Care Home: Beckfield

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What the care home does well People who live at the home have their needs assessed before they come to stay. This ensures that the home can meet their needs. Visitors are encouraged and made welcome. This helps people maintain contact with family and friends. People who live at the home have regular meetings and have been able to make changes so that their needs are met. The home is very clean, homely and well maintained. The home has good access and there is a lift and wide corridors that meet the needs of people with mobility problems. Staff receive training that helps them understand and meet the needs of people they look after.The service caters for and meets the cultural and religious needs of people from South East Asian and Eastern European backgrounds What has improved since the last inspection? Care plans are now in place for everyone including people who come for a short stay. This means that staff have instructions about how to meet people`s needs. A shower curtain has been provided to help respect people`s privacy and dignity. The complaints procedure is displayed in the areas people live as well as the reception area. There are plans in place to have the complaints procedure translated into other languages so that the home can be sure that everyone knows how to complain or report anything. Medication procedures have been made more robust and medication records are now fully completed. This helps staff to make sure that everyone is getting the medication and healthcare they need. All staff now receive regular supervision to make sure that individual concerns, support and training needs are met. What the care home could do better: A contract or a statement of terms and conditions should be made available to people. This will help make sure that people have all the information they need and will be clear about what care and facilities the home will provide. Care plans and records should be regularly updated to make sure all staff have clear instructions on people`s care needs. This will help make sure that people get the care they need Staffing levels should be kept under review to make sure that staff have the time to assist people with social care needs. Night time staffing levels should take account of the dependency levels of people and the layout of the home. This will help make sure that people get the care they need in a timely way. Replacing the bath on one unit should ensure that people have access to convenient safe bathing that suits their routines and preferences. The manager should make application to be registered with the Commission as soon as possible this will give the people who live at the home further reassurance that she has the skills and training needed to manage the home. CARE HOMES FOR OLDER PEOPLE Beckfield 70 Bolton Lane Bradford BD2 4BN Lead Inspector Sughra Nazir Key Unannounced Inspection 17th December 2008 09:30 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 Beckfield DS0000033521.V373542.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. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beckfield Address 70 Bolton Lane Bradford BD2 4BN 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) 01274 203001 01274 203002 City of Bradford Metropolitan District Council Department of Social Services Manager post vacant Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th January 2008 Brief Description of the Service: Beckfield provides care and support for people over sixty-five in a multi cultural setting. The home is owned and managed by Bradford Local Authority; it is in a residential area, close to local amenities and is about two miles from Bradford city centre. The home can be reached by bus and has car parking space within the grounds. The home is built on two levels and houses four wings and a day centre. The day centre is not currently subject to inspection. The four residential units provide for group living and include bedrooms, lounge, dining room and domestic style kitchen. There are 35 single bedrooms available. The home offers long and short stays, respite and day care. The home is equipped to meet the specialist needs of people from Eastern European and Southeast Asian backgrounds including those with mobility problems. There is level access into the building. A lift connects each floor and the home has assisted bathing facilities. Outside the home there is a there is a small garden/patio area, which is accessible by wheelchair. The fees are between £98.63 and £ 435.68 per week (as at January 2008) and cover all meals and snacks, care and support and laundry. People pay extra for hairdressing, personal newspapers and magazines and personal toiletries. Visitors are welcome at any time. Copies of the service user guide and the last inspection report are available in the home’s reception area. Beckfield DS0000033521.V373542.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 stars. This means the people who use this service experience good quality outcomes. This report is based on information gathered in a number of ways. • A review of the information held on the home’s file since its last inspection. • Information sent to us by the registered provider in a document called the Annual Quality Assurance Assessment (AQAA). This tell us what the home does well, what improvements they have made and what they could do better. • Seven surveys sent back to us by people who live at the home, and two survey forms received from staff. • An unannounced visit to the home, which lasted about six hours. This visit included a tour of the premises and talking to people who live at the home, staff and management. We also looked at menus and people’s care plans and watched staff looking after people. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the service does well: People who live at the home have their needs assessed before they come to stay. This ensures that the home can meet their needs. Visitors are encouraged and made welcome. This helps people maintain contact with family and friends. People who live at the home have regular meetings and have been able to make changes so that their needs are met. The home is very clean, homely and well maintained. The home has good access and there is a lift and wide corridors that meet the needs of people with mobility problems. Staff receive training that helps them understand and meet the needs of people they look after. