Inspection on 03/04/07 for Prestbury Beaumont

This inspection was carried out on 3rd April 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

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Prestbury Beaumont Collar House Drive Prestbury Cheshire SK10 4AP Lead Inspector Gill Matthewson Unannounced Inspection 3rd April 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 Prestbury Beaumont DS0000069252.V331085.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. Prestbury Beaumont DS0000069252.V331085.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Prestbury Beaumont Address Collar House Drive Prestbury Cheshire SK10 4AP 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) 01625 827151 01625 827336 Barchester Healthcare Homes Ltd Ms Susan O’Hara Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability (3) of places Prestbury Beaumont DS0000069252.V331085.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the maximum of 35, 3 PD places only under 65 years of age. Date of last inspection 3rd January 2006 Brief Description of the Service: The Prestbury Beaumont care home is located approximately one mile from the centre of Prestbury village. The care home is part of a close care complex set in its own grounds, comprising privately rented bungalows and apartments and a care home. Bedroom accommodation for the care home is situated on the first floor of the main building and consists of 29 bedrooms, 23 of which have en-suite facilities. Six of the rooms are large enough to be used as double rooms to accommodate any residents who may wish to share a room, for example married couples. In addition to three lounges and conservatory on the ground floor the home provides two lounges and an informal sitting area on the first floor. There is a dining room and licensed bar adjacent to the conservatory. Access to the first floor is by two passenger lifts and two staircases. A hairdressing salon, pool for hydrotherapy, recreation and physiotherapy rooms are also provided within the home. Fees for the care home range from £880 to £1,243 per week, depending on the room provided and care needed. Prestbury Beaumont DS0000069252.V331085.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on 3rd April 2007 and lasted eight hours. This visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires were also made available for residents, families and health and social care professionals to find out their views. Other information received since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of residents, relatives and staff were also spoken with and they gave their views about the service. What the service does well: Residents living at Prestbury Beaumont continue to have their health and personal care needs met to a good standard and are satisfied with the care they receive. Residents can make choices how they could spend their day. Social activities at the home are varied and a full programme is always on offer. Meals are well balanced and nutritious and cater for varying cultural and dietary needs. Residents have access to an effective complaints procedure and are protected from abuse. The home is well maintained and has a warm and welcoming atmosphere. Staffing levels are good and staff are well trained to meet the residents’ needs. Residents and relatives are consulted about their opinion of the service. Prestbury Beaumont DS0000069252.V331085.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Prestbury Beaumont DS0000069252.V331085.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 Prestbury Beaumont DS0000069252.V331085.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessment procedures before residents move into the home are thorough and allow family members to be part of the process. EVIDENCE: Residents care files contained preadmission assessments. The assessments had been carried out by the manager or matron and were supported by additional assessments by other health or social care workers, for example, where people had been admitted from hospital, staff there had carried out discharge assessments. Prestbury Beaumont DS0000069252.V331085.R01.S.doc Version 5.2 Page 9 Residents and relatives confirmed that the resident’s needs had been discussed as part of the admission process and that the manager had visited them prior to their admission to the home. Prestbury Beaumont DS0000069252.V331085.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, 10 & 11. 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 that people receive is based on their individual needs. EVIDENCE: Care files contained detailed assessments and care plans for activities of daily living such as mobility, risk of falls, moving & handling, continence, pressure area care, nutrition, hygiene and general dependency. All were up dated and reviewed on a regular basis. Records were also made of support from, and visits by, other health professionals such as GP’s, physiotherapists, opticians and chiropodists. A speech and language therapist was visiting a resident at the time of the inspection. Prestbury Beaumont DS0000069252.V331085.R01.S.doc Version 5.2 Page 11 The care plans were detailed and gave clear instructions to staff to enable them to fully meet the needs of the residents in their care. Medication arrangements were inspected. Medicine Administration Records were examined and found to have been completed correctly. An audit of controlled drugs was carried out, which found that the home fully complies with controlled drugs legislation. All other medicines were stored and disposed of appropriately. The home had completely refurbished the clinical store since the last inspection, providing all new cupboards and shelving and a new drugs trolley. Most residents spoken with stated that they were happy with the care and attention they received at the home and felt that their dignity was maintained and their privacy respected. One relative commented that the home did well in “maintenance of dignity in all situations”. However, one resident said it upset them that occasionally some night staff from overseas would speak to each other in their own language in front of her. This was brought to the attention of the manager and matron, who said that overseas staff are instructed during their induction that this is disrespectful to residents and must not be done. They said they would address this matter straight away. Staff were seen to always knock on doors before entering and to address the residents in a courteous manner. Staff spoken to were aware of the needs of the residents and of their likes and dislikes. Staff were observed in the routines of providing care and support. This was done in a very respectful way. The matron and some of the staff had received training in palliative care. The company had an end of life care pathway that was used when a resident was identified as being near the end of their life. This was discussed with the resident and/or their representative before being implemented and included input from the nursing home GP who had also had training in this area. The end of life care pathway contained information such as what pain relief was to be used if required and this was stored in the home ready for use if it was needed. Prestbury Beaumont DS0000069252.V331085.