Care Home: Beaufort House Care Home

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What the care home does well The Annual Quality Assurance Assessment (AQAA) stated that the home manager or the deputy would go out and assess a prospective resident before admission to ensure that the home is able to meet their needs. The AQAA also stated that the home has comprehensive documentation about individuals and the aim is to promote independence to the level manageable to the person. The home manager told us that nutrition is an important part of the day and the nutritional standards are monitored regularly. Changes to the menu are done if residents do not like or want certain foods. Residents are regularly consulted. We noted on the day of the visit that staff ensure meals are not hurried and that people who are unable to feed themselves are assisted in a respectful and dignified manner.The home has an open house policy and encourage visitors and encourage outings for residents and their families and friends. A complaint procedure is in place to enable service users, families, friends and advocates to complain if unsatisfied with the services provided by the organisation. The complaints procedure also gives them the option of how to contact the Commission for Social Care Inspection it they were not satisfied with the way that their complaint was handled. The home follows thorough recruitment practices to ensure that appropriate staff are employed at the home. The environment is well maintained, tidy and safe giving the service users a sense of homeliness and security. There is an ongoing training course to enable staff to meet individuals` needs for example the development of Yesterday, Today and Tomorrow training which explains dementia, people`s feelings, vulnerabilities, moods, aggressive behaviour and the how staff can help to manage these in a more supportive way. What has improved since the last inspection? The home told us that a new cook has been employed who is in the process of reviewing the menus to ensure that the new menus contain 5 fruits and vegetables protein and carbohydrates for the nutritional well being of the residents. The home has employed an activities coordinator who is focused on providing individualised activities as well as communal activities to ensure that all the resident receive adequate stimulation while living at the home. In terms of improvement in the environment the laundry has been improved and redecorated for safer hygiene control and better working environment. All radiators have been fitted with individual valves to enable the heating in the home to be controlled based on peoples` preferences. New worktops have been fitted in the kitchen to promote better hygiene for food preparation. CARE HOMES FOR OLDER PEOPLE Beaufort House Care Home High Street Hawkesbury Upton South Glos GL9 1AU Lead Inspector Grace Agu Unannounced Inspection 9th September 2008 09:15 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 Beaufort House Care Home DS0000061734.V368887.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. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beaufort House Care Home Address High Street Hawkesbury Upton South Glos GL9 1AU 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) 01454 238589 01454 238589 info@beaufortcare.co.uk Beaufort Care Ltd Ms Glenda Elizabeth Graham Care Home 28 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (22) of places Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd September 2007 Brief Description of the Service: Beaufort House is a care home in an attractive village location where there are shops, community facilities and a bus service. Several staff members working in the home live in the village. The home is registered to accommodate 27 older people and may accommodate 6 people with dementia. The home is approximately 4 miles from Wotton-Under-Edge and 8 miles from Chipping Sodbury. Bristol and Bath are within easy commuting distance. The property is a large mature house that has been extended. Accommodation is arranged on three floors. There is a passenger lift. Rooms consist of 27 single bedrooms and one double room. 17 bedrooms have en-suite toilet facilities. The home is set in attractive, well maintained gardens with lawns and a patio. The gardens are accessible to all service users and have been made safe. Fees are currently £441-£520 based on levels of care needs. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced inspection which was undertaken over nine hours to review the requirements made at the last inspection and also to review the care practice to ensure that it is in line with the legislation and that best practice is followed at the home. Generally the home was found warm, clean, tidy and free from offensive odour. Individuals living in the home were found relaxed in their homely environment and looked well cared for with positive and respectful interaction with staff. We met with Glenda Graham the registered manager and the two registered providers Jane Roberts and Carol Bird who were very professional and assisted with the inspection process. A tour of the building was undertaken and a number of records were viewed. Thirteen service users, three staff members and two relatives were spoken with on the day. What the service does well: The Annual Quality Assurance Assessment (AQAA) stated that the home manager or the deputy would go out and assess a prospective resident before admission to ensure that the home is able to meet their needs. The AQAA also stated that the home has comprehensive documentation about individuals and the aim is to promote independence to the level manageable to the person. The home manager told us that nutrition is an important part of the day and the nutritional standards are monitored regularly. Changes to the menu are done if residents do not like or want certain foods. Residents are regularly consulted. We noted on the day of the visit that staff ensure meals are not hurried and that people who are unable to feed themselves are assisted in a respectful and dignified manner. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 6 The home has an open house policy and encourage visitors and encourage outings for residents and their families and friends. A complaint procedure is in place to enable service users, families, friends and advocates to complain if unsatisfied with the services provided by the organisation. The complaints procedure also gives them the option of how to contact the Commission for Social Care Inspection it they were not satisfied with the way that their complaint was handled. The home follows thorough recruitment practices to ensure that appropriate staff are employed at the home. The environment is well maintained, tidy and safe giving the service users a sense of homeliness and security. There is an ongoing training course to enable staff to meet individuals’ needs for example the development of Yesterday, Today and Tomorrow training which explains dementia, people’s feelings, vulnerabilities, moods, aggressive behaviour and the how staff can help to manage these in a more supportive way. What has improved since the last inspection? What they could do better: To prevent serious injury to a resident it could be better if identified staff receive training update on manual handling. Whilst there was evidence of staff training in the records viewed, two staff members were observed lifting a resident in the lounge area in a manner that could potentially cause serious injury to the resident and themselves. This practice was discussed with the manager and the providers. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 7 It was agreed that the manager send us an action plan on how the home would ensure the staff members attend up to date training on manual handling. The home sent us a detailed urgent action it had taken to prevent this from being repeated in order to protect the resident. The Commission found the action plan satisfactory. 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. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 8 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 Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 9 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): 3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The process of admission of prospective residents is comprehensive, detailed and well planned to enable the home to determine if the home is suitable to meet the person’s needs and for the resident to make a choice of moving into the home. EVIDENCE: We looked at the information obtained by the home on one recently admitted resident. The appropriate pre-admission paperwork, including a needs assessment and a care plan drawn up by a social worker were in place. The resident’s daily records and review sheets evidenced that the resident’s care plan was being evaluated and updated for daily living in the home. The manager stated in the Annual Quality Assessment Assurance that, she would visit the person at home or in hospital and would also consult with the person’s relatives and relevant professionals to assess the suitability of the home for the person. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 10 In addition the manager would obtain professional assessments and any necessary specialist reports or advice on a prospective new service user prior to admission. There were positive comments expressed by two relatives about kindness of staff. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers care and support to residents throughout their lives and towards the end, it also protects the residents by reviewing their health needs and there is appropriate drug administration. EVIDENCE: We looked at four care files at this visit. There was evidence of pre assessment before the residents were admitted to the home. The care files seen contained individualised care plans in relation to each assessed need and gave clear direction to staff to enable them to deliver appropriate care to the individuals. Staff spoken with stated that they have access to the care files. There were records of intervention and actions required to meet needs review notes, personal intervention sheets risk assessment (including risk assessment relating to falls) daily record sheets and medical information. These care files were noted to have been reviewed monthly and when needs change. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 12 Whilst touring the building we noted that one resident in her room appeared distressed, in pain and discomfort due to medical condition. There was evidence that the individual had been referred to a specialist health professional in order to assist the person and offer appropriate strategies to support staff in meeting this person’s needs. There was evidence that the District Nurses have been involved in the treatment of the pressure sore that the individual developed 8 weeks a ago. There was evidence that there were specialist equipment in place to assist with providing appropriate care. We noted that there was a care plan identifying that the individual was on pain control medication. There was a care plan to support staff with monitoring the pain. We were also informed that this individual’s medication had been reviewed again and that the home would be monitoring the behaviour to ensure that the person and other service users health and safety are not compromised. The inspector attended the staff meeting that took place on the day of the visit At the meeting the manager discussed the recently introduced Care Coordinators whose responsibility is to ensure that the shift run smoothly and that residents receive appropriate care that meet their needs. We are led to believe that this is a commendable initiative as staff confirmed that they feel confident to go to the person if there were any concerns during