Inspection on 23/05/07 for Beyer Lodge Nursing Home

This inspection was carried out on 23rd May 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Beyer Lodge Nursing Home 27/06/06

Beyer Lodge Nursing Home 18/02/06

Beyer Lodge Nursing Home 15/09/05

Beyer Lodge Nursing Home 12/01/05

Beyer Lodge Nursing Home 02/06/04

Beyer Lodge Nursing Home 12/02/04

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

CARE HOMES FOR OLDER PEOPLE Beyer Lodge Nursing Home 65 Taylor Street Gorton Manchester M18 8DF Lead Inspector Sue Jennings Unannounced Inspection 23rd May 2007 10:00 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 Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 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. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beyer Lodge Nursing Home Address 65 Taylor Street Gorton Manchester M18 8DF 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) 0161 223 7785 0161 223 9927 sharon.blackwell@anchor.org Anchor Trust Lynn Burch Care Home 16 Category(ies) of Dementia - over 65 years of age (0), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (0) Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users, who all require nursing care , will be 16. All service users shall be above pensionable age and require care by reason of mental disorder (excluding learning disability) or dementia. Minimum nursing staffing levels indicated in the Notice served in accordance with Section 13 (5) of the Care Standards Act 2000 issued on 29 October 2003 must be maintained. 27th June 2006 Date of last inspection Brief Description of the Service: Beyer Lodge Nursing Home is registered to provide accommodation with nursing care for a maximum of 16 older people aged 65 years and above assessed as requiring nursing care for mental health needs. The home was purpose built in the early 1990’s, is on one level, and is totally wheelchair accessible. There are 16 single bedrooms, all with en-suite bathrooms. There are three lounges and a dining room; one of the lounges is designated as a smoking area. The home is set in its own small grounds with a secure, well-maintained garden. It has its own car park. The home is situated on Taylor Street in the Gorton area of Manchester. Shops, public houses and other social areas and amenities are within a short walk of the home, which is close to public transport services. Anchor Trust operates the home. When there is a vacancy at the home Manchester Mental Health and Social Care NHS Trust must first be offered the chance to admit a new resident to fill the vacancy, and only if the vacancy is not filled within 8 weeks is it offered elsewhere. Residents’ ongoing mental health care is the responsibility of a NHS Consultant in older age psychiatry; the residents’ own General Practitioner is still responsible for day-to-day health care. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was undertaken as part of a key inspection, which includes an analysis of any information received by the Commission for Social Care Inspection in relation to this home prior to the site visit. The visit was unannounced and took place over the course of 4 hours on Wednesday 23rd May 2007. During the course of the site visit time was spent talking to the acting manager, 5 residents, a visitor and 3 members of staff to find out their views of the home. The inspector spent time examining records and the residents’ and staff files. A tour of the building was also made. The requirements from the previous inspection were being addressed and there was evidence that the home was continuing to work hard to develop the service. The home and the Commission for Social Care Inspection had not received any complaints in relation to this home. Fees are currently from £422 to £594 a week. Private chiropody, hairdressing, toiletries, magazines and newspapers, meals out and transport are all extra. What the service does well: What has improved since the last inspection? The cultural needs of residents are reflected in the menus. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 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 Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs were identified and met and the home provided sufficient information to people in order for them to make an informed choice about admission. EVIDENCE: All residents were admitted to the home following an assessment of their care needs. Multi disciplinary assessments were carried out by the NHS Mental Health and Social Care Trust or Primary Care Trust or by the local authority. There is also a hospital discharge summary that provides additional information. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 9 Prospective residents are invited to visit the home on a number of occasions before making a decision about admission and usually stay for a meal and progress to an overnight stay. This was to make sure that the home was able to meet the persons needs and that the person was happy to move in. The manager or a senior nurse visited prospective residents in hospital to carry out a pre-admission assessment and to get to know the person. Other staff also visited so that the person knew some of the staff before being admitted. This made the move easier because on the day of admission to the home people were met by staff they knew. A relative spoken to at the time of the site visit confirmed that a visit to the home was arranged before admission. The home did not provide intermediate care. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of the residents were being met at the home. EVIDENCE: A sample of care plans was examined. Each resident had a care plan that identified care needs and the action taken by staff to meet those needs. These were drawn up using the pre-admission assessments and also from appropriate risk assessments undertaken by the home following admission. Medication is dispensed in a monitored dosage system. Residents were registered with a General Practitioner and visits from other health care professionals, including dentists and chiropodists, were arranged as required. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 11 The medication was stored in a metal trolley, which was stored securely in a treatment locked room. The Medication administration sheets were examined and were up to date with no gaps in recording. There was a system of coding the reasons why medication had not been taken. However the code used was not fully explained on the Medication Administration record. An example of this was that one resident had not taken medication since the 20/4/07. The nurse stated that it made her vomit but there is no evidence that a GP had stopped the medication or of any further investigations. Reasons for not administering medication must be clearly recorded and should be used to prompt staff into seeking medical advice if the resident cannot tolerate the medicine. There was no medication policy in the treatment room. This policy is a working tool and should be kept with the medication trolley so that staff can refer to it. A list of signatures of those staff responsible for the administration of medication was not kept. It is recommended that this is compiled to identify that only trained staff give medicines to residents. It is also recommended that photographs of residents are held on Medication Administration Records to identify the resident and help to minimise the risks of medication being administered to the wrong person. There was evidence that temperatures were recorded for the fridge used to store medication requiring cold storage. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided a good environment for the residents with some activities available and meals served at the home appeared to be well balanced. EVIDENCE: Residents at the home were able to choose when to get up and go to bed. One resident spoken to said there were ‘no rules’. The layout of the building gave residents a choice of seating areas. One of the lounges had a television, there was a radio playing in another and the conservatory was designated as a smoking area. Residents were observed sitting and reading watching television or listening to the radio. Residents stated that staff welcomed visitors at any reasonable time and this was confirmed by a visitor. There was an activity co-ordinator employed for 16 hours a week, and a range of activities undertaken by her or other staff was available. A film was shown every Wednesday night and other activities Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 13 included quizzes and board games, and trips out shopping and to cafes and pubs. The residents, some relatives and staff were preparing for an outing to a local restaurant to celebrate an 80th birthday. Staff spoken to said they “usually celebrate special birthdays by going for a meal or by having a party”. The cook makes a cake and a buffet tea. The residents use the ‘ring and ride’ bus service and those who are able to go out independently are encouraged to do so. For those residents who are not able to go out independently a member of staff will take them out. Relatives assist residents with managing finances. Where this is not possible residents have access to an advocacy service There was evidence that equality and diversity had been addressed in that menus included some African Caribbean and Nigerian dishes. Meals were served in a dining room at set times with hot or cold drinks and snacks available throughout the day. Residents were asked at mealtime what they would like to eat from the choices available. Resident’s likes and dislikes had been recorded. The meal on the day of the site visit was roast beef and Yorkshire pudding or Lamb stew, broccoli, cauliflower and carrots. The meal looked appetising and well presented. The menus were written on easy to read posters so that all residents could see them. Cooked breakfasts are provided on request and residents have a hot drink and snack in the evening before they go to bed. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has policies and procedures in place to safeguard residents from abuse and there is an ongoing programme of staff training. EVIDENCE: The home has a complaint procedure that residents were aware of. Copies of the complaint procedure were included in the service user guide and displayed in the home. The Commission for Social Care Inspection had not received any complaints about this service and the acting manager stated that the home had not received any complaints since the last inspection. The home had a policy on protection of vulnerable adults from abuse in line with the Manchester Multi-Agency policy and procedures. Staff spoken to were aware of the procedure and of the action to be taken in the event of an allegation being made. Staff spoken to were able to identify what constituted adult abuse and how to report it. Staff knew the seriousness of such abuse and the need to report it and ensure appropriate external investigation. One visitor spoken to said, We have no complaints. One resident spoken to said, “I have no complaints but if I did I would speak to the staff”. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises are safe and the homes environment including the standard of hygiene was generally well maintained both internally and externally. EVIDENCE: The home felt comfortable and homely. All areas of the home were tastefully decorated and furniture was of a domestic nature and of a good standard. The conservatory was being used as a smoking lounge. This area was not enclosed and adjoined the dining room. The smell of cigarette smoke was noted in the dining room and one of the lounges. There should be an effective method of ventilating this area so that other residents are able to enjoy their meals in a smoke free environment. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 16 Advice must be taken from Environmental Health to ensure smoking arrangements comply with the Smoke Free legislation which comes into force on 1 July 2007. Staff spoken to were aware of appropriate infection control procedures to ensure that the risk of cross infection is reduced as much as possible. Privacy locks were fitted to bathroom and toilet doors and an emergency call system was available. There were no signs identifying where the toilets were. This could be distressing for any new residents who do not know the lay out of the building, and it is recommended that signs are provided to help residents to identify where they are. There is a garden that is accessible from the conservatory. Garden furniture is available for residents wishing to sit out in the good weather. Since the last inspection the radiators have been assessed and it has been decided to replace them. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff appeared sufficient to meet the needs of the clients accommodated. EVIDENCE: The registered manager was on sick leave at the time of the site visit. An acting manager facilitated the visit. Accommodation was provided on one level, with the minimum staffing levels of 4 staff in the morning and 3 staff in the afternoon and evenings being provided. Two waking staff were on duty overnight. All staff have a training programme and record and have undertaken training including Moving and Handling, Fire Safety, Health and Safety and Protection of Vulnerable Adults over the last year. Two members of staff have also undertaken an Anchor Safer Backs course to enable them to be back care coordinators and lead Moving and Handling training. The organisation has introduced “live the dream” which is an award for staff with 100 attendance. Staff achieving this receive a bouquet of flowers and a certificate. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 18 A number of the staff spoken to have been employed for 7 – 10 years creating a close team that residents and visitors knew well. Observations showed that he staff team were enthusiastic and provided a good level of care to the residents. A sample of staff recruitment files was examined and found to contain proof of identity a CRB disclosure and two written references. Some provided evidence of vocational training in service related areas, e.g. moving and handling, food hygiene, safe administration of medicines and fire safety. Staff spoken to confirmed that they had attended training courses and study days. There was little documentary evidence that regular supervision was being provided, although staff said that they received supervision and felt supported. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had systems and procedures in place which safeguard and protect residents’ financial interests. EVIDENCE: Fire safety equipment is inspected at prescribed intervals. Practical fire drills are carried out as required. The home’s certificate of registration was publicly displayed. The home is currently registered to accommodate up to 16 older people. The home encourages relatives to help manage residents’ finances. Some residents manage their own finances and where necessary Age Concern can Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 20 provide an advocate. Some personal allowances are managed by the organisation to meet residents’ everyday needs for toiletries etc. There is a system of maintaining accounts was reviewed and found to be well maintained to ensure that residents’ finances were safe guarded as much as possible. As identified in the previous inspection report the home operates an Anchor audit system known as SAM and this was being used to gain residents, visitors and staff views on the home and how it operated and met residents needs. These results were fed back to residents at residents’ meetings, which were held on an irregular basis. It is recommended that these are held more frequently. Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 21 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 22 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. 1 Standard OP19 Regulation 23 (2) (a) Requirement Advice must be taken from Environmental Health regarding smoking arrangements in the home. Where medication is not administered the reason must be entered and the MAR sheet. Timescale for action 01/07/07 2. OP9 13 (2) 01/07/07 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 Refer to Standard OP9 Good Practice Recommendations • • A medication policy should be kept with the medication trolley for staff to refer to. A list of signatures of the staff responsible for administering medication should be kept with the MAR sheets. 2 3 OP19 OP32 MAR sheets should have a photograph of the resident. Toilets should be appropriately signed to help residents identify where they are. Residents’ meetings should be held on a regular basis. DS0000021633.V337051.R01.S.doc Version 5.2 Page 23 Beyer Lodge Nursing Home Beyer Lodge Nursing Home DS0000021633.V337051.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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