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 6 The service caters for and meets the cultural and religious needs of people from South East Asian and Eastern European backgrounds What has improved since the last inspection? What they could do better: A contract or a statement of terms and conditions should be made available to people. This will help make sure that people have all the information they need and will be clear about what care and facilities the home will provide. Care plans and records should be regularly updated to make sure all staff have clear instructions on peoples care needs. This will help make sure that people get the care they need Staffing levels should be kept under review to make sure that staff have the time to assist people with social care needs. Night time staffing levels should take account of the dependency levels of people and the layout of the home. This will help make sure that people get the care they need in a timely way. Replacing the bath on one unit should ensure that people have access to convenient safe bathing that suits their routines and preferences. The manager should make application to be registered with the Commission as soon as possible this will give the people who live at the home further reassurance that she has the skills and training needed to manage the home. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 7 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. Beckfield DS0000033521.V373542.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 Beckfield DS0000033521.V373542.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): 1, 3 and 6 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People have the information they need to decide whether the service is right for them. By carrying out a through assessment the home can be sure that staff will be able to meet peoples needs. EVIDENCE: Information about the service is up-to-date and is made available in languages and formats that suit peoples needs. Three people who returned surveys told us they had not received a contract showing terms and conditions of their stay. The manager said that there had been a delay in getting a contract to one person and that contracts may not have been provided to people who stay on a rotational basis. People should receive information that tells them what is covered by the fees and what they must pay for themselves. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 10 The files we looked at showed detailed assessments of peoples needs are carried out before people move in. This helps the home make sure that they will be able to provide care to meet those needs. People or their relatives are always involved in the assessment process. The home provides care on an intermediate or short-term basis for people making the transition from hospital to home. Files we saw show that there are assessments in place that help people build up their skills to care for themselves independently. Beckfield DS0000033521.V373542.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 and 10 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The health and personal care people receive is based on their individual needs. The principles of respect dignity and privacy are put into practice. Staff know how to look after people properly because they have detailed information that tells them about peoples abilities and needs. EVIDENCE: Care plans are now in place for people on the short stay unit so that they get the care they need. There are better records now of peoples social interests and activities undertaken. Most care plans clearly indicate the action that staff need to take to meet people’s needs. However, there were some gaps that could mean that people do not get the care they need. Staff told us about care one person needed with their hearing aids and that the persons hearing aids had not been removed the night before, there was nothing in the care plan to remind staff to do this. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 12 This was a recent change and had not been added to the care plan. Staff keep a record of activities undertaken and one persons file had not been updated with this information since September. We saw that risk assessments were detailed and clear. All the files we saw had good evidence that healthcare professionals are involved in peoples care. We saw that people get personal care in private and staff respect dignity when helping people move or talking to people about their care needs. All medication records seen were accurately maintained showing when medication, ointments and creams have been applied or administered, the dosage and reasons for omissions. Policies are robust. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 13 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 and 15 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People have flexible routines and have access to some activities and food that meets their needs. They are supported to keep in contact with family and friends. EVIDENCE: There is a daycentre within the care home building and people can join in with activities that take place there. Staff told us they didn’t always have time to do activities with people who don’t go to the day centre. People told us There is always something going on at the day centre. I used to visit my friend on another unit but they have passed away so I don’t do much now Theres not much going on Activities take place in the home but I am too ill to take part. Routines are flexible and we saw that a couple of people returned from trips out. Visitors are encouraged and made welcome we saw signs inviting visitors to make themselves drinks etc. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 14 Having smaller units means people enjoy their meals in a more relaxed informal atmosphere. Tables are set with tablecloths and matching crockery and cutlery. People can choose whether they sit in the dining area or their rooms to eat, Portion sizes are varied. Three different meals were served in the home in order to meet peoples religious and cultural needs. People told us, Food is very nice and they do very well. You can always have something else if you don’t like theyll always do something else for you. More variety is needed We want freshly cooked chapattis The manager told us that a number of options had been explored to try and provide freshly cooked chapattis and that menus are being revised so that more variety is introduced, Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 15 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, 17 and 18 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People can be confident that their views will be listened to and acted upon. Staff are trained to keep people safe from abuse EVIDENCE: We have received no complaints about this service since the last inspection. Information the home sent us tells us that complaints made directly to them are responded to in a timely way. We looked at the complaints record in the home. Any complaints received recently have full details showing the response to the person who made the complaint. Information notices telling people how to complain are now displayed around the home. The home has arranged for the procedure to be translated into languages spoken by people who live at the home. We saw documents confirming that advocates have been involved in supporting people at the home. All staff have had some training on keeping people safe from abuse. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 16 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 and 26 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People live in a home that is generally very clean and well maintained. Replacing the bath on one unit will mean that the home provides excellent facilities to meet people’s physical and cultural needs EVIDENCE: Corridors and lounge areas are spacious and suit the needs of people who use wheelchairs. All shared areas and bedrooms we looked at were clean and smelt fresh. Bedrooms are comfortable and have a range of items to make them personal to the person using them. The home is warm well-lit and has a friendly, homely, atmosphere. There is a shower room which meets the needs of people who shower independently and those who prefer to shower for religious reasons. A bath on one unit needs replacing. People who live on that unit currently use the Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 17 facilities on other units and staff told us that people sometimes have to wait or cannot have a bath at the time they would like. The home has carried out work recommended by Environmental health including reminding staff about keeping colour-coded mops and cloths for specific areas such as kitchens and bathrooms. This helps keep the home infection-free. People told us that the laundry service is very good. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 18 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 and 30 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Peoples needs are met by staff who are trained and qualified. EVIDENCE: Four people told us that staff listen and act on what they say. One person said no and then said the action they take varies On the day of inspection the home had one member of staff on each unit and a senior carer on duty who acted as “float” across all the units. In addition to this there are domestics and catering staff on duty. We saw that staff were busy and people got their personal care needs met in a timely way. Staff told us they didn’t always have time to carry out activities. During the night there are two staff on duty in the home. Night-time staffing levels should be kept under review to make sure that people get their care in timely way. Consideration should be given to peoples dependency levels and layout of the home, for instance the service has one person who needs two staff to assist with care and the units are arranged on three floors. The manager told us that the duties for the floating member of staff were now more formalised to make sure that this staff member supported the unit that was busiest. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 19 The three staff files we looked at showed that thorough checks are being carried out on staff before they start work at the home; this is to make sure they are suitable to work with older people. Staff • • • • • • • • training is excellent with access to a wide range of courses including; Skills for care induction Food hygiene Moving and handling Adult protection Fire safety Catheter care Diabetes care Domestic abuse and older people Some training has been provided on the specialist needs of people from Eastern European and South-east Asian backgrounds. We discussed again making this training available to staff from those backgrounds to give them more confidence and to make sure that peoples needs are not overlooked. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People receive care in a well-managed service offering robust procedures that safeguard their health and safety. EVIDENCE: Our records show that the manager is not registered with the Commission. Her registration will mean that people who live at the home will be sure that the home is run by a person who is qualified and trained to do so. The home has regular meetings with people who live at the home and uses a range of methods to check and assure people about the quality of care. There are robust systems in place for handling people’s money. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 21 The information the home sent us tells us that regular maintenance and safety checks are carried out as required. We sampled some records and found required records are in place. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 22 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 4 2 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X 2 X X X X 4 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP2 Good Practice Recommendations A contract or a statement of terms and conditions should be made available to people. This will help make sure that people have all the information they need and will be clear about what care and facilities the home will provide. Care plans and records should be regularly updated to make sure all staff have clear instructions on peoples care needs. This will help make sure that people get the care they need Replacing the bath on one unit should ensure that people have access to convenient safe bathing that suits their routines and preferences. Staffing levels should be kept under review to make sure that staff have the time to assist people with social care needs. Night time staffing levels should take account of the dependency levels of people and the layout of the home. This will help make sure that people get the care they need in a timely way. DS0000033521.V373542.R01.S.doc Version 5.2 Page 24 2. OP7 3 4. OP21 OP27 Beckfield 5 OP31 The manager should make application to be registered with the Commission. This is so that people can be sure that she has the skills and qualifications to manage the home. Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Beckfield DS0000033521.V373542.R01.S.doc Version 5.2 Page 26 - 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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