Inspection on 26/02/09 for Berwick House Rest Home

This inspection was carried out on 26th February 2009.

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

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Berwick House Rest Home 1 Berwick Road Blackpool Lancashire FY4 2PT     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: Jacqueline Riley     Date: 2 6 0 2 2 0 0 9 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 03000 616161 (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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Berwick House Rest Home 1 Berwick Road Blackpool Lancashire FY4 2PT 01253342181 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Europe Care Holdings Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 24 Number of places (if applicable): Under 65 Over 65 0 24 dementia old age, not falling within any other category Additional conditions: 24 0 The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of people who can be accommodated is: 24 Date of last inspection Brief description of the care home Berwick House is a residential care home providing care for up to 24 residents with conditions associated with old age and Dementia. It is a large detatched property set within a residential area of Blackpool. There is good access to the transport network close by. The home is of a domestic design comprising of two lounge areas. A dining room and Care Homes for Older People Page 4 of 27 Brief description of the care home twenty two single bedrooms and one double bedroom situated on both ground and first floors. Rooms to the first floor can be accessed by either the stairs or passenger lift. There is also a stair lift for people wishing to access the first floor. Residents rooms are decorated to a good standard and residents are encouraged to personalise their rooms to make them homely. Furnishings and fittings throughout the home are of a domestic nature and the lounges have a range of seating available to residents. There is a conservatory to the rear lounge which overlooks the garden area. The garden is well designed and walled to ensure privacy. There is a Statment of Purpose and Service User guide made available to all users of the service. It provides information about the qualifications and experience of the owners and staff and what services the residents can expect if they choose to live at the home. At the time of the inspection the range of fees were £300.51 to £361.06 per week. 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: This was an unannounced inspection and took place over a five hour period, on 10th February 2009. It was the first inspection since registration of this service in August 2008. We spoke to the registered provider, manager,four staff members, and a number of residents. We spent time in and around the communal areas of the home making general observations to get a flavour of how the home operates on a daily basis. As part of the inspection process we talked to people using the service and asked staff about those peoples needs. We also looked at their rooms, care plans, records and daily notes this is called case tracking. We also invite others using the service to pass Care Homes for Older People Page 6 of 27 on their opinions if they wish, however due to the level of dementia some of the comments were limited. We had some responses from questionnaires sent to people who use the service for their views on how they experience the service. Comments were positive and some are included in this report. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, and to make an assessment of the quality of the service. We use this information, in part, to focus upon our inspection activity. We looked at recruitment and training records of two staff members. We walked around the building and watched people living and working in the home to see how everyone supported and talked to each other. 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. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Older People Page 8 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering living at the home have information about what services they can expect to receive if they choose to live there. Admission and assessment procedures are in place so that the home knows they can meet the individual needs of residents. Evidence: We looked at the records of three residents living at the home. The records were for residents living there on a permanent basis. We saw they had assessment details in place from social workers, or healthcare professionals. In addition there had also been a pre admission assessment carried out by the homes manager when a placement had been an emergency and there had been limited professional assessment provided. The information showed the home is informed through these assessments of the needs of the residents. Staff spoken to said they use this assessment information to determine the level of care the resident needs. Comments received said, We aim to get as much Care Homes for Older People Page 11 of 27 Evidence: information as we can before a resident comes into the home, It can be difficult sometimes to get the information quickly, if this is the case we always make sure we do out own assessment first. We saw the home has produced up to date information about the home and what services it provides. This information is given to residents and to prospective residents or their families or advocates, so that they know what the home can provide and make an informed decision based upon information they receive. 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. Promotion of health is taken seriously. Residents welfare is monitored and their health needs are identified and met. Evidence: The three care planning records we looked at were accurate and up to date. There was good information about individual healthcare needs as well as how those needs are going to be met. Staff we spoke to said the information is clear and they can follow the plans to maintain and support residents who live in the home. Comments included, we have a key worker system and so we are involved in writing things up in the kardex, we follow the care plans which tell us all about the residents needs. The records we looked at show there are risk assessments in place for residents, which highlight what the risk is, how it can be managed and what the outcome is for the resident. There was evidence of risk assessments and care plans being reviewed on a monthly basis by the manager. In some instances there was evidence of changes being made as the needs of the resident changed, so that staff were able to meet the Care Homes for Older People Page 13 of 27 Evidence: presenting need of the resident at the current time. Senior care staff are involved in the review process and those spoken to recognised the importance of review due to the changes in dependency. By looking closely at the records we found there are links between the home and other healthcare professionals including, doctors, district nurses, and psychologists, so that residents healthcare and psychological needs are being met. Medication records and observation of practices in administration showed us it is safe. Only senior staff or the manager administers medication. We looked at three records and found them to be complete and up to date. We looked at how the home stores medication and found it to be in a locked purposeful facility, with metal locked cupboards bolted to the wall to ensure the security of medication. We saw residents privacy and dignity is respected during the visit by looking at how staff talk to and respond to residents. We found staff to be respectful and sensitive to individual residents needs throughout the inspection. Staff spoken to said, we treat residents with respect at all times, The dementia can be distressing sometimes and so we especially make sure their dignity is protected. 