Inspection on 12/12/05 for Bethune Court

This inspection was carried out on 12th December 2005.

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

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

Other inspections for this house

Bethune Court 29/07/09

Bethune Court 23/08/06

Bethune Court 06/06/05

Bethune Court 07/01/05

Bethune Court 05/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Bethune Court 30 Boscobel Road St Leonards-on-sea East Sussex TN38 0LX Lead Inspector Elizabeth Dudley Unannounced Inspection 12th December 2005 11:30a 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 Bethune Court DS0000021051.V272293.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. Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bethune Court Address 30 Boscobel Road St Leonards-on-sea East Sussex TN38 0LX 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) 01424 719393 Anchor Trust Mrs Olga Blything Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is fortyfive (45) Service users to be over sixty-five (65) years of age Date of last inspection 6th June 2005 Brief Description of the Service: Bethune Court is a purpose built residential home on the outskirts of St Leonard’s on Sea in East Sussex. The home incorporates single flatlets for all residents which are furnished with resident own furniture, however furniture can be provided if required. There are several communal areas within the home, and a small well maintained garden, which is easily accessible to all residents of the home. Residents also run a small shop and library and hold meetings to decide what activities and outings they wish to take part in. The home holds many parties and photographs of these adorn the walls of the home. All residents can receive help with personal care, and local GPs and community nurses visit the home. Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 12th December 2005 over a period of four and a half hours, this forms part of the annual inspection programme for this home. During the course of the day thirteen residents, six members of staff and five visitors were spoken with, comments received were positive about life at the home, the care and social activities and the catering. Residents and visitors praised the staff and management for their kindness, help and patience, visitors saying they were always made welcome. A tour of the home took place and documents including care plans, medication charts, menus, personnel files and health and safety documentation were examined. Thanks are extended to the manager, staff and residents for their help, courtesy and hospitality during the day. What the service does well: Residents are encouraged to participate in the major decisions relevant to their life style. The resident’s committee, which meets on a monthly basis generates the ideas for activities and outings and is involved in menu planning. The manager attends these resident’s meetings and therefore is able to listen to their ideas and also to any concerns or complaints that they may have. The standard of catering is good, and separate dishes of vegetables are put on tables for the residents to help themselves. A nice touch is the provision of teapots with tea cosies on the supper tables. Residents can have their meals in their rooms if they prefer. Staff have regular training with over 50 having attained their NVQ2 in care. The manager and some staff have been at the home since it opened, 14 years ago, this has the advantage of continuity of management practice and care and in this case, this has been beneficial. Residents spoken with stated that they like living at the home: ‘it’s a wonderful place’, ‘Staff are so understanding and kind. Bethune Court DS0000021051.V272293.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. Bethune Court DS0000021051.V272293.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 Bethune Court DS0000021051.V272293.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): 1,2,3,4,5, The home provides sufficient information to enable prospective residents to make informed choices as to whether they wish to make Bethune Court their home. EVIDENCE: The home provides a statement of purpose and service users guide, which meet this standard, and provides comprehensive information about the home. All residents receive a copy of the service users guide. A statement of terms and conditions is provided to all residents on their point of entry into the home. Anchor Trust has now formatted a new statement of terms and conditions, which meets this standard. All prospective residents are assessed by the manager prior to being considered for admission to the home. This process ensures that not only is the home suitable for the resident, but that the home can meet their care and social needs. Prospective residents are also invited to visit the home, have lunch or tea, and meet other residents. Staff receive appropriate training in the care of the older person, to ensure that they can meet the needs of people coming to live in the home. Bethune Court DS0000021051.V272293.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): 7,8,9,10,11 Care plans address the assessed needs of the residents but the methods of meeting these needs must be clearly identified. Some risk assessments regarding self-medication need reviewing in order to ensure the safety of residents. All residents appeared well cared for and comfortable. EVIDENCE: A sample of six care plans examined showed evidence of monthly review and the involvement of the resident or their relative. All contained risk assessments relative to the assessed needs of the resident. However the care plans must also contain risk assessments to show whether the resident is able to hold a key to their room and the risk assessments for self-medication were not adequate to assess all the risks involved. This was discussed with the manager and guidance given. This was made a requirement at the last inspection and has not been fully complied with. Although care plans identify the care required by the resident, clarity as how these needs are to be met, is required. All residents can be seen by their preferred GP, unless out of area, and various health care professionals are accessed as required. District nurses deliver care to those residents who require nursing input. Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 10 A nutrition profile has been undertaken on all residents and regular weighing of residents carried out if necessary. The community dietician has visited the home to give advice for specific residents. Pressure relieving equipment is provided by the District nurses for those residents that require this. Although medicine administration records for the previous month were unable to be checked due to the new charts having been commenced and the previous months charts filed in individual care plans, the standard of medicine administration appeared good, with several members of staff having attended accredited medication training. Staff appeared to have an awareness of the various medications used and their responsibilities relating to this. All records relating to the correct accounting and administration of controlled drugs were in place and all external medications had their dates of opening recorded. The drug fridge and clinic room were clean and the correct temperatures for these were maintained. Residents who are very ill can remain in the home. They receive nursing care from District nurses and Macmillan nurses and some staff have attended training given by the ‘end of life project’. Care staff spoken with were enthusiastic about this training and those who had not yet undertaken this were anxious to do so. District nurses spoken with stated that they found that the staff followed their nursing directions and they felt that the care given to the dying resident was ‘very good’. Relatives may stay with the dying resident and the manager will access ministers of religion or advocates as necessary. Previous inspections have shown that those residents who were very ill were comfortable and appeared well cared for. Bethune Court DS0000021051.V272293.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): 12,13,14,15 The standard of entertainment, activities and catering contributes towards a good quality of life for residents. EVIDENCE: Monthly resident’s meetings are held within the home, and during these the residents decide what activities and outings they wish to have. A varied range of activities are provided throughout the year, and those around Christmas include lunch at a pub, carol singing, a visit to Eastbourne for Christmas shopping, a Christmas party and a visit by the local Brownies. Activities have taken place on alternate days since December 1st and will continue until Christmas. The home hires a minibus to take residents out to venues of their choosing and the residents committee decides which places to visit and other activities have included ‘bric-a brac’ sale, a barbecue and a garden party. Photographs of the various activities, parties and outings are displayed around the home. Residents stated that they could have visitors when they wish, and this was verified by visitors, who said that they were always ‘ made welcome’. Residents spoken with felt that they were able to exercise choice in their activities of daily living and that they were free to live the type of life that they Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 12 wanted. The manager was heard asking residents what time they would like to go out and what they would like staff to do for them. Good staff/ resident interaction was apparent, with staff seen talking to various residents about their lives and their interests, all parties holding lively conversations. Residents can have their meals in either the large dining room or in their rooms. Most residents prefer to come into the dining room and enjoy the social interaction with other residents, and it was noted that teapots and tea cosies are provided at suppertime on the tables, these provided a pleasant homely touch in keeping with the era of these residents. A varied menu, planned by residents, is offered and the cook makes the majority of the cakes and desserts served. The menu on this day was sausage casserole or sausage and onions, or salad or jacket potatoes, followed by spotted dick, fresh fruit or jelly. Fresh fruit is provided on a daily basis. Residents stated “ the food is superb”, “You couldn’t wish for better” and “ it is always so well cooked and you always have a choice”. The kitchen was clean although some requirements have been made by environmental health relating to cupboards and work surfaces. These are due to be addressed when the refurbishment of the kitchen takes place in 2006. All records relating to fridge, freezer and cooked food temperatures were in order and the cook has completed the hazard analysis training and is implementing this. The second cook requires to have his food hygiene course updated and a requirement has been made around this. Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 13 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): 16,17,18 Residents were confident that any concerns they might have would be addressed and rectified. Staff were aware of their responsibilities relating to the protection of those within their care. EVIDENCE: Residents state that they feel able to take any complaints or concerns that they may have to the manager. Those that have made concerns known to the manager or staff said that these were dealt with in a fair and satisfactory manner. The complaints procedure is displayed in the hall and is included in the service users guide and meets this standard. Residents are helped to access solicitors and financial advisors if required and take part in the civic process; this is mainly achieved by postal votes, although some residents state that they go to the polling station. All staff have had training in the protection of the vulnerable adult, but although those spoken with were aware of their role in adult protection, the training should be reviewed at regular intervals. Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 14 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): 19,20,21,22,23,24,25,26 Bethune Court provides a safe, clean, well maintained and pleasant home for residents. EVIDENCE: Bethune Court is a purpose built home on three floors consisting of 45 single rooms, all with en-suite facilities, a dining room and small sitting areas, plus large lounges on each floor. The dining room accesses a small well-maintained garden. The home is pleasantly decorated and carpets in individual rooms are replaced when a resident leaves the home. Residents bring their own furniture into the home, although the home has some furniture and variable height beds that can be used if necessary. All rooms have locks to their doors, keys being given to residents if the manager feels they are able to have these. A requirement has been made that risk assessments relating to this are kept in the care plan. The majority of rooms have a lockable facility. Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 15 Radiator covers and window restrictors are in place and water outlets are thermo-regulated. These are checked on a regular basis and records showed that these were within recommended parameters. Communal bathrooms offering assisted bathing facilities are provided and these are kept in a clean condition. The home has been assessed by an occupational therapist and provides a range of aids to help independence and moving and handling equipment. The home is clean and well maintained and staff were aware of basic infection control. The domestic staff are to be congratulated on the cleanliness of the home. Due to some residents using commodes, recommendations have been made to Anchor Trust regarding purchasing a sluice in view of the latest research on the spread of droplet infection. However, they must at the very least, purchase visors to protect their staff. Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 16 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): 27,28,29,30.Staff turnover is low and staff receive induction and ongoing training to enable them to fully meet the assessed needs of the residents. EVIDENCE: The home provides adequate staff on duty to meet the assessed needs of the residents, with 7 staff being employed to work mornings, 6 in the afternoon until 10pm and 2 at night, a minimum of one senior carer is on duty at all times. The home runs a ‘Key worker’ system, thus allocating particular staff to residents and ensuring continuity of care. Staff spoken with stated that they felt there were sufficient staff on duty at all times and said that they felt they had sufficient time to spend with residents. Agency staff are used at times to cover staff sickness or holidays, but this is rare, the home having its own bank of staff. Twelve members of staff are in possession of NVQ2 and three members of staff have NVQ 3, with other staff studying for these, thus 50 of present staff have an NVQ qualification. There are three new members of staff and they were spoken with. They confirmed that they had received a full induction course, and records of this was seen. Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 17 Staff files relating to six members of staff were examined, and these were seen to include all documentation as required by Regulations 18 and 19. Training, both in-house and from external sources is offered to staff on an ongoing basis. This has included catheter care, accredited medication training, end of life training and dementia care. All staff have the mandatory health and safety training. Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 18 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): 31,32,33,34,35,36,37,38 The home is run in the best interests of the residents, allowing their views to be heard within a positive atmosphere. Residents can be assured that all measures are in place to ensure their safety. EVIDENCE: Mrs Olga Blything has managed Bethune Court since it opened, fourteen years ago. She is an RGN (Level 1), is on the register of accredited social workers and holds the Registered Managers Award. Some staff have worked with Mrs Blything since the home opened. The ethos in the home is very positive with residents saying ‘ it’s a lovely place’, ‘ you can’t fault it here’, ‘ no problems with this home, so you are wasting your time’, ‘ the staff are very kind’. Similar comments were also received from visitors with one saying ‘ I’m so pleased we found this place, it gives us peace of mind’. Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 19 All residents were positive about the homes management and the catering, and said that all grades of staff in all areas were approachable, kind, helpful and caring. The home holds monthly residents meetings and staff meetings take place on a regular basis. There is a quality monitoring system in place and the home elicits the views of residents and relatives and more recently, visiting health care professionals. The manager provided evidence that these views are collated and acted upon. Anchor trust now banks all resident’s personal allowances, although other resident’s money is handled through solicitors. It was unclear of whether the personal allowance account is generating interest for residents and further clarification will be received in due course. The business plan for the home and relevant insurances were in place and appeared to be viable and in order. Formal supervision of staff is taking place at intervals dictated by this standard and the regional manager undertakes regulation 26 visits on a monthly basis. Copies of these reports are received by the CSCI. All records are kept securely and there was evidence that the majority of policies and procedures have been reviewed on a regular basis and are relevant to practices at the home. Following the review of the self-medication risk assessment, the policy will also need to be reviewed to reflect the current practice. Service documents and certificates for all utilities and equipment were in date and in place. All staff have undertaken mandatory health and safety training, including domestic and maintenance staff. Automatic door closures have now been fitted to the doors of resident’s personal accommodation and these will enable those residents who wish to do so, to keep their doors open. The hairdressing door must be fitted with a lock or bolt to prevent residents going in when no members of staff are present. Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 20 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 4 3 3 4 4 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 3 3 3 3 3 Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation Reg 15(1) Requirement That care plans clearly address the actions to be taken to meet the care requirements of the service user. That self-medication risk assessments are reviewed regularly. This was a previous requirement June 2005 That all catering staff are in possession of the food hygiene course. That face visors are provided for staff to prevent droplet caused infection. Timescale for action 20/01/06 2 OP9 Reg 13(2) 20/01/06 3 4 OP15 OP26 Reg 13(3) Reg 13(3) 26/01/06 26/01/06 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 OP38 OP38 Good Practice Recommendations That risk assessments undergo a complete review at regular intervals That a lock or bolt is affixed to the hairdressing room. Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Bethune Court DS0000021051.V272293.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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