Inspection on 12/04/05 for Bethany House

This inspection was carried out on 12th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bethany House 16/12/08

Bethany House 09/01/07

Bethany House 15/12/05

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Bethany House 3 Margaret Road Harrogate North Yorkshire HG2 0JZ Lead Inspector John Trainor Unannounced 12 April 2005 09:45 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Bethany House Version 1.10 Page 3 SERVICE INFORMATION Name of service Bethany House Address 3 Margaret Road Harrogate North Yorkshire HG2 0JZ 01423 501650 N/A N/A Franklin Homes Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Maria Oakes PC Care Home 8 Category(ies) of Mental Disorder (8) registration, with number of places Bethany House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 23/11/04 Brief Description of the Service: Bethany House provides personal care and accommodation for up to 8 adults who have mental health problems. The home is situated in a pleasant residential area of Harrogate and is within easy reach of the town centre its amenities and facilities. The people who live there have single bedrooms most of which are en suite. There is a variety of communal space available for their use. The accommodation is over four floors and accessed by flights of stairs. There is parking available on the road at the front of the house. Bethany House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited for a day, unannounced and spent six and a half hours inspecting. Four of the five people living at the house were spoken to in order to get their views. Records and care plans were read and the house was looked at, including shared areas, individual rooms, kitchen and bathrooms. Three members of staff were spoken to including the manager. What the service does well: What has improved since the last inspection? What they could do better: The contracts need further change to include detailed breakdown of who is responsible for paying the fees and what proportion so people are clear on the financial arrangements. Some of the people living at the home are not aware of the detail in their written care plans and the staff could review the plans with the individual more to improve this. Some changes to how the medication system is managed when people go out on leave or to day care were recommended in order to ensure things were done safely and recorded properly. Better training for staff to ensure they can meet people’s needs and protect their well being should be developed. Though bedrooms and wash facilities are adequate some changes could be made to enhance people’s privacy and provide for individual preference. The full version of this report includes instructions to the provider how to improve these areas. Bethany House Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bethany House Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Bethany House Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 5 The service at Bethany house assesses people’s needs and aspirations well and provides some written information on the home so individuals are aware of the service and rules when making a choice to live there. This allows for peaceful communal living. EVIDENCE: The future prospective resident has a copy of the statement of purpose and service user guide including the rules and regulations which existing people found useful to establish boundaries for communal living. There was a copy of community care assessments on file and the prospective service users assessment was in the home. Further assessment documentation has been developed by the home to supplement the community care assessment and add to the care planning process which means the service is better for the people living in the home. People said the home met their needs and they had access to specialist services they needed. Visits were being organised including an overnight stay for the prospective resident. Contracts do not state a breakdown of the fees and who is responsible for paying them and a recommendation is made to ensure this information is included for people so they understand the financial arrangements. Bethany House Version 1.10 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 and 10 This home is good at supporting people and encouraging them to fulfil their individual potential. EVIDENCE: Each person had a file which included a care plan built from the assessment process but when people were asked if they knew what was in their care plan they were unaware. The care plan is used as a document for staff and reviewed regularly but more effort could be made to ensure people living at the home know what is in their plan and actively participate in each review. Files included risk assessments for individuals with risk management strategies. Some care plans make use of written agreements signed by people receiving care which evidences the partnership element of supporting people into good self care practices. Improvements had been made to the recording process so information was stored individually as recommended from the last inspection. People spoken to follow their own hobbies and participate in activities outside of the home according to their wishes. People have access to the information held on them by the home. Bethany House Version 1.10 Page 10 Whilst people were encouraged to make individual decisions, take risks within a risk assessment framework and had an individual care plan, people were not aware of how their changing needs were reflected in the care plan. This could be improved by more regular reviews of the plan of care with the individual to clarify all elements of the caring partnership. Bethany House Version 1.10 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12,13, 14,15,16,and 17. People are supported to live in a way which respects dignity, has meaning and purpose and promotes health. EVIDENCE: People participate in the local community, attend college, do voluntary work and pursue their own hobbies and pastimes. People make use of health spa, take walks in the valley gardens as the home is conveniently placed for access to this resource and use leisure facilities. People have choice over what they eat and impact on the development of the menu in the home. Friends and relatives can visit at any reasonable time and people spend time visiting their families. Bethany House Version 1.10 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20. People receive personal health care and support in a way which meets their assessed needs ensuring they are content with the service they receive. EVIDENCE: People fed back to the inspector their care needs were met in a way which respected their dignity even when delicate matters of personal hygiene were involved. Staff were observed to deal with people in a respectful way. Multi agency records showed people have improved in their well being since being resident at the home. Care Plans detailed access to primary health care teams, secondary psychiatric services and dentistry and optician services. This information was corroborated by