the shift. In regard to how residents perceive their care at the home, one resident stated, “ I am happy here, staff look after me well, I have a medical condition and is being managed well. I get up when I like and I go to bed when I like.” Staff members on duty were observed treating service users with courtesy and respect at all times. They had obviously developed a good rapport with service users and this was supported by comments made such as, Staff are very good Each resident had his or her own room in which personal care was provided. Service users were able to have their own telephone line and there was a communal telephone. We discussed a concern raised by relatives about a service user entering another person’s room. The manager told us that the home is working hard to address the issue to ensure that everyone’s privacy is maintained. All residents were registered with GPs and members of the primary care team visited the home to provide treatment or advice as necessary. For example we noted in the care file of one resident that District Nurses visit to apply dressings to a wound sustained by a resident and to provide advice on and training on various topics relating to resident’s care. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 13 The home’s policy and procedures for the administration and control of medicines were applied in the home. No service users administered their own medication. Senior staff had responsibility for administering medicines. The storage and recording of medicines was found to be satisfactory. Staff spoken with were aware of measures to be taken if a resident became terminally ill and in the event of death. Staff also demonstrated awareness of the importance of ensuring that information about residents is kept confidential. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 14 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 good This judgement has been made using available evidence including a visit to this service. Service Users benefit from a varied activities programme, which is both enjoyable, stimulating and meets individual preferences and expectations, People living in the home receive a varied and wholesome diet that they are able to influence. EVIDENCE: The home employs a new Activities Coordinator that ensures that a variety of activities are arranged throughout the week with walks and outings when the weather is good. An activity notice board was displayed showing daily/weekly activities and activities for service users both inside the home and in the wider community. Discussions with residents and staff evidenced that visits by local Pastor were made, religious services were held in the home. The activities Coordinator state that activities provided at the home works well with residents who have dementia and that there are activities in the home for less able service users, sometimes on a one to one basis. There was record of those who took part in Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 15 the activities; those activities include Quiz, massage, music, table games and outside entertainment. Discussion with the relatives, staff members and evidence from the visitors’ book showed that the service users maintain good contact with families and representatives. The home would contact an individual’s next of kin should they need to be informed of issues, which affect the well being of an individual living at the home. During a visit around the building service users were seen spending time in their bedrooms and the communal lounges. Evidence from speaking with one resident showed that the individual is able to choose when to get up and retire, what to eat/drink and how they were to be assisted with aspects of their daily life. The home employs two full time cooks. There was a four-week menu. Service users were offered three meals a day with a main meal at lunchtime. There were alternatives on offer. The cooks obviously took pride in cooking appetising home made food and this was demonstrated in discussions with the cook on duty and the meals served. Food stocks were plentiful, well ordered and of good quality. Fresh vegetables and fruit had been ordered and fruit were available if residents wanted them. Service user’s likes and dislikes had been recorded. The manager stated at a discussion and also in the AQAA that the cook is developing new menus to include to 5 a day fruit and vegetables and proteins and carbohydrate. The cook who had been in post for 8 weeks showed knowledge about service users’ preferences and dietary requirements. The kitchen was very clean and tidy and well equipped. The inspector observed a staff member assisting and encouraging a service user to eat. Nutritional assessments have been completed for all service users. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 16 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. Individuals living in the home are enabled to complain and are confident that their complaint will be listened to. Practices at the Home ensure protection of service users from harm and abuse. EVIDENCE: There were policies and procedures in place on the protection of service users from abuse. There was a complaints book in place for recording details of complaints, the action taken to resolve a complaint and the outcome of the complaint. Six complaints had been received in the home since the last inspection. The home’s concerns and complaints procedure was also detailed in the statement of purpose. The information provides the complainant details of how the CSCI can be contacted if the individual is not satisfied with the outcome of the complaint made to Beaufort House. These details included the name, address and telephone number of the CSCI local office. We looked at the care file of one individual whose relative was not happy about personal care. We noted that that the care plans in place provided staff with appropriate information on how to support this individual. We also noted that the person was well looked after. The individual told us “ I am satisfied with my care”. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 17 However, whilst reviewing the care file we noted some entries in the daily note that suggests that the individual have been challenging when care was being provided. We noted that there was no care plan to assist staff during the challenging episodes. Furthermore the language used on those entries were undignifying. For example kicking scratching and squeezing. The manager told us that the complaint had been satisfactorily resolved and would ensure that staff record incidents in a more constructive way. The home would ensure that appropriate care plan is in place to support staff in meeting the challenging needs of this individual. One staff member demonstrated the importance of ensuring that allegations and incidents of abuse and observation of bad practice are reported to ensure safety of the residents. The individual confirmed that staff have received training on the Protection of Vulnerable Adult from Abuse. One new staff member’s files reviewed evidenced that two satisfactory references and Criminal Record Bureau Disclosures had been obtained before commencement of employment to ensure that individuals living in the home are adequately protected. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 18 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): 19,21,22,23,24 25 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is suitable to meet the needs of residents currently living at the Home, and is clean and satisfactorily maintained. EVIDENCE: Beaufort House is a care home in an attractive village location where there are shops, community facilities and a bus service. Several staff members working in the home live in the village. The home is registered to accommodate 28 older people. The home is approximately 4 miles from Wotton-Under-Edge and 8 miles from Chipping Sodbury. Bristol and Bath are within easy commuting distance. The property is a large mature house that has been extended. Accommodation is arranged on three floors. There is a passenger lift. Rooms consist of 27 single bedrooms and one double room. 17 bedrooms have en-suite toilet facilities. The home is set in attractive, well maintained gardens with lawns and Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 19 a patio. The gardens are accessible to all service users and have been made safe. Residents’ rooms seen whilst touring the home looked clean and pleasantly tidy free from offensive odours with personal objects displayed and in use. The rooms appeared well maintained in a domestic style of decoration. The maintenance book was up to date clearly stating jobs/tasks to be carried out, date completed and any relevant comment in relation outstanding jobs. The home stated in the AQAA that all communal areas have been decorated and all radiators in the home have been fitted with individual valves in order to monitor the heating in the rooms for residents’ safety and comfort. All of the above were confirmed at the inspection. The laundry was found clean and was equipped with two professional washing machines that had a sluice wash. The laundry assistant stated a new dryer had been installed to provide better laundry for the residents and a vent had been installed to reduce the hot temperature in the laundry in order to provide a better working environment for the staff member. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 20 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 good. This judgement has been made using available evidence including a visit to this service. Residents are provided with sufficient numbers of staff to meet their needs, adequate training is also provided to its staff to protect the residents. EVIDENCE: Evidence from staff rota and discussion with the manager showed that the home has a sufficient staffing level to meet the needs of the residents. For example there were five carers working between 8am and 1330pm and four carers between 1330pm and 10pm and two waking night staff from 10pm and 8am. There were 27 residents in the home on the day of the visit. In addition to the care staff the manager is always available and is supported by a deputy manager and an administrator. The home also employs two cooks house keeping staff and maintenance person. The manager has developed a training matrix to enable the home to identify what courses each staff member has attended and to ensure that relevant courses are provided. Staff have attended training to include manual handling update fire safety, Protection of Vulnerable Adult form Abuse and Care skills. This enables the home to keep up to date and apply current practice in the care of the residents. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 21 However we observed unsatisfactory manual handling practice that could cause potential injury to a resident. We discussed this with the manager and the two registered providers present on the day. The practice confirms the observation we received from health professions regarding unsatisfactory manual handling practice in the home and that this could be linked to staff going of work due to ‘bad backs’. It was agreed that the two staff must receive further training on Manual Handling and must follow the instructions given in relation to residents’ handling profile. This had been discussed earlier in the report. The Commission for Social Care Inspection has received action plan from the home on how this training will be delivered and the plan to ensure that all staff follow manual-handling instruction correctly to ensure safety of the individuals living in the home. All staff have Personal Development Plans folders to enable the home to monitor individual training and to ensure that all staff receive training relevant to their roles. The manager told us and also stated in the AQAA that the home