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Inspection on 07/10/08 for Beulah Lodge Rest Home

Also see our care home review for Beulah Lodge Rest Home for more information

This inspection was carried out on 7th October 2008.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides a homely and comfortable home where residents have ample personal and communal space to meet their needs. Comprehensive pre-admission assessment of needs is conducted to ensure the home can meet the needs of the individual and trial periods are offered so that residents can decide whether the home meets their expectations. Residents are encouraged and supported in making their own decisions and take control of their own lives within a safe environment. People living in the home are routinely consulted about life in the home and their views underpin any decisions made as to the development of the service.

What has improved since the last inspection?

Since the last inspection the home has made many improvements that benefit the outcomes for residents. The home has appointed an experienced manager, two heads of care and increased staffing levels at peak times. Two new cooks have been employed who provide nutritious meals with fresh fruit and vegetables and in consultation with residents. Procedures for dealing with medication have been reviewed under the guidance of a consultant pharmacist and measures implemented to ensure the safety and well-being of residents. Staff training has been ongoing with 75% of staff trained to NVQ level 2 or higher. Recent training for staff includes safe handling of medication, health and safety, fire awareness and optical awareness. Regular fire safety checks are carried out and residents familiarised with actions to take in case of fire. Robust recruitment procedures have been introduced that include all the necessary checks to ensure the safety of people living and working in the home. Staff members receive regular supervision and the provider monitors the quality of the service through regular visits and maintains written records. The home has carried out a renovation programme and purchased new items of furniture that residents benefit from.

What the care home could do better:

