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Inspection on 18/11/08 for St Bennetts Care Home

Also see our care home review for St Bennetts Care Home for more information

This inspection was carried out on 18th November 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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

St Bennett`s provides a good standard of care within a homely atmosphere. Residents are supported to maintain their independence as much as possible. Staff are friendly and supportive to the residents and their families. Staff are supported with training needs to help them provide better care for the residents. Residents confirmed that staff were caring and respectful to them, ensuring their privacy and dignity at all times.

What has improved since the last inspection?

The manager has applied for registration with the CSCI to become the Registered Manager for the service and is awaiting confirmation following interview. All staff have attended safeguarding adults training so they are aware of their responsibilities in safeguarding vulnerable people. The manager has introduced a quality assurance system to help improve service provision.

What the care home could do better:

The manager should formulate person cented care plans for each resident that details their past and present life expereinces, and preferences, from which an individula plan of care can be implemented. The Statement of Purpose and Service Users Guide should be updated to include Social Service and current CSCI contact details, timescales for the complaints process, and include that the home provides care for persons with dementia. Care plans should be rationalised to include all aspects of a persons care in one file. Hand written entries on the Medication Administration Records (MAR) should be signed and countersigned to minimise the risk of errors. Advice on advocacy service should be made available. Staff should receive regular, recorded supervision to ensure that their personal development needs are identified and addressed.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Bennetts Care Home 346-348 London Road Leicester LE2 2PL     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: Carole Burgess     Date: 1 8 1 1 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) 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. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: St Bennetts Care Home 346-348 London Road Leicester LE2 2PL 01162745959 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Jennifer RosemaryClark Type of registration: Number of places registered: Mr M A Mapara care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability old age, not falling within any other category sensory impairment Additional conditions: No person to be admitted to the Home in category DE(E) when there are 10 persons in total of this category already accommodated in the Home. No person to be admitted to the Home in category SI(E) when there are 10 persons in total of this category already accommodated in the Home. Date of last inspection Brief description of the care home This home is a centrally located on London Road, Leicester, which offers a service to older people. The location is convenient for transport links. Accommodation is on three floors serviced by a passenger lift. There are 3 lounges and 1 dining room on the ground floor. A large number of bedrooms are well over the National Minimum Standards size and some have en suite facilities. Service users have a ramped way to Care Homes for Older People Page 4 of 28 Over 65 10 10 27 10 0 0 0 0 Brief description of the care home the rear garden and a patio where they can sit. The Statement of Purpose and Service Users Guide are available in the hallway and a copy of the last inspection report is available on request. The weekly fees range from £331 to £525 depending on care needs. There are additional costs for individual expenditure such as hairdressing, newspapers and chiropody. Care Homes for Older People Page 5 of 28 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 is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. We as it appears throughout the Inspection Report refers to The Commission for Social care Inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who use the service and their views of the service provided. Care Homes for Older People Page 6 of 28 The site visit was unannounced and took place over seven hours. We selected four residents and tracked the care they received through a review of their records, discussions with them (where possible), other people who use the service, visitors, the care staff, and observation of care practice. We spoke with staff members regarding training and support. Planning for the inspection included assessing notifications of significant events, and review of the Annual Quality Assurance Assessment (AQAA) sent to the CSCI by the service. Surveys were sent to the service to residents, staff and health professional to provide feedback to the CSCI. Four were received, two from residents and two from a members of staff. These were mostly positive but one indicated that a resident did not always feel listen to, and a member of staff suggested that menus should have more variety and more time should be spent on activities for the residents. 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. Care Homes for Older People Page 8 of 28 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 9 of 28 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 10 of 28 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 are provided with sufficient information about the home and have their health and welfare needs assessed so that they will be met once they more into the home. Evidence: The home provides prospective residents and their relatives with a Statement of Purpose and Service Users Guide that provide information about the home to help them decide if the home is the right one for them. When next updated the Service Users Guide, which includes the complaint procedure, should include the contact details of Social Services, the CSCI, and include timescales for response to complaints, and that the category of dementia is included in their registration. Care Homes for Older People Page 11 of 28 Evidence: Four residents care assessments were seen. These contained appropriate care needs assessments to show that the home could meet their specific health and welfare needs. They included personal details, relative and GP contact details, past and present medical information, current healthcare requirements and medications to demonstrate that the home could meet the individuals personal health care needs. Assessments were satisfactory although they lacked detailed information about peoples social background, past and present hobbies and interests, and personal preferences (see Daily Life and Social Activities) to show that they could provide individualised, person centered care. The service does not proved