Random inspection report
Care homes for older people
Name: Address: Bethany Francis House Bethany Francis House 106 Cambridge Street St Neots Cambridgeshire PE19 1PL one star adequate service 08/03/2010 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Shirley Christopher Date: 1 5 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Bethany Francis House Bethany Francis House 106 Cambridge Street St Neots Cambridgeshire PE19 1PL 01480476868 01480473799 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) ADR Care Homes Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 34 Number of places (if applicable): Under 65 Over 65 0 34 dementia old age, not falling within any other category Conditions of registration: 34 0 The maximum number of service users who can be accommodated is 34 The registered person may provide the following categories of service only: Care Home only - Code PC to service users 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 Date of last inspection 0 8 0 3 2 0 1 0 Care Homes for Older People Page 2 of 10 Brief description of the care home This home was sold in October 2008 to ADR care homes, who bought it as an ongoing business. They own several other homes. Bethany Francis House is a listed building, set back from the main St Neots to Cambridge road. It has large extensive gardens. It is a Victorian property which has been extended and provides spacious accommodation on two floors. The upper floor is accessed by a wide sweeping stair case at each end of the house. There is a lift available. The home can accommodate up to 34 people who fall into the category of older people, with or without dementia. There are three double rooms and 28 single rooms. 21 have ensuite facilities. The first floor has two bathrooms with hoists and toilets and two individual toilets and one shower room. There are attractive gardens and a number of the residents help with the garden. They have hanging baskets and raised flower beds. The grounds are enclosed and their are suitable seating areas. The home is situated just a few minutes walk from the market town of St Neots where a range of shops and leisure facilities can be accessed. It is close to public transport; the railway station and bus routes. A copy of the homes statement of purpose and service user guide are made available by the home. The current inspection report is available in the hallway. Care Homes for Older People Page 3 of 10 What we found:
We, The Care Quality Commission, (CQC) carried out an unannounced inspection to the home on the 16 June 2010. The purpose of this visit was to check that the home had met the requirements made during the last key inspection which was conducted in March of this year. In March 2010 there was a meeting held under the protection of vulnerable adults to decide if Cambridgeshire should lift the embargo on the home. This had been imposed on the service until identified, necessary improvements had been made. The home has a new manager and area manager in post and they were able to provide evidence at this meeting that the care standards had improved and they were now compliant with the Care Standards Act and with their contractual responsibilities with the Local Authority. At this meeting it was agreed that the Local Authority were happy to start using the service again. The CQC wanted to ensure that progress identified and measures taken to improve the quality of the service were being maintained. On the day of inspection we were met by a senior carer. The provider was also on the premises and the manager for the service arrived at the home to discuss what they had implemented since the last inspection. We met one relative, spoke to a care manager, met some of the residents, spoke to staff on duty and observed care practices. We looked at a new admissions folder, a revised care plan, some maintenance records and looked around the home. At this inspection we saw evidence that requirements made at the last key inspection in March 2010 had been met and no new requirements were made as part of this inspection. What the care home does well:
A new manager has been employed at the home and she is being supported by an area manager who is also new in the post and a deputy manager. There are senior staff in post and the home has a strong management presence. The new manager is enthusiastic and has a lot of ideas and has already introduced a lot of changes. The home has a full compliment of staff, with the exception of one night post vacancy. The home do not use agency staff, but cover staffing hours through overtime. The home are committed to improving the existing skills of their staff and the majority of staff either hold or are working towards a national vocational course relevant to the work they do. The manager stated that staff providing catering support and staff providing activities will also undertake a national vocational course relevant to them. The home was in good decorative order and was maintained and cleaned to as high standard. We identified improvements to the service in all six outcome areas. The pre-admission assessments had improved and will assist the home in determining the persons levels of dependency and the required staffing ratios.
Care Homes for Older People Page 4 of 10 The home has improved their record keeping in respect of their care plans, which have been audited and are lot clearer and more person centred. Access to health care has improved by better record keeping and improved joint working with other health and social care agencies. The quality and quatitiy of food has improved and residents are putting on weight which is being monitored using better nutritional screening tools. We only identified one person with weight loss and that had already been identified and measures taken to prevent further weight loss. The social needs of residents are identified and there was some evidence that these are met through in-house activities. The home had put together photographic evidence of activities they were providing and they are holding a number of events throughout the year. They have recognized that staff providing activities should have specific training. We did not look specifically at complaints or protection but know that the home have had a number of complaints and safeguarding issues which have gone through the correct channels and have been dealt with appropriately. The manager newly in post has been responsible for dealing with the homes legacy work and providing evidence that the home have improved and met requirements set by the CQC and met actions identified by the Local Authority. The environment was light and airy, which provided comfortable accommodation. It was clean and no maintenance issues were identified. There are areas of the home which need refurbishment but we are confident that the home will address this. Staff recruitment checks were more robust and the manager was keen to drive up staff performance through internal processes such as staff supervision, appraisals and better access to staff training. We are confident with the current management arrangements. The home have internal quality audits in place. The area manager completes a monthly audit as required by regulation 26. We looked at the one completed last month and this gave a very detailed reflection of residents experiences in the home. We look at staff recruitment and staff support and there were robust procedures in place. We looked at a number of maintenance records, fire records and water temperatures and they were in order. The manager stated that the current dining room was going to become the sitting room, which would enable residents to sit at the front off the house and be able to see what was going on outside the window and be more involved with people coming and going. What they could do better:
The home is moving in the right direction but would benefit from a period of stability in terms of its staffing situation. Retention of staff would help in terms of building peoples confidence with the service and to increase staffs knowledge of residents needs. The manager in post remains unregistered with the Care Quality Commission and must put in
Care Homes for Older People Page 5 of 10 an application. On the day of inspection there were four staff on duty. The home had five bed vacancies. We asked the manager for evidence that staffing levels were sufficient to meet the residents assessed needs. The manager was able to show us how staffing levels are determined and stated that staffing levels would increase if additional people moved to the home. During our observations in the morning residents were left unattended in the lounges with the exception of lunch time and when provided with mid morning drinks. We did not observe any activities, taking place. It would be good if residents were kept more active and involved in routines within the home such as assisting with drinks, folding laundry or being encouraged to pursue personal hobbies and interests.( Activities were provided in the afternoon.) At lunch time the cook served up the meal in the dining room, and cut food up as appropriate. Choice was offered to residents and the food seemed to be enjoyed by everyone with little waste. During the meal we saw very little staff assistance and other staff were assisting some residents who needed help with their meal. Additional staff at meal times or providing two sittings at lunch may help. 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 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 8 12 Medicines must be given to people in accordance with the prescribers instructions This will ensure people receive their medicines as intended by the prescriber. This requirement has not been met in full by the given timescale of 31/12/09 This will ensure people receive their medicines as intended by the prescriber 31/03/2010 2 9 13 Records made when 31/03/2010 medicines are given to people must be accurate and complete. This requirement had not been met in full by the given timescale of 31/12/09 This will demonstrate that people receive the medicines prescribed for them. 3 9 15 Where people are prescribed 31/03/2010 medicines on a when
Page 8 of 10 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 required basis, there must be clear guidance in care plans of the circumstances they are used and staff must follow this guidance. This requirement had not been met in full by the given timescale of 31/12/09 This will protect people from harm and ensure medication is not given inappropriately 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 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