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. Social activities and meals are arranged to meet the residents needs, however activities were not seen to be varied which has the potential to have a negative impact on residents. Evidence: We spoke to some of the staff about routines in the home. They said they are flexible and residents can get up and go to bed when they choose. We saw two residents using their rooms during the day. Other resident were in the lounge and dining areas. We saw they are free to move around the home when they choose to. We saw there is plenty of space in the communal areas for residents to use, and a number of residents spent time walking around the lounges and dining rooms without any restrictions. Staff were seen to interact well with them, talking to them, spending time with them when they were having a drink or eating a meal. The interaction between staff and residents was seen to be positive at all times during the inspection. Staff told us they like the way they can spend time with individual residents, comments included, we often have a laugh together, its good to spend time with the residents, they are all such characters. Care Homes for Older People Page 15 of 27 Evidence: The lunchtime meal was being prepared and seen to be wholesome and nutritious. A resident said, they liked the meals and we saw they can eat them when they choose if they are out during mealtimes. Another resident chooses to eat all meals in their room. This is acknowledged by the staff without it being a problem. Comments included, if residents choose to eat in their room then thats O.K. although we do encourage residents to eat together as its a social event as well, where they can have some banter together. We saw staff supporting some residents with their lunchtime meal. This was carried out sensitively by way of the member of staff sitting with the resident and talking to them. Menus we looked at were balanced and the use of fresh produce is made available whenever possible. We spoke to the cook who has been in post for a number of years and has got to know the likes and dislikes of the residents. The cook told us they like preparing the meals for residents, and that they know that due to the home being of a moderate size they know the likes and dislikes of individual residents and they respect this. We were told that there have been instances where special diets are necessary, but the staff always work with the doctor or other health professional for advice and guidance. The Statement of Purpose shows there is a range of activities designed for residents specifically with dementia. By looking at the records of activities we found that not all the activities have yet been introduced. We spoke to the manager about this and were told this is an area which is currently being developed so that residents have more choice and stimulation available to them. We spoke to staff members who said they tend to use the afternoons for activities as this has been found to be the best time. On the day of the inspection there was a film being played and at least six residents were seen to be enjoying the film. Records showed there are often afternoon teas to go along with a showing of a film. There are no restrictions for visitors to the home, however there were no visits during the time spent doing the inspection. 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. The arrangements for recording and responding to complaints are good making sure people feel listened to. Some staff have attended safeguarding training for the protection of users of the service. It is intended all staff will receive this training so that people are protected. Evidence: We looked at the homes complaints procedure, which is made available to residents and their relatives or advocates during the admission process. We were told by staff and a resident they are aware of the complaints procedures and how to use them. Comments included, we are told about complaints and how they are managed during our induction, I think the manager would take complaints seriously if somebody is not happy about something. There have been no complaints made to the Commission since the registration in August 2008. We spoke to the manager and staff about how residents are protected. We were told this is an area being developed so that all staff have access to safeguarding adults training in order to ensure people are protected. Some of the training files we looked at showed us that some staff have previously attended training in this area, but in order for the users of the service to be protected all staff must receive training in Care Homes for Older People Page 17 of 27 Evidence: safeguarding adults. Care Homes for Older People Page 18 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. The home is designed to be homely and comfortable, with ongoing refurbishment for the comfort of residents. Evidence: We looked at the homes layout and design, and found to to be of a domestic nature homely and comfortable. There are two ground floor lounge areas used by most residents. There is a dining room to the rear of the home. In addition there is a large conservatory which has recently been refurbished and is now ready for use. All residents have their own bedrooms. Residents were seen to be moving around the home freely with some residents using the lounge and dining areas in between meals. There has been decoration and replacement of carpets in the front lounge and dining room, as well as the side stairs and hallway. The entrance area has also been decorated. There are plans in place for the continued improvement to the homes environment so that residents live in a well maintained home. There is a passenger lift to access the first floor of the home, as well as a chair lift on the stairs. We saw residents rooms are situated