intermediate care. Care Homes for Older People Page 12 of 28 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. Residents are cared for in respect of their health and personal care. Evidence: Residents care plans provided sufficient information to enable staff to provide the basic care people required. However, it was noted that information was disseminated in a number of files and books which made it difficult to easily and quickly assess what care was required for each person. There were, in addition to the main care plan, separate monthly assessment files, night care plans, a risk assessment file and some information being collated about peoples lives. Care plans were regularly reviewed by the manager in the Monthly Assessment plan, and provided an overview of the care required. Some sections which should have been completed by the care staff were incomplete and/or lacked detail or a rational for the care provided for example: One resident had had their blood pressure taken on one day and a blood sugar reading taken the next day. There was no reason given, no follow up or outcome recorded to explain why the resident had required this to be Care Homes for Older People Page 13 of 28 Evidence: done. Medication policies and procedures were generally sound but hand written entries on the Medication Administration Records (MAR) should be signed and countersigned to minimise the risk of errors - noted at the previous inspection in November 2007. Carers who administer medication had had medication training and received annual updates to ensure that residents received their medication safely and as prescribed. Observation during the inspection showed that staff had a good awareness of how to protect residents privacy and dignity. Staff were friendly and spoke to residents and visitors in a respectful and supportive way. Those people spoken with said that staff were very caring and that they were well cared for. Two people responded to the pre inspection surveys: Their comments about care were generally positive. One person said that they always received the care they needed but another commented that they should be allowed more pads and sometimes had to wait to go to bed because night staff were busy. The manager should ensure that care staff remain vigilant to residents individual needs and preferences which should be noted in their plan of care. Care Homes for Older People Page 14 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff work to ensure that residents experience a safe and homely life style but a lack of detail regarding social information may result in people not having their expectations, preferences, cultural, religious and recreational needs fully met. Evidence: Observation during the inspection showed the lounge to be well laid out so that people sat in small groups watching television, reading, doing crossword puzzles, chatting or just snoozing. Some ladies had their her set during the morning. There was no activities organiser and the manager said that the cares support daily activities that included knitting, skittles, reading and baking. A notice in the lounge advertised daily reminiscence groups but this was not seen to take place that day. Occasional, organised activities included visits to the pub or local hotel in small groups, coffee mornings and clothes parties, film shows (in the home) with a Carol service and Christmas party arranged to celebrate the festive season. The manager was using Quality Dementia Care in Care Homes published by the Care Homes for Older People Page 15 of 28 Evidence: Alzheimers society to inform her and the care staff of appropriate activities for persons with memory loss or dementia. Although there was some information regarding personal preferences and lifestyle, such as, for one person, a preferred bedtime routine, and brief information about another person going to a day care to meet their cultural needs, their was little evidence in the care plans of individual social care information about peoples past life experiences, past and present hobbies or religious and cultural needs on which to build a person centered care. Residents said that they could have visitors at any time and a number of people visited during the day. Residents spoken with said that they could get up and go to bed when the liked, although one person said that she sometimes had to wait to go to bed a the night staff were busy. Most people spoken with said they were happy with the amount of activities provided. Meals were prepared in the homes kitchen by the cook. The manager did most of the food shopping in local supermarkets. There were choices at all meals, food looked well presented and people said the meals were usually good. Special diets could be catered for and staff were seen to help people who required assistance eating their meal in an unobtrusive and unhurried manner. One person said that they would like more choice at teatime. All of the residents spoken with said staff were very good and looked after them well. Care Homes for Older People Page 16 of 28 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. Arrangements for receiving and responding to complaints are satisfactory resulting in the protection of residents rights. Evidence: Residents and staff comments showed that people feel at ease discussing any concerns with the staff. In the pre inspection surveys one person said that they knew how to make a complaint But feel like I can not talk to the manager and with some staff I feel there is a language barrier. The same person also said that sometimes that they felt they were not listened to. This was discussed with the manager at the conclusion of the inspection during feed back. The CSCI has not received any complaints about the service but had received one anonymous call regarding a lack of heating and hot water (see Outcome Area 5). The homes complaint policy and procedure reflects local safeguarding guidance and staff had received appropriate training and were able to show that they knew how to protect residents rights and keep them safe. The complaints policy requires updating to include timescales in responding to peoples complaints and it was recommended that information about advocacy service was made available so that residents or their relatives knew how to access independent Care Homes for Older People Page 17 of 28 Evidence: advice and support should this be required. Care Homes for Older People Page 18 of 28 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. A comfortable, clean, warm and homely environment is provided for the residents. Evidence: The home was clean, warm and comfortable with adaptations to suit residents specific needs. Residents rooms were spacious, well personalised and some had televisions and some of the residents home furnishings. Some rooms had en suit facilities. There were sufficient additional toilets, bathing and assisted bathing facilities for those residents without en suit facilities. At the time of inspection the home