Care Home: Beaumanor Nursing & Residential Home

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What the care home does well The home provides a good standard of care within a bright and homely environment. The home and attractive garden are well maintained and provide a safe environment for people to enjoy where residents can be supported to maintain as much independence as possible. The home maintains a good standard of decor and cleanliness throughout. Food is nutritious and well presented, individual diets and preferences are catered for Visitors are made welcome. Levels of staffing ensure that the peoples` health and welfare needs are fully met. People who live in the home and a visiting relative confirmed that staff are very caring and respectful, ensuring peoples` privacy and dignity at all times. What has improved since the last inspection? The home continues to provide a good service for the people who live there. There are no outstanding recommendations or requirements. What the care home could do better: The complaints policy and procedure requires updating to provide information to people who use the service about the role of Social Services in managing complaints; and the contact details for CQC required updating. The Registered Manager is strongly recommended to ensure that she has had sight and copies of PoVAFirst checks, enhanced Criminal Record Bureau (CRB) checks and staff references prior to a nurse or carer joining her team. This is so that she can be sure that these checks have been completed because she is responsible for the safety and welfare of the vulnerable people in her care. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Beaumanor Nursing & Residential Home 41 Cartwright Street Loughborough Leicestershire LE11 1JW     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: 2 6 0 6 2 0 0 9 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. that people have said are important to them: They reflect the things 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 25 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Beaumanor Nursing & Residential Home 41 Cartwright Street Loughborough Leicestershire LE11 1JW 01509239443 01509239446 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Rushcliffe Care Limited care home 53 Number of places (if applicable): Under 65 Over 65 53 53 2 old age, not falling within any other category physical disability sensory impairment Additional conditions: 0 28 2 No one falling within category OP may be admitted to Beaumanor Nursing & Residential Home where there are 53 persons of category OP already accommodated in the home. No one falling within category PD may be admitted to the home where there are 28 persons of category PD already accommodated in the home. No one falling within category PD(E) may be admitted to the home where there are 53 persons of category PD(E) already accommodated in the home. No one falling within category SI may be admitted to the home where there are 2 persons of category SI already accommodated in the home. No one falling within category SI(E) may be admitted to the home where there are 2 persons of category SI(E) already accommodated in the home. To be able to admit the person of Category LD, PD & DE named in variation application number 34229 dated the 22nd July 2002. Date of last inspection Care Homes for Older People Page 4 of 25 Brief description of the care home Beaumanor Nursing and Residential Home, Rushcliffe Care Limited, is a care home situated on the outskirts of Loughborough and is registered for fifty-three nursing and residential beds, providing personal and nursing care for older persons. The home is a purpose built, well-appointed accommodation on two floors, accessed by a passenger lift. Bedrooms are single with en-suite facilities and all areas of the home, including the safe patio area and garden, are accessible to all residents. Located close to the centre of the town and situated on the banks of the Grand Union Canal, the home has pleasant views, and is within a ten-minute walk of the train station. There is adequate car parking. The Statement of Purpose, Service Users Guide & Inspection Report are available on request (these provide information on how the home is organised and what services they provide). The Statement of Purpose and Service Users Guide are provided for all prospctive new residents. At the time of the site visit the Registered Manager stated that weekly fees were: £380 - £750 (room supplements and additional charges apply). Care Homes for Older People Page 5 of 25 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: The quality rating for this service is 2 Stars. This means the people who use the service experience good quality outcomes. We as it appears throughout the Inspection Report refers to the Care Quality Commission. The focus of the inspections undertaken by the Care Quality Commission(CQC) is upon outcomes for people who use the service and their views of the service provided. The previous key inspection was undertaken on 4th July 2007 Care Homes for Older People Page 6 of 25 The site visit was unannounced and took place over six hours. We selected four people 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 practices. We spoke with staff members regarding the training and support they receive. Planning for the inspection included assessing notifications of significant events, a review of the Annual Quality Assurance Assessment (AQAA) sent to CQC by the service. Surveys were sent to people who live in the home, staff and health professionals to provide feedback to the CQC prior to the inspection visit. Four residents, two members of staff and one GP returned the surveys. They were mostly positive about the care provided at Beaumanor Nursing and Residential Home. Two people said there should be more staff, and one said the laundry lady should call more often. However, other people said there were sufficient staff and that they were happy with the laundry provision. Other people said that there was a high standard of hygiene and excellent laundry facilities; that there were a brilliant variety of meals and that staff were very friendly and helpful. One person stated, Beaumanor was our first choice of home after viewing several. First impression was of cleanliness. We turned up unexpectedly. We were given the grand tour and were very impressed. People said that Lynn (the Registered Manger) was very approachable and eager to resolve any problems which may arise. Another person said since their relative moved to the home he looked cleaner, healthier and was sleeping better and had been out for the first time in years. Staff said they felt that the home was well run and staff worked as a team and that they received the training and support they needed and this reflected on the people who lived in the home. The GP said that staff were a caring and enthusiastic team and that they work well with other services. The Registered Manager, Senior Manager and other staff spoken with were positive and helpful during the inspection. The fees at the time of inspection were between £380 - £750 per week. Extras include hairdressing, some personal toiletries, newspapers and magazines and private chiropody. 