CARE HOMES FOR OLDER PEOPLE
Bethel & Bethesda Residential Home Equity Road East Earl Shilton Leicestershire LE9 7FY Lead Inspector
Kim Cowley Unannounced Inspection Thursday, 29th September 2005 12:00 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 Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 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. Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Bethel & Bethesda Residential Home Address Equity Road East Earl Shilton Leicestershire LE9 7FY 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) 01455 847505 01455 850042 Cooper Residential Homes Limited Mrs Judith Anne Wright Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The home may admit one named service user, category Sensory Impairment SI(E), over 65 years named in the application number V9153. Previous Authority. The home may accommodate a named person who falls within the category Sensory Impairment SI(E) as named in the previous authority records dated 18th March 2002. 28th June 2005 Date of last inspection Brief Description of the Service: Bethel and Bethesda is a residential care home for older people. It is close to the centre of Earl Shilton where there is a range of shops and other local amenities. The home caters for 34 residents. All bedrooms but one are single and 21 have ensuite facilities. There are four lounges, two dining rooms, two kitchens, and a secluded courtyard garden. The premises are single-storey and all areas are accessible to residents with limited mobility. Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on a weekday. During inspections the Commission for Social Care Inspection (CSCI) focuses on the outcomes for residents living in a home. In order to do this, the inspector ‘case tracked’ three residents. This means the inspector checked their care records and met with them to talk about their experiences of living in the home. In addition the inspector met a further three residents, and interviewed the Owners and three of the carers. Further care and other records were examined. Staff training was commended. No Recommendations or Requirements were made. What the service does well:
The home has a lively and sociable atmosphere and relationships between staff and residents were seen to be good. All residents interviewed said they felt happy and well cared for in the home. Their comments included, ‘You couldn’t get a better home than this’, and ‘I’d like to be here for the rest of my life.’ Staff were seen welcoming visitors and offering them refreshments. The Registered Manager was on leave on the day of inspection so the Owners showed the inspector round the home. They are energetic, helpful and approachable. During the paperwork part of the inspection a number of residents came into the office. They were always met with courtesy, and the Owners stopped what they were doing to attend to their needs/queries. It is evident that residents come first at Bethel and Bethesda. Staff were observed treating residents with dignity and respect. All residents interviewed confirmed that this was always the case and commented ‘The staff are very respectful and are never rude’, and ‘The staff always knock before they come in my room.’ The staff team is established and some members have worked at the home for many years. The Owners and Manager are supportive of the staff team and encourage them to increase their skills and gain qualifications. This results in better care for residents. One member of staff said, ‘We’re really encouraged to get on and learn all about care and go on courses.’ This is commended. All residents interviewed praised the staff team. One resident said ‘The staff are very good, in fact they are marvellous’, and another commented ‘The staff are terrific.’ Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 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 Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were inspected at the last inspection on 28.06.05. Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9. 10 The home’s medication systems are well organised and staff are trained to administer medication safely. Staff treat residents with respect and uphold their right to privacy. EVIDENCE: The home employs a part-time drugs administrator whose role is to ensure medication systems are safe and work effectively. She is responsible for checking medication in and out of the home, and for some in-house medication training. Only seniors are authorised to administer medication and all have completed a ‘Safe handling of Medication’ course with a local college. In addition the home’s contract pharmacist inspects medication systems every three months. The Owners said if there are any concerns about a resident’s medication their GP is contacted and asked to review it. At present no residents self-medicate although the Owners said they are encouraged to do so where possible. Staff are trained to treat residents with dignity and respect during their ‘First Steps’ induction. This lasts six weeks and covers the principles of good care
Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 10 including privacy, dignity, and choice. The Owners said all staff are observed in their interactions with residents and their performance discussed during supervision. When residents come into the home they are asked to complete a ‘Residents Preferences’ form which sets out their likes and dislikes, including terms of address and personal care routines. Residents made the following comments: ‘The staff are very respectful and are never rude.’ ‘The staff always knock before they come in my room.’ ‘The staff know what they’re doing – they are very gentle when they move (transfer) me.’ Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were inspected at the last inspection on 28.06.05. Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were inspected at the last inspection on 28.06.05. Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were inspected at the last inspection on 28.06.05. Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29, 30 Sound recruitment procedures are in place to protect residents. Staff are offered good training opportunities, supervision, and support EVIDENCE: Records showed that staff turnover in the home is low. The staff team is established and some members have worked at the home for many years. The Owners said it is seldom necessary to recruit new staff, but when the home does proper procedures are followed and checks carried out. These include a requirement for two written references (one of which must be from the candidate’s most recent employer) and enhanced CRB clearance. All new staff work under supervision and have a three months trial period. A programme of formal staff supervision is in place. This includes an annual appraisal and six further supervision sessions. The latter are task-based and comprise of an assessment of a member of staff carrying out a specific role, for example giving personal care, bed making, or serving meals. These supervisions are linked with NVQs to enable staff to gain qualifications as they work. NVQs are established in the home and eight members of staff are currently studying for NVQ Level 2. Some already have NVQ Levels 2 and/or 3. Training in basic literary skills is given to staff where necessary.
Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 15 The Owners and Manager are supportive of the staff team and encourage them to increase their skills and gain qualifications. This results in better care for residents. One member of staff said, ‘We’re really encouraged to get on and learn all about care and go on courses.’ This is commended. All residents interviewed praised the staff team. The following comments were made: ‘The staff are very good, in fact they are marvellous.’ ‘I get on very well with the staff.’ ‘The staff are terrific.’ ‘The staff are a smashing crowd.’ Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 The home is run and managed in the best interests of residents by experienced professionals. Staff safeguard residents’ financial interests. Good policies and procedures are in place to promote and protect the health and safety of staff and residents. EVIDENCE: The Registered Manager has 21 years experience in care. The Owners are equally experienced and are fully involved in the day to day running of the home. The Owners said Bethel and Bethesda aims to be homely and noninstitutional with residents encouraged to maintain their independence and make choices about their lifestyles. Records supported this, for example bedtimes range from 7.30pm – 11pm, and getting up times from 6am to 10am. Late risers can have their breakfast in bed if they wish. One resident commented, ‘The staff bring food to my room when I don’t want to go to the dining room.’ Residents meetings are held every two to three months and give
Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 17 residents the opportunity to air their views about the home, raise issues, and make requests The home looks after small amounts of money for some residents who are not able to look after it themselves. Residents or their representatives sign an agreement if they want this arrangement. Appropriate records are kept. Staff at the home do not get involved in any other aspect of residents finances. These are handled by relatives themselves or by their relatives/representative. If staff have any concerns about how a resident’s finances are being managed social services are involved. Polices and procedures are in place for safe working practices and staff receive appropriate training. A designated person oversees the maintenance of the building and carries out a monthly audit/risk assessment. On a day-to-day basis staff use a maintenance book to record areas in need of attention. Contractors do the servicing and maintenance of appliances in the home. The home had a fire inspection on 15.09.05 and fire officers met with the Owners on 22.07.05 to discuss the installation of a new fire alarm system, which they plan to purchase. The Owners said the home’s Fire Risk Assessment is in the process of being updated following consultation with the fire officers. The Environmental Health Officer inspected the home on 9.05.05 and made a number of recommendations. The Owners said that all of these have been met, with the exception of improvements to the kitchen floor, which they said would be completed by the end of this year. During the inspection a resident came to the Owners to report that one of the rubber ‘shoes’ on her Zimmer frame was faulty. By the end of the inspection it had been replaced. The resident said ‘Look how quickly this has been done! I’m very pleased.’ Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 18 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations Bethel & Bethesda Residential Home DS0000001817.V252787.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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