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): 12, 13, 14 & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to make choices about their lifestyle and are supported to maintain their life skills. Social, cultural and recreational activities meet individuals’ expectations. EVIDENCE: A programme of activities was available on the notice board in the entrance hall and in the main corridors of the home. Residents spoken with said that varied social activities took place at the home. Activities in March included hydrotherapy with the home’s physiotherapist, games, socials, sing a longs, reminiscence, bridge, bingo, exercise classes, quizzes, crosswords, poetry readings, crafts, film shows and baking. There had also been entertainment provided by Music in Hospitals, a production of Oklahoma by a local school and a slide show on Northern Ireland. The home has a minibus which is used on a regular basis to take residents shopping and on visits to places of interest. Prestbury Beaumont DS0000069252.V331085.R01.S.doc Version 5.2 Page 13 Plans were well under way for Easter. Residents were making Easter cards and bonnets on the day of the inspection, church services had been arranged and a choir were going to perform Handel’s Messiah. The atmosphere throughout the home was warm, friendly and relaxed. Residents said that they could do as they please and could get up and go to bed as they wished and that they could choose where they spent their days. They also said that the staff were aware of their needs and they were encouraged to make decisions about their life. Several visitors were observed throughout the home during the inspection and residents confirmed there was open visiting and they could also go out and visit family and friends as they wished. Menus at the home offered choice and snack foods were available between meals if requested. The inspector took lunch with those residents that required assistance. The food was well presented and there was plenty of choice available. Lunch was sociable and relaxed and staff helped those residents that required assistance with eating in a calm, discreet and dignified manner. The chef was well aware of residents’ likes and dislikes and met with residents to select dishes they would enjoy. She had recently purchased a vegetarian recipe book to facilitate this process with one resident. She had recently had additional training in home baking, which was very popular with the residents. The home had achieved the company’s five star catering award. Prestbury Beaumont DS0000069252.V331085.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): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to an effective complaints procedure and are protected from abuse. EVIDENCE: No complaints had been made to CSCI since the last inspection. One complaint received by the manager had been dealt with under the company’s complaint procedure and resolved. A copy of the complaints procedure is available in the service users’ guide. Residents and relatives spoken with said that they had no complaints and that they were aware of who to speak to if they were unhappy about any aspects of the home. Satisfactory policies on the protection of vulnerable adults and whistleblowing were in place. Staff spoken with were aware of these policies and received up-dated training annually. Prestbury Beaumont DS0000069252.V331085.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): 19, 21, 22, 24 & 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well maintained and comfortable environment. EVIDENCE: The living environment was homely, safe, comfortable and well maintained. There was arrange of up to date specialist equipment and adaptations to meet the individual needs of the residents. Residents could personalise their rooms and use their own furniture if they wished. Since the last inspection one of the bathrooms had been completely refurbished and a rise and fall Malibu bath provided. New en-suite facilities had Prestbury Beaumont DS0000069252.V331085.R01.S.doc Version 5.2 Page 16 been provided in 5 rooms. The main dining room and lounge had been refurbished and new kitchen equipment had been purchased. The home was clean and free from unpleasant smells. Residents and relatives spoken with said that the home was always very clean. All staff received training in infection control. Prestbury Beaumont DS0000069252.V331085.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): 27, 28, 29 & 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a service that provides adequate staffing levels and well informed and knowledgeable staff. EVIDENCE: Duty rotas were seen and the staffing numbers at the home were satisfactory for the number and dependency of the residents. The manager and matron were supernumerary. The home did not use any agency staff. The records of three recently appointed staff contained evidence that all the appropriate checks necessary had been carried out prior to employment. These included two written references, one of which was from a previous employer, enhanced checks with the Criminal Records Bureau and a health record. Staff spoken to were aware of their various roles and responsibilities, had an understanding of the policies and procedures that directed their work and had a very good relationship with those they cared for. Prestbury Beaumont DS0000069252.V331085.R01.S.doc Version 5.2 Page 18 All staff received a full induction that covered all of the Skills for Care induction standards. Staff had also received additional training in such topics as customer care, care of people with dementia, the management of medication, assertiveness, communication, handling complaints, continence care, managing time and information, wound management and appraising staff performance. Further training was planned in person centred care, management skills and the implications of the Mental Capacity Act. Fifty per cent of care staff had achieved NVQ level 2 in care and two more were working towards it. Residents were very complimentary about the staff, using comments like “the staff are excellent”, “ the staff are lovely, very caring, nothing is too much trouble”, “perfect”. One relative said “my wife experiences nothing but kindness from all levels of staff”. Prestbury Beaumont DS0000069252.V331085.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): 31, 33, 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is managed by a qualified, competent manager who looks for continuous improvement for the benefit of the residents. EVIDENCE: The registered manager has been in post for five years. She is a first level registered nurse in the fields of adult and mental health. She also holds a Certificate in Health Service Management. One relative commented on the “excellent management” and “marvellous atmosphere”. Prestbury Beaumont DS0000069252.V331085.R01.S.doc Version 5.2 Page 20 Residents living at the home said that their opinions were listened to. A senior manager visited the home on monthly basis, unannounced, to form a view of the quality of the service by talking to residents and staff and reviewing records. These visits and any resulting actions were recorded. The home sent out a customer satisfaction survey in September to residents and relatives. Ninety percent of the respondents said they would recommend the home to others. The manager had collated the findings and was planning on presenting them to residents and relatives in May. Comprehensive policies and procedures were in place. They were due for review in September 2007. The home did not take responsibility for any residents’ personal finances. Staff were supervised on a daily basis and received formal documented supervision three monthly. Annual appraisals were carried out for all staff and training and development needs were identified. Pre- inspection information submitted indicated that all the required safety checks were carried out on equipment and installations. Staff records and observation of staff practice showed that staff were trained in safe working practices. Ten staff had a current first aid certificate. Prestbury Beaumont DS0000069252.V331085.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 4 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X 3 4 X 3 X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X N/A 3 X 3 Prestbury Beaumont DS0000069252.V331085.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Prestbury Beaumont DS0000069252.V331085.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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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