatted to briefly. Four relatives were spoken to directly as they were in the home. Six care plans, and records for medication were examined. Also staff files, training records and health and safety documentation was looked at. A random inspection was carried out on 2nd May 2006. This was to respond to concerns expressed from an individual who wished to remain anonymous. During this visit two additional requirements were identified however progress had been made to addressing the requirements made at the previous key inspection. There were ten requirements made at the last inspection they have all been met. No additional requirements were made as a result of this inspection. Two recommendations have been made. What the service does well: What has improved since the last inspection? There have been significant improvements in the environment in the home including a redecoration programme and replacement of furniture and carpeting. Care plans are now detailed and up to date and contain good information about the needs of the residents and how they should be cared for. The staff training and supervision is now up to date and there is a good programme to ensure that they are given sufficient training opportunities and support to fulfil their roles. Berwick Care Centre DS0000066367.V304595.R01.S.doc Version 5.2 Page 6 Administrations of medicine practices are now improved and the staff follow the policies and procedures. 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.V304595.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.V304595.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&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have a good assessment before moving into the home and the appropriate equipment is made available for them at the time of admission. Intermediate care is not provided. EVIDENCE: Four residents files were checked and all of them contained a copy of a full needs assessment carried out by either the referring Care manager or the home staff. For those service users who are self funding, the registered manager or a senior nurse completes a detailed pre-admission assessment. Care plans contained a range of appropriate information on which to plan the care being given including any equipment needed to meet their needs. Berwick Care Centre DS0000066367.V304595.R01.S.doc Version 5.2 Page 9 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. Care plans were checked and staff members spoken to during the visit. These confirmed that a range of specialist services are provided to service users. Staff interviewed had had a range of relevant training and experience. Intermediate care is not provided. Berwick Care Centre DS0000066367.V304595.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, 10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has comprehensive care plans. Individual care for planning is good and care is being delivered in line with these plans. The residents are having their health care needs assessed and met. Staff treat residents with respect and maintain their privacy when they are caring for them throughout their daily life. There are good procedures in place for administering medication, which are being followed by staff. EVIDENCE: Four care plans were examined, they are up to date and in good detail to allow the staff to used 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 Berwick Care Centre DS0000066367.V304595.R01.S.doc Version 5.2 Page 11 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 included a number of intermittent pressure-relieving mattresses and patient hoists. A skin integrity assessment tool is used to reduce the risk of them developing pressure damage. All residents are assessed formally for their nutritional status and staff take necessary action to increase the residents calorie intake if they begin to loose weight. Residents are weighed regularly. No weight loss was noted in the care plans examined. 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. Two of the care plans looked at during the visit did not contain continence assessments. These were residents who had lived in the home for some time. In one case the care plan had been examined in the past by the inspector when the continence assessment was present. The Manager following the visit investigated this. It is believed that they had been removed for re-assessment, they were returned to the care plan. It would be better for them to remain in the care plan or if removed a note should be made in the plan to explain their absence. 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 and 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. Any examinations by medical or nursing staff are carried on in the resident room. Berwick Care Centre DS0000066367.V304595.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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are satisfied with the flexibility of their routines for daily living and activities, which are appropriate to meet their cultural, social, religious and recreational interests and needs. Arrangements for residents to maintain contact with their family and friends and the local community are suited to each individual’s needs and vary accordingly. EVIDENCE: Some residents described the ways 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 choices about how they spend their day. The home employs an activities co-ordinator working 21 hours per week, who is interested in offering the resident differing opportunities for the residents Berwick Care Centre DS0000066367.V304595.R01.S.doc Version 5.2 Page 13 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 and dominoes are particularly popular with the current relatives. Two residents asked said “I really enjoy taking part in the social side of the home” and “we have some lovely times”. The records of the activities provided is 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. 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 resident was having afternoon tea with her two visiting relatives, which was served on a nicely presented tray. They confirmed that they do this on their daily visit. Berwick Care Centre DS0000066367.V304595.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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home informs residents and relatives about the complaints policy. The Manager is active in dealing with complaints. Investigations are detailed and comprehensive with good action plans to address any issues identified. The home protects the residents from abuse by having a policy in place and by training staff in how to recognise and react if abuse is suspected. 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. Berwick Care Centre DS0000066367.V304595.R01.S.doc Version 5.2 Page 15 Records of a recent complaint were examined and had been competed in detail. The home has policies and procedures in relation to the prevention of abuse and whistle blowing; all of the staff have had training in these areas of practice. The protection of vulnerable adults is included in the induction programme and the ongoing in house training programmes. Berwick Care Centre DS0000066367.V304595.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, 20, 24 & 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 decorated to a good standard. The shared rooms are pleasant and are furnished to give a homely atmosphere. The bedroom areas are pleasantly personalised according to the wishes of the residents. The outside of the home is tidy and gives the residents the opportunity to sit out if they choose. The home is clean, tidy and there was no unpleasant odour in the home. EVIDENCE: The service user bedrooms are pleasantly furnished and were personalised to the taste of the occupant, and in line with the National Minimum Standards. Berwick Care Centre DS0000066367.V304595.R01.S.doc Version 5.2 Page 17 There have been significant improvements to the decoration of communal areas and they 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 decoration in the home; she said that she was happy with the changes that had been made. The home has a documented 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 is a space to the rear of the home the home that has seating and the residents said the in the summer they sit out. The gardens are tidy for the time of year. 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. 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.V304595.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures that there are sufficient staff with the correct skill mix to meet the needs of the residents in the home. The staff in the home are recruited in line with the companies policies and procedures. It ensures the safety of the residents. Training is being provided with a good range of both statutory and clinical training. EVIDENCE: The manager makes sure 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. Berwick Care Centre DS0000066367.V304595.R01.S.doc Version 5.2 Page 19 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 that the staff are equipped with the 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 commence employment on a trial basis and undertake an induction period depending upon their previous experience and qualifications. Berwick Care Centre DS0000066367.V304595.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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager, Mrs Griffiths, ensures that there are systems in place to make sure that the home is managed effectively taking into account the needs and wishes of the residents. The resident’s personal allowances are being managed effectively and in recorded in detail. Health and safety is promoted effectively in the home by both the systems in place and the staff working hard to maintain them. Berwick Care Centre DS0000066367.V304595.R01.S.doc Version 5.2 Page 21 EVIDENCE: Mrs Griffiths and the senior staff of the home are continually monitoring the views and wishes of the residents by speaking to them on a daily basis. The manager is continuing to arrange 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. Records were examined of the staff meetings, which take place regularly, and the contents of these suggest that there is a broad spectrum of relevant issues discussed. Regular reviews 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.V304595.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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 X 18 3 3 X X X X X X 3 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 X 3 X 3 X X 3 Berwick Care Centre DS0000066367.V304595.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? 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. 2. Refer to Standard OP19 OP7 Good Practice Recommendations Provide dining chairs with arms and skids. If it is necessary for anything to be removed from the care plan a note must be made to explain its absence. Berwick Care Centre DS0000066367.V304595.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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.V304595.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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