Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Bexton Court Bexton Court Bexton Road Knutsford Cheshire WA16 0BZ The quality rating for this care home is: The rating was made on: three star excellent 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: June Shimmin Date: 3 1 1 0 2 0 0 8 Information about the care home
Name of care home: Address: Bexton Court Bexton Court Bexton Road Knutsford Cheshire WA16 0BZ 01625374166 01625374167 Jill.Greenwood@cheshire.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Cheshire County Council care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability 5 0 Over 65 22 1 Conditions of registration: This home is registered for a maximum of 23 service users to include: * Up to 22 service users in the category DE(E) (Dementia over 65 years of age) * Within the 22 DE(E) service users 5 may be in the category DE (Dementia aged between 55 and 65 years) * No more than 1 service user may be accommodated in the category LD(E) (Learning disability over 65 years of age) Date of last inspection Brief description of the care home Bexton Court is a purpose built community support centre owned and managed by Cheshire County Council. It is near to Knutsford Town Centre, where there are a wide range of shops and other amenities. The fees at Bexton Court are based on a financial assessment of the individual. Bexton Court provides accommodation on a single floor with some office accommodation sited on a second floor. The premises are physically linked to a ward in the adjoining hospital. The home is registered to provide care to a Care Homes for Older People
Page 2 of 9 maximum of 23 service users. Bexton Court is an established provision. It is a wellequipped facility offering a range of short- term respite services for people with dementia, which are tailored to an individual?s needs. Care can include short breaks, flexible day and overnight care. There is a day care unit, which provides 5 places each day from Monday to Friday. In Bexton Court, all rooms are easily accessible to wheelchair users. All bedrooms have wash hand basin facilities, with hot and cold water, door locks and facilities for calling staff should assistance be needed. There are several specially equipped bathrooms with bath and shower facilities. There is a secure garden area for service users and visitors to use. Care Homes for Older People Page 3 of 9 What we found:
Choice of home People and their families are given sufficient information about the home to help them decide if their needs can be met there. Wherever possible people are encouraged to visit the home before deciding to move in. Staff from the home obtain information about the person before they move in and in an emergency on the day they move in. This helps to make sure there is enough information available so the care home staff can draw up a care plan and identify any risks relating to the persons care. Health and Personal Care We looked at care plans of two people who were living at Bexton Court. The care plans were very brief and consisted of one sentence to describe the persons need and a further sentence to describe the actions to be taken by staff to meet that need. This needed to be expanded to include more detail about what staff must do to meet the persons needs in the way they prefer. One care plan we saw included a risk assessment for an identified risk but the care plan for the person who had moved into Bexton Court five days before our visit did not include a risk assessment. The records we saw showed the staff at the home maintain good links with health and social care professionals about the health care needs of each person who lives at the home so those needs are recognised and managed promptly. We saw that staff behave in a sensitive and calm manner with residents and they showed by their actions that they understood the individual needs of each person they were working with. This means that care is person centred and that people living at Bexton Court are receiving excellent care. Feedback from residents and relatives confirmed that staff treated them with dignity and respected their privacy. One of our pharmacy inspectors recently visited Bexton Court to check the management of medicines in the home. The minor improvements recommended at that visit to the layout of the medicines records had been dealt with so they showed clearly that people were receiving their medicines safely as prescribed by their doctors. Daily Life and Social Activities When people are being assessed before they move into Bexton Court, some information about their social background is recorded. This information is important to help staff make sure they can provide good, person centred care for people with dementia. However, after the initial assessment, staff from the home do not obtain further information from the family in the form of a life history. Better information about peoples lives before they move into the home would enable staff to understand significant events in the persons past and what is important to the person now so that care is based on the persons unique care needs. The care staff at Bexton Court provide social activities and we saw a great deal of interaction between staff and residents during our visit. Residents appeared to be enjoying the experience of chatting with the staff. Residents and their relatives Care Homes for Older People Page 4 of 9 commented that there were opportunities for them to be involved in activities if they wished. Residents are reminded of the different seasons and time of year by the activities, which is good practice. For instance the residents had been involved in creating wall displays and collages of the harvest season and Halloween decorations also helped them to identify that it was late October. We saw lunch being served during our visit and this was a relaxed and enjoyable experience for residents. Staff had asked residents in advance what they would like but residents were also able to choose something else if they had changed their mind. A staff member sat at each table with the residents to offer support if needed and so that they could monitor whether residents were eating enough food to keep them well and healthy. Complaints and Protection Complaints at Bexton Court are well managed so that people know their concerns will be listened to and taken seriously. There are appropriate policies and procedures at the home about safeguarding adults and all staff had undertaken training on this during the previous year so they knew the right action to take to protect people who live in the home from possible abuse. Environment Bexton Court is kept very clean, tidy and provides residents with a pleasant environment in which to live. Bedrooms are personalised and residents are encouraged to bring items into the home so they have familiar things around them in their rooms. Hard floor covering has been installed in several of the bedrooms, where an assessment has shown this would be an improvement in maintaining cleanliness. There are various aids and adaptations provided in the home such as light sensors in toilets to help residents find their way round. We saw notices over at least two radiators to warn residents that the radiators could become very hot. Further work needs to be done to manage this problem as some of the residents may not be able to understand the notices. There are very pleasant and secure gardens where residents can walk with minimal supervision and take exercise. Staffing There were very good staffing levels during our visit so that staff had plenty of time to interact with residents. Staff said they enjoyed working at Bexton Court and had opportunities to do further training to help them carry out their role to a good standard. Most of the staff have undertaken training in person centred care so they are well equipped to meet the needs of people with dementia and are able to promote good communication We looked at the recruitment records of a new member of staff and these showed that thorough checks are done to make sure new staff are suitable to work with the residents so the residents are protected from possible harm or poor practice. Management Care Homes for Older People Page 5 of 9 Bexton Court is very well managed and has a strong management team, who are committed to providing high standards of care for people living in the home. There are effective systems in place at the home to monitor whether good standards are being maintained. These include questionnaires to families to find out what they think of the care that is provided. We saw two completed questionnaires that showed people were very satisfied with the services provided at Bexton Court. Relatives and a senior nurse practitioner also commended Bexton Court and said that the home provides excellent care for residents. We looked at the records of tests the fire safety equipment and fire safety training for staff. These showed that regular fire drills are carried out but it was not possible to check whether all staff had taken part in one during the previous six months. The training records showed that a number of staff have not undertaken refresher fire awareness training in the last year so may not be fully up to date about what to do if there is a fire at Bexton Court. What the care home does well: 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 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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 1 38 Any staff who have not undertaken fire awareness training in the last year should undergo this training so they are aware of what to do in the event of fire. Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 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 © (2009) 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 9 of 9 - 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!