has commenced training on Yesterday Today and Tomorrow, Alzheimer’s disease Society training for better understanding of dementia. It had also used the Short Observation Framework for Interaction (SOFI) to monitor interaction between staff and residents. One staff stated at a discussion ‘the experience is brilliant’. In relation to induction the manager stated that new staff have good induction before starting work and the areas covered by the manager includes Basic Care, Vulnerable adults dementia and moving and handling. The individual works with the deputy manager for the first three shifts before commencing the Skills for Care Induction programme for three months. Evidence showed that five care staff have achieved NVQ at level 2, one care staff completed NVQ at level 3, two staff at level 4 and two staff have achieved the Registered Managers Award. Review of records of recently employed staff members showed that statutory required documentation were in place before commencement of employment. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 22 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): 31,32,33,35,36,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed it protect the residents through of appropriate health and safety practices and regular staff supervision. EVIDENCE: The atmosphere at the Home on the day of inspection was positive and welcoming. Staff were noted interacting with residents in an informal and friendly manner. A well- qualified and competent manager who has been at the home for many years manages Beaufort House. Glenda Graham has attended many training courses to enable her to provide leadership and direction to staff, to meet the needs of the residents. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 23 Glenda works hard and has achieved the Registered Manager’s Award is an NVQ assessor and is supporting the staff towards their NVQ training at both Levels 2 and 3. Glenda is supported by a deputy manager with good skills and knowledge of the category of the residents at Beaufort House. Glenda stated that the two registered providers met on the day visit the home regularly to support the home both morally and administratively. Residents and staff spoken with on the day were supportive and complementary of the manager’s commitment to the home and care to the residents, also her ability to manage the home. One staff stated, “Glenda is approachable and she will always listen to what I have to say”. Staff spoken with stated that staff work as a team and this has enabled staff to provide quality care and to support the residents. Staff supervision records were reviewed. Evidence from the records viewed showed that staff has received supervision. The staff member stated that they benefited from the exercise. It afforded them the opportunity to express their opinion about the services provided at the home and to discuss areas of concern in relation to residents’ care. Staff spoken with stated that they receive regular supervision to enable them to perform their duties effectively and deal with any areas that need improvement in relation to meeting the needs of the residents. Individual service users’ records were noted securely locked at the home along with other service user information. The homes audits the quality of its’ services through regular medicines and environmental audit, annual questionnaires to next of kin of residents to obtain feedback about the services provided at the home, provider’s monthly visit (Regulation 26). The Statement of Purpose and Service users Guide is also updated regularly. Other tools used to monitor quality include, staff supervision, care plan reviews, daily communication at handovers; Social Services, General Practitioner (GP) and other health professional reviews and thank you letters from families and friends. The inspector sat in the staff meeting on 9/09/08 and areas discussed included, SOFI observation so far’ medication laundry, reviewing care planning importance of having someone in the lounge to monitor the residents. Team working and good interaction between staff especially in the mornings. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 24 The fire-log book is well maintained as well as the home’s maintenance book and there is evidence that staff have attended fire lectures, Health and safety records including passenger lifts, fire alarm systems, test of all portable electrical appliances and generic risk assessments of various areas of the home were up to date. Door guards were noted fitted on fire doors to maximise fire protection for the residents. Accident reports were reviewed and it was noted to be satisfactory Regulation 37 notifications are sent to the Commission for Social Care Inspection to report any incidences/ serious accidents as required by the regulation. Policies and procedures in the home included, Health and Safety, Nutrition, Complaints, Protection of Vulnerable Adults and Medication Control of Substances Hazardous to Health (COSHH). These were updated. Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 25 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 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 26 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 OP30 Regulation 18 Requirement Ensure that two identified staff receive training update on manual handling in order to protect the residents. Appropriate care plan must be in place to support staff in caring for identified individual. Timescale for action 30/09/08 2 OP7 16 30/09/08 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 Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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. Extracts may not be used or reproduced without the express permission of CSCI Beaufort House Care Home DS0000061734.V368887.R01.S.doc Version 5.2 Page 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. 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