people’s feedback. Medication procedures meant staff were secondary dispensing when people went home for a visit or out to day care. This practice should be reviewed in conjunction with the pharmacist to remain in line with royal pharmaceutical guidance and to ensure people always get their prescribed medication, recorded appropriately in a way which provides a clear audit trail. Bethany House Version 1.10 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Whilst service users feel they are listened to and their views are acted upon staff have yet to be trained in adult abuse issues leaving people vulnerable to the risk of abuse being missed or inappropriate action taken should it occur. EVIDENCE: The complaints procedure is clearly posted on a service user notice board in the kitchen. People spoken to felt they would be listened to if they had any concerns though one person did express a reluctance to upset staff. A recommendation from the last inspection to have abuse training has not yet been acted upon though plans are underway to secure the training. The multi agency abuse strategy was not available in the home though the manager said she had requested one from the local authority. Bethany House Version 1.10 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 27, 28 and 30 The home provides facilities that meet people’s needs, is clean, safe and hygienic making it a pleasant place to live. EVIDENCE: Individual bedrooms were suitably furnished in a style liked by people living there though had no lockable space for privacy or security of medications should people be able to self medicate. The home is in the process of being refurbished to improve communal space and people are having their say about how to improve things. The home was clean and infection control policy was in place. The kitchen area, which was beginning to need some decoration was on the programme for refurbishment. People liked the house and the geographical location. Though the home has sufficient bathroom facilities, two of the people expressed the preference for a shower but do not have this facility which could be provided, over bath, without too great an expense. Laundry facilities were acceptable. Bethany House Version 1.10 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 and 36 The home had enough staff on duty to meet people’s needs and people felt supported by the staff. EVIDENCE: Training on Mental Health issues has been organised for May. The manager is committed to continuing to access good quality training for staff and continues to look for training opportunities. There are no staff currently employed who have achieved NVQ training.The registered person should make such arrangements as necessary for staff to work towards achieving NVQ qualifications. Adult Abuse training has not been secured or implemented though it is planned to remedy this. Staff recruitment processes were robust and met the required standard. There was not evidence of sufficient supervision in line with the National Minimum Standards. Bethany House Version 1.10 Page 16 There is usually two staff working to a shift and one person living at the home commented that it is better when three staff are on because then it is easier to go out with staff. On the day of inspection staff took people out to the town and walking in the Valley Gardens. The manager does cover as a staff member in the home so people can go out with staff. One member of staff is on long term sick leave which impacts on the ability to deploy greater numbers of staff though current staffing levels are acceptable. Bethany House Version 1.10 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 The home was managed in a way which ensured the health and safety of people living there. People felt listened to and had a say in the way the home developed. EVIDENCE: Fire extinguishers had been reviewed in April 2005 and the home had current health and safety certificates in respect of gas and electrical safety. The premises is checked by food safety and there was evidence in the home staff are trained in food hygiene with prompts for food safety in the kitchen. There is a quality assurance system, which includes visits under regulation 26 and service user questionnaires. Fire training is 3 monthly and a fire risk assessment has been done. There are regular fire drills. The registered manager is in the process of studying for the registered managers award. Staff are trained in first aid. Appropriate insurance was in place and evidenced at inspection. The registered manager is studying for the registered managers award. Bethany House Version 1.10 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 2 Standard No 22 23 ENVIRONMENT Score 3 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 2 3 x 3 Standard No 11 12 13 14 15 Bethany House 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 2 3 3 1 1 Version 1.10 Page 19 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x 3 x Bethany House Version 1.10 Page 20 Yes 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. 1. Standard 23 Regulation 13 (6) Timescale for action Training on Adult Abuse issues 30th June must be implemented and a copy 2005. of the multi disciplinary policy and procedure obtained. The registered person is required 30th May to implement a staff training and 2005. development programme, which should include structured induction and foundation training for staff. (Timescale of 30th January 2005 not met.) Staff must be supervised at least From 12th 6 times per year in line with April and to National Minimum Standards and be records of these supervisions maintained maintained for inspection to thereafter. evidence this takes place. Requirement 2. 35 18(c) 3. 36 18 (2) 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 5 6 Good Practice Recommendations It is recommended the contract includes a proportionate breakdown of fees and who is responsible for paying them. It is recommended that people are more actively involved in the review of their care plans so they are aware of the Version 1.10 Page 21 Bethany House 3. 20 4. 5. 6. 7. 26 27 32 37 detail included and the nature of the caring partnership. Medication practices for leave and day care should be reviewed with a pharmacist to ensure pharmaceutical guidelines are followed and secondary dispensing does not occur. Consideration should always be given to a persons ability to manage their own medication if they are able. This decision should be taken in a multi disciplinary context assessing all risks including compliance issues. Lockable space should be provided in peoples bedrooms. Consideration should be given to installing showers for people who exoress the preference for use of this facility. It is recommended 50 of staff are trained to NVQ level 2 by 2005. It is recommended the manager completes the registered managers award within the timescale. Bethany House Version 1.10 Page 22 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bethany House Version 1.10 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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