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. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 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 9 of 25 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. People who may wish to move into the home are provided with sufficient information to help them decide if it is the right home for them. Evidence: The home had a Statement of Purpose and Service Users Guide (both provide information about the home and the type of the care provided) to help people decide if the home was the right one for them. People spoken with were unsure about what information had been provided as the could not remember, but copies of the Statement of Purpose and Service Users Guide were provided for people in their rooms so that they had this information to hand. Four peoples care plans were reviewed and contained both a pre-assessment by the placing authority and by the Registered Manager for the home. The assessments were Care Homes for Older People Page 10 of 25 Evidence: satisfactory and demonstrated that the home would be able to provided for peoples individual health, personal and social care needs. The home does not provide intermediate care. Care Homes for Older People Page 11 of 25 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. People who live in the home are well cared for and have their health, personal and social care needs met. Evidence: We checked four care plans, three for people who were residential and one for a person requiring nursing care. The care plans provided nurses and carers with sufficient information to ensure that people received the specific care they needed. For example: People who had diabetes had a care plan which provided staff with information about medication, any urine and blood tests required, dietary needs, and the symptoms and responses to a diabetic attack. Where people required regular blood glucose monitoring and/or urine tests this had been carried out, and acted upon as necessary, to ensure that people with diabetes were monitored and their specific healthcare needs met. Contact with healthcare professionals such as GPs, District Nurses, hospitals etc were Care Homes for Older People Page 12 of 25 Evidence: recorded to ensure that peoples healthcare needs and treatments were addressed. Nurses and carers completed a daily log and updated care plans to show that people had received their identified and changing care needs, such as assistance with personal care. There were appropriate risk assessments, pressure ulcer prevention and nutritional assessments where these were required. These had been regularly reviewed and updated and care plans signed by the person receiving the care, or by their representative, to show that they were involved in and greed with their personal plan of care. Medication policies and procedures were satisfactory. Medicine profiles were detailed with indications, side effects and contraindications for all prescribed medications. Medication Administration Records (MAR) were checked and were completed correctly. Only trained nurses ordered, administered and disposed of medication, and they had received updated training to ensure that people received their medication safely and as prescribed. People spoken with during the inspection visit said that they were well cared for by very caring staff. People also said that staff responded promptly to call bells and that they did not have to wait if they needed to go to the toilet. One lady said that she enjoyed her showers and that staff always took time to do her hair and she said that the staff were very kind people who couldnt do more. Care Homes for Older People Page 13 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are support to meet their social, religious and cultural expectations and preferences. Evidence: The home had an activities organizer, who was currently on leave. Care staff had been given additional hours to cover her role until she returned. New residents complete a Getting to Know You form which included details of their past and present hobbies and likes and dislikes. Each person had an activities care plan so that the carers were aware of their each persons personal presences. On the day of inspection people were listening to music, watching television and were enjoying the warm summer weather and watching the boats go by as the garden overlooks the canal. The home had a number of pets including fish and birds, and a parrot that had moved to the home with its owner. The Registered Manager said that she was happy to consider any pets as she was aware of how important these were for a residents wellbeing and how upsetting if they were parted. Care Homes for Older People Page 14 of 25 Evidence: The home provided weekly activities which include sing-a-longs, one-to-one time to encourage people to chat about what ever they chose, manicure sessions (a number of ladies had varnished nails) and people spoken with said that they were taken shopping and to the pub next door; and a number of the people had been on an organized boat trip on the canal the previous week. Festivals and special days such as Christmas, Easter, Valentines Day, Dwali and birthdays were celebrated. There were monthly Church of England services and a nun who visited regularly people that were Roman Catholics. Other faiths were supported where necessary. Residents and relatives meetings were held bi-annually; the meetings and a topical news letter published by Rushcliffe Care Ltd ensured that people were kept informed and felt involved with the day-to-day life of the home. One person who returned the pre-inspection questionnaire said that they would like more activities, but when questioned was not sure what they would like to do. Other people spoken with said that they were happy with the level of activities provided; another said that it was a lovely place (to live). Meals were well planned and nutritious with choices at all main meal times. Special diets such as diabetic or soft diets were catered for. Meal times were unhurried and those people who required help were given this in a discreet manner. This was observed both during breakfast and lunch time. People who lived in the home, and a relative, said that the choice of food was good and that the cook would do something else if asked. One person said that she preferred to take all her meals in her room and this was accommodated. Care Homes for Older People Page 15 of 25 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 and people