on the ground and first floor of the home. We looked at some of the residents bedrooms. We found them to be a good size and they had various items of furniture. This helps them to feel comfortable with Care Homes for Older People Page 19 of 27 Evidence: personal things around them. All rooms are being decorated as they become vacant so that they can be improved. Some residents had personal items with them including individual pieces of furniture and personal items such as photos, pictures and ornaments. We found a resident likes to use their room at all times and this is not seen as a problem by the staff team. Another resident was seen to use their room at various times of the day as well as using the lounges. The garden area to the front and rear is being maintained and we were told is being prepared for the summer months when residents will be encouraged to use this area as it is secure and not overlooked to ensure the privacy of the residents. The number of bathing facilities meet the needs of residents currently accommodated. In addition a ground floor bathroom is currently being concerted to a wet room so that residents access to bathing will be improved. We saw there are a range of aids and adaptations including hoists and walking aids to help residents move around the home. Care Homes for Older People Page 20 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 procedures in place for recruiting staff, ensuring the safety and protection of residents. Training is being developed so that the staff team will have the necessary skills to meet the residents needs. Evidence: We looked at how the staff team is utilised to meet the needs of the residents during the day and night time periods. We found the home is using a skills mix of staff so that there is always a member of staff on duty with the knowledge and skills in a senior position. We saw there are sufficient numbers of staff to meet the needs of the residents living there. Staff we spoke to said they were happy with the way they are supported and how they work in the home. Comments included, we work as part of a team, There have been some changes but we are all settling down now. The way staff are trained is being reviewed and we saw there is evidence the staff team are going on courses to meet the needs of residents living in the home. Staff have recently attended moving and handling training. There is ongoing development of staff gaining a care qualification, with current numbers up to 40 percent. The manager told us all staff have now either got a care qualification or are working toward gaining it. Training in the area of dementia is another area for development and the manager told us they are seeking a suitable training course for this topic so that the staff team Care Homes for Older People Page 21 of 27 Evidence: will be equipped with the specialist knowledge and skills. Staff spoken to said they had either worked in this specialist area before and had undertaken training in dementia care, or had completed a module in dementia care as part of gaining their care qualification. We looked at two induction training records and found the area of induction covers all aspects of caring for older people. In one instance the record was not complete, however when speaking to the manager we were told the member of staff had completed the training and the record required updating. In all instances where induction training is to be recorded this should take place so that there is evidence as to the competencies of the member of staff in the aspects of care reflected in the record. We looked at two staff files. They showed us staff are recruited safely using procedures which take into account information about their skills and competences for the role applied for. Information about them included application and interview records, references which have been checked, Criminal Record Bureau (CRB). Protection of Vulnerable Adults (POVA)checks to make sure they are safe to work with people who may be vulnerable. Care Homes for Older People Page 22 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. The home is managed for the benefit of all users of the service with systems and policies in place for the safety and protection of residents. Evidence: We saw the manager is running the home on a day to day basis in the best interests of residents and staff. Comments included, we feel supported by the management team, you can talk to the manager if you need to, if we are not sure about anything we can ask. We talked to the management team about team meetings and were told one had taken place following registration to encourage the staff to get to know the management team and to be able to share ideas on the development of the home. Staff told us it was useful and more are planned as the service develops further. We found that all records and systems in the home have been reviewed or are at the Care Homes for Older People Page 23 of 27 Evidence: review stage, so that the information is comprehensive and up to date. Staff were able to follow clear instructions in the records for the health and welfare of residents. We saw there is a clear line of management responsibility and that staff communicated well with the owner throughout the inspection process. We spoke to the administrator about how residents money is handled and were told , residents expenditure on chiropody and hairdressing is paid for by the home and then the residents family or advocate is invoiced so that no money is maintained on the premises. By looking at records we saw regular tests and servicing of essential equipment including, gas, electric and fire they were safe. Care Homes for Older People Page 24 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 25 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 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 1 12 The home should continue to develop a wider range of activities for residents including activities designed for people with dementia so that they receive the stimulation they need. In order to ensure the protection of residents the home should continue to make provision for all staff to receive training in this area. The home should continue to work toward the workforce achieve national vocational qualifications in care to ensure the workforce has the necessary skills to carry out their roles. Staff training should continue to be developed especially in areas of safeguarding adults and dementia so that the care staff are equipped with the knowledge of current good practice. Staff induction records should be completed with the member of staff when induction training is being completed, so that there is a record of the competences of the staff member and areas identified for future development. 2 18 3 28 4 30 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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