The home has met all of the requirements from the last inspection and is to be commended for the improvements made and quality outcomes for people living and working in the home. There are no requirements arising from this inspection.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Beulah Lodge Rest Home 1 Beulah Road Tunbridge Wells Kent TN1 2NP     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: Paul Stibbons     Date: 0 7 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Beulah Lodge Rest Home 1 Beulah Road Tunbridge Wells Kent TN1 2NP 01892548447 01892539040 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Beulah Lodge Rest Home Ltd Type of registration: Number of places registered: care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 21. The registered person may provide the following category/ies of service only: Care home only - (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 (OP). Date of last inspection Brief description of the care home Beulah Lodge is registered for 21 older people. A small number of residents also have mental health difficulties. Beulah Lodge is a detached property with 19 single bedrooms and 1 bedroom which can be shared on request; all have en-suite facilities with WC. There are telephone points in 7 bedrooms, call points and TV points to all bedrooms. There is a shaft lift to all floors. The home is a listed building in a residential area of Tunbridge Wells, close to Victoria Place shopping centre. There are a number of smaller family run shops close by. The Home is on a local bus route and there is a Care Homes for Older People Page 4 of 26 Over 65 21 0 Brief description of the care home main line station in the town. There are gardens to the front and rear of the building with a small car park to the rear of the building. There is an outbuilding housing Company offices to the rear of the house. The owner has 30 years experience in running residential homes and the Manager has 19 years experience working with the elderly in a residential setting and holds the Registered Managers Award and NVQ level 4 in care. The home provides care staff, working a roster, which gives 24-hour cover. Staff are also employed for catering and domestic duties. Current basic fees for the home start from 463 pounds per week. Additional costs include hairdressing, personal toiletries, chiropody, newspapers, transport and personal telephone. Full information about the fees payable, the service provided and the homes Statement of Purpose are available from the owners. Care Homes for Older People Page 5 of 26 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 unannounced Key inspection was conducted over a period of 5 hours on the 7th October 2008. A completed AQAA (Annual Quality Assurance Assessment) was submitted to the commission prior to the inspection taking place. A tour of the premises was carried out and a variety of documents and records were examined. The inspector held discussions with the management, staff members, residents and visiting relatives and noted observations of practice. Care Homes for Older People Page 6 of 26 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 26 Care Homes for Older People Page 8 of 26 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 9 of 26 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. Prospective residents have sufficient information on which to make an informed decision as to whether the home can meet their needs. A trial period and full assessment of needs is conducted before a permanent placement and written contract of terms and conditions is offered to prospective residents. Evidence: The home understands the importance of having sufficient information when choosing a care home and has developed clear information to help prospective residents understand what services the home can provide. The home provides a statement of purpose that is specific to the individual home and the resident group they care for and it clearly sets out the objectives and philosophy of the service supported by a service users guide. The guide details what the prospective residents can expect and gives a clear account of the services provided, quality of the accommodation, qualifications Care Homes for Older People Page 10 of 26 Evidence: and experience of staff and how to make a complaint. Admissions are not made to the home until a full needs assessment has been undertaken. For people who are selffunding and without a care management assessment, a skilled and experienced member of staff always undertakes an assessment. The assessment is conducted professionally and sensitively and involves the individual and their family or representative, where appropriate. Prospective residents are given the opportunity to spend time in the home and an overnight stay to meet other service users and staff. An individual member of staff is allocated to give them information and to help them understand how the home is organised and run and the facilities and services available. The allocated staff member will give them special attention, help them to feel comfortable in their surroundings, and enable them to ask any questions about life in the home. New residents are provided with a residency contract that sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the individual. Care Homes for Older People Page 11 of 26 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. People living in the home have an individual plan of care that sets out how their health, personal and social care needs will be fully met. People living in the home are protected by the homes policies and procedures for dealing with medication. People living in the home are treated with respect and their right to privacy is upheld. Evidence: People receive personal and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. Personal healthcare needs including dietary requirements are clearly recorded in each person centred plan. They give a comprehensive overview of their health needs and act as an indicator of change in health requirements. Personal support is responsive to the varied and individual needs and preferences and the delivery of personal care is individual and is flexible, consistent, reliable, and person centred. Care Homes for Older People Page 12 of 26 Evidence: Staff members were observed in respecting privacy and dignity and are sensitive to changing needs. The service listens and responds to individuals choices and decisions about who delivers their personal care. People are supported and helped to be independent and can take responsibility for their personal care needs. Residents spoken with confirm that staff members listen and take account of what is important to them. Residents have the aids and equipment they need and these are well maintained to support them and staff in daily living. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. Regular management checks are recorded to monitor compliance. Care Homes for Older People Page 13 of 26 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. People living in the home have the opportunity to participate in a range of activities that meet their social, spiritual and recreational interests and needs. People living in the home enjoy a healthy and varied diet that is of their choosing. Evidence: Residents are involved in daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. During the visit residents were observed reading, watching television and generally socialising. Residents have been fully involved in the planning of their lifestyle and quality of life and the home regularly seeks feedback from residents and relatives about the service and any changes they would like to see. The AQAA states that as a result of listening to people they will be reviewing activities offered and providing further opportunities within the community. People who use the service have the opportunity to develop and maintain important personal and family relationships. There are communal areas where residents can entertain friends and family other than their own rooms if they wish. Visiting relatives Care Homes for Older People Page 14 of 26 Evidence: spoken with during the inspection spoke very highly of the service, for example, We looked at several homes for mum, and this was by far the best. The home has employed two new cooks and the menu is varied and healthy and according to the residents wishes. Fresh fruit was available on every table and residents spoken with were very complimentary about the quality of food. Care Homes for Older People Page 15 of 26 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. People living in the home can be confident that their views will be listened to, taken seriously and acted upon. People living in the home are protected from abuse. Evidence: The home has an open culture that allows residents to express their views and concerns in a safe and understanding environment. Residents spoken with say that they are happy with the service provided, feel safe and well supported by the staff team. The service has a complaints procedure that is clearly written and easy to understand and there is also a complaints book to help anyone living at, or involved with, the service and who wish to remain anonymous to make suggestions for improvement. The complaints procedure is supplied to everyone living at the home and is displayed in a number of areas within the service. Residents and others involved with the home understand how to make a complaint and are clear about what will happen if a complaint is made. The manager states the home keeps a full record of complaints and this includes details of the investigation and any actions taken. There have been no complaints received by or about the service since the last inspection. The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Staff members spoken with at the service know Care Homes for Older People Page 16 of 26 Evidence: when incidents need external input and who to refer the incident to. There is a clear system for staff to report concerns about colleagues and managers. Staff that blow the whistle on bad practice are supported by the service. Training of staff in safeguarding is regularly arranged by the Home. Care Homes for Older People Page 17 of 26 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. Residents benefit from living in a safe, well-maintained environment with ample personal and communal space to meet their needs. Evidence: The home provides a physical environment that is appropriate to the specific needs of the people who live there. The well maintained environment provides specialist aids and equipment to meet their needs. The home is a very pleasant, safe place to live and the bedrooms and communal rooms meet the NMS or are larger. All bedrooms have en suite facilities and residents are encouraged to personalise their bedrooms. The service has recently refurbished 7 of the residents bedrooms and purchased new furniture for the dining room and communal lounge. The hallway and other areas of the home have been redecorated and one resident spoken with says its a lovely home, they are always decorating. The environment promotes the privacy, dignity and autonomy of residents. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in private. The home has also developed a quiet library area for the benefit of residents. The home is well lit, clean and tidy and smells fresh and the management has a good infection control policy. Care Homes for Older People Page 18 of 26 Evidence: The home has large well maintained gardens and there are plans to purchase more garden furniture for the summer. The home employs a gardener. Care Homes for Older People Page 19 of 26 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. People living in the home are in safe hands at all times supported by a trained staff team in adequate numbers. People living in the home are protected by robust recruitment policies and procedures. Evidence: The staff rotas have been reviewed and there are consistently enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activity. The staffing structure is based around delivering outcomes for residents and is not led by staff requirements. All staff receive relevant training that is focussed on delivering improved outcomes for residents. The home puts a high level of importance on training and there are plans to develop personal target plans for individual members of staff highlighting their specific training requirements. Staff members undertake external qualifications beyond the basic requirements and 75 per cent of staff have achieved an NVQ qualification of level2 in care or higher, managers encourage and enable this and recognise the benefits of a skilled, trained workforce. Each member of staff have been issued with copies of the General Social Care Councils Codes of Practice and accurate job descriptions and specifications clearly Care Homes for Older People Page 20 of 26 Evidence: define the roles and responsibilities of staff. There is a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the home recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. Staff meetings and supervision sessions take place regularly with a focus on improving outcomes for people using the service. Care Homes for Older People Page 21 of 26 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. Residents benefit from living in a home that is run by a competent manager and the ethos, leadership and management approach of the home. The home is run in the best interests of the residents and their health, safety and welfare is promoted and protected. Evidence: The manager has the required qualifications and experience and is competent to run the home and has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. They work to continuously improve services and they provide an increased quality of life for residents with a strong focus on equality and diversity with residents shaping service delivery. There is a strong ethos of being open and transparent in all areas of running of the home with staff and residents stating that the management are approachable and listen to their views. Care Homes for Older People Page 22 of 26 Evidence: The AQAA contains clear, relevant information that is supported by a wide range of evidence. The AQAA lets us know about changes they have made and where they still need to make improvements. It shows clearly how they are going to do this. The data section of the AQAA is accurately and fully completed. The home works to a clear health and safety policy and all staff are fully aware of the policy and are trained to put theory into practice. Regular random checks take place to ensure they are working to it. Safeguarding is given high priority and the home provides a range of policies and guidance to underpin good practice. There is also evidence of monitoring by the providers with comprehensive written records of their visits. Records viewed during the course of the inspection are of a good standard and are routinely completed. People are supported to manage their own money where possible and the home is not appointee to any residents. Individuals have access to their records whenever they wish. The home has access to professional business and financial advice and has all the necessary insurance cover to enable it to fulfil any loss or legal liabilities. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 © (2008) 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. Care Homes for Older People Page 26 of 26 - 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!