feel confident that there concerns will be listened to and acted upon. Evidence: CQC had not received any complaints about the service. The homes complaints process reflected the locally agreed procedures for safeguarding vulnerable adults. Staff were provided with appropriate training and concerns and complaints were dealt with in a sympathetic and professional manner. People said that knew how to complain if necessary and felt that their concerns would be listened to and addressed. Advocacy information was readily available to ensure that people had access to independent help, advice and support if this was required. The homes complaint procedure, displayed in the hall, required updating to reflect the role of Social Services in managing complaints, and to provide people with the correct contact details of CQC. Care Homes for Older People Page 16 of 25 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. People live in a comfortable, clean and safe environment. Evidence: The home was clean and well maintained with adaptations to suit peoples specific needs such as grab rails, hoists, profiling beds and air wave mattresses for people requiring nursing or were at risk from pressure ulcers. It was decorated and furnished to a good standard that created a comfortable environment for the people who lived there. The Registered Manager said that they had won £500 in the companys Christmas decorations competition. This had been spent on decorating the corridors. Each one was a different colour and themed e.g the blue corridor had an underwater seen in relief, which was visually pleasing, and also helped people who were partially sighted, or a little confused, to find their way around the home. All residents rooms had an en suite toilet and hand-washbasin and nurse call. People who were in their rooms or in bed had their nurse call bell within easy reach. People were able to take items of their own furnishings to the home to personalise their rooms. The rooms seen were well personalised with home furnishing, pictures and Care Homes for Older People Page 17 of 25 Evidence: photographs, soft toys and ornaments. There were sufficient additional toilets, showers and bathrooms with assisted bathing facilities on both floors. The home had both generic and specific individual risk assessments in place to ensure that the environment was safe for both residents and staff. The home was fresh and clean throughout on the day of the inspection visit. Care Homes for Older People Page 18 of 25 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 well trained and sufficient in number to meet the needs of the people who live in the home. Evidence: There were 50 residents at the time of inspection. Staffing level at the point of the inspection visit were sufficient to meet peoples needs. There were six carers and a Registered Nurse on shift throughout the day and three carers and a Registered Nurse at night. There were additional ancillary staff such as cooks, cleaners and a maintenance person to ensure that care and nursing staff were free to provide care. People spoken with, and a relative, said that there was always sufficient staff. Staff were very visible throughout the home during the day of the unannounced inspection visit. Four staff files were checked during the visit to ensure that a satisfactory recruitment process was in place to safeguard the residents and ensure that they were protected from harm. Care Homes for Older People Page 19 of 25 Evidence: One file did not contain a record of a PoVAFirst, enhanced Criminal Records Bureau (CRB) and had only one reference. These appeared to have been undertaken put had since been lost. The Registered Manager and Senior Manager were very concerned and undertook to locate the information as soon as possible and provide copies to CQC. A PoVAFirst check was provded within three working days and a replacement CRB check applied for. Recruitment was completed centrally, where staff employment files were kept, by Rushcliffe Care Ltd at their Epinal Way, Loughborough office. The Registered Manager was strongly recommended to ensure that she has had sight and copies of PoVAFirst checks, enhanced CRB checks and staff references prior to a nurse or carer joining her team so that she can be sure that these checks have been completed as she is responsible for the safety and welfare of the vulnerable people in her care. All new staff carry out an induction programme and were provided with a staff handbook. Staff received mandatory, annual updates and had undertaken training in Health & Safety, Moving & Handling, Fist Aid, Infection Control, Fire Training, Person Centered Care, Palliative Care, Challenging Behavior and Dementia Care. Staff were able to show that they understood about Whistelblowing and safeguarding procedures so that people who lived at Beaumanor were protected from harm. The Registered Manager said that seven care staff had undertaken a National Vocational Qualification (NVQ) in Care Level 2 or 3 and all other carers were taking NVQ courses. This and the training programme ensured that staff had the necessary skills to give safe care to the people who live in the home. Care Homes for Older People Page 20 of 25 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 Registered Manager provides strong and effective leadership and ensures that people who live in the home receive a good standard of care. Evidence: The home has a Registered Manager who is a Registered Nurse and works mainly in a supervisory capacity. However, she does work clinically as part of the nursing and care team for approximately two days per week which she felt kept her in touch with both staff and residents. The home conducts ongoing quality audits such as medication and falls audits to ensure that people continued live in a safe environment. Surveys were sent to people who lived in the home, and to their relatives each September. These were then analise to establish where improvements could be made.The results were published with the Statement of Purpose so that people who use the service, and perspective service Care Homes for Older People Page 21 of 25 Evidence: users and their relatives could see where improvements had been made. Staff received regular, recorded supervision (a review of their personal and training needs) to ensure that they continued to work well with the residents and other staff and had the necessary skill to provide good care for the people who lived there. Health & Safety policies and procedures, such as regular recorded fire drill, fire alarm tests, and hot water checks were carried out to ensure that residents and staff lived and worked in a safe environment. Care Homes for Older People Page 22 of 25 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 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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