had been without the boiler which provided central heating for the home for one week. A replacement has been ordered. This had affected all of the residents personal accommodation and the communal areas. Hot water was available. Convector heaters had been provided and the home felt warm. The manager said that care staff had been instructed to switch off heaters in the residents room when they were not in use and during the night, but to put them on if the residents required care or if they were in their rooms during the day; and extra blanket had been provided. the manager has agreed to keep the CSCI and Social Services informed Care Homes for Older People Page 19 of 28 Evidence: regarding the progress in fitting the new boiler. Care Homes for Older People Page 20 of 28 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. Staff at the home are trained and sufficient in number to meet the residents health and welfare care needs. Evidence: There were nineteen residents at the time of the inspection. Staffing levels at the point of inspection were sufficient to meet the current residents health care needs, and additional ancillary staff such as administrative staff, cooks and a part time cleaner. Residents and a relative said that there usually seemed to be enough staff. Four staff files were checked during the inspection and three showed that there was a satisfactory recruitment process to ensure that residents were well protected. The fourth person was on work experience through an agency and therefore not employed by the home. The manager said that this persons duties were to remain in the lounge under the supervision of other carers and that she was not allowed to provide personal care. It was discussed that it was the responsibility of the Responsible Individual (owner) and the manager to ensure that all people who worked in the home had had an enhanced Criminal Records Bureau Check (CRB) and the manager was advised to obtain written verification from the placing agency so that she could be sure that the Care Homes for Older People Page 21 of 28 Evidence: residents were in safe hands. Staff carry out an induction programme recorded in a booklet which covers all aspects of basic care. Staff undertake training in specific areas such as fire training, first aid, moving and handling, food safety, infection control and safeguarding adults. The manager is Moving and Handling trainer and provides this training for staff. Staff receive mandatory, annual updates in all of the key areas. The manager said that seven staff had completed a National Vocational Qualification (NVQ) in Care, Level 2 and that a number of other staff had degree level qualifications in health and social care. The manager said that she and a number of other staff were undertaking a dementia awareness course to enable them to provide more effective care for persons with short term memory loss or dementia. Staff at St Bennetts have their training needs identified and addressed so that they continue to provide safe care for the residents. Care Homes for Older People Page 22 of 28 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. The manager provides supportive leadership to staff ensuring that residents receive a good standard of care. Evidence: The manager is a Registered Nurse with many years of experience in care. She has recently been interviewed by CSCI to become the Registered Manager for the service and is currently awaiting the outcome. She works in a supernumerary capacity but sometimes provides hands on care and works some weekends so that she can work with staff and ensure that residents needs were being met. She ensures that she keeps professionally up to date and had undertaken numerous course in the last twelve months that include Health and Safety, food hygiene, safeguarding vulnerable adults, Moving and Handling, medication and dementia courses (the list is not exhaustive). She is also a dignity champion for older people. Care Homes for Older People Page 23 of 28 Evidence: There was good interaction between staff, residents and residents relatives ensuring that there is a culture of openness and friendliness in the home. The home keeps small amounts residents money for their personal use. Records of deposits and with-drawls were recorded in residents files. Quality Assurance Questionnaires were provided for residents between July September 2008. Verbal feed back was provided at a meeting with residents and relatives. It was recommended that feedback could be provided in a written format, particularly for those people who are unable to attend meetings. This would ensure that everyone received information to confirm that their opinions were valued and actions taken that helps to improve the service. Staff files showed that staff do receive recorded supervision but this at present was not on a regular basis, although the manger said that it takes place informally. It was recommended that supervision takes place regularly (National Minimum Standards suggest at least six times a year) to ensure that staff receive guidance in all aspects of practice, the philosophy of care the home and their career development needs. Health and Safety policies and procedures, such as regular fire drills and fire alarm test were completed to ensure the health and safety of residents and staff. Care Homes for Older People Page 24 of 28 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 25 of 28 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 1 12 16 To introduce person centred care plan which detail peoples past and present life expereinces and preferences from which an individualised plan of care can be implemented. To ensure that people find the lifestyle of the home matches their expectations and preferences. 19/01/2009 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 1 It is recommended that the Statement of Purpose and Service Users Guide be updated to include Social Service and current CSCI contact details, timescales for the complaints process, and that the home provide care for persons with dementia. It is recommended that care plans are rationalised to include all aspects of a persons care in one file. It is recommended that hand written entries on the Medication Administration Records (MAR) should be signed and countersigned to minimise the risk of errors. Page 26 of 28 2 3 7 9 Care Homes for Older People 4 16 It is recommended that the complaints procedure should be updated to include contact details of local social services and the CSCI, and also include the timescales for response to complaints. It is recommended that advice on advocacy service is made available. It is recommended that staff receive regular, recorded supervision to ensure that their personal development needs are identified and addressed. 5 6 17 36 Care Homes for Older People Page 27 of 28 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 28 of 28 - 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. 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