Care Home: Beddell House

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What the care home does well People who we spoke to at the home were complimentary about their care and the way that staff support them to maintain their lifestyle. What the care home could do better: Use of Bedrails Risk assessments must be in place which demonstrate that the use of bedrails is required and measures have been taken to reduce the likelihood of harm. Where staff are using bedrails they must be suitably trained in their use by competent and qualified persons. Where bedrails are in use there must be instructions for their safe use including how they are to be maintained by suitably trained and qualified persons. The Care Quality Commission must be notified of a death illness or any event which adversely affects the wellbeing or safety of any service user as described in Regulation 37 of the Care Homes Regulations 2001. Everyone who lives at the home must have a care plan which describes their care needs and the actions that staff are to take to support them. Peoples needs must be reviewed and care plans evaluated regularly. Where people who live at the home are taking risks there must be an assessment in place which demonstrates that measures have been taken to reduce the likely hood of harm. Where people have additional dementia care needs, then care planning arrangements should be in place which will effectively describe their support and follow current best practice. Methods of maintaining the refrigerated storage of medication should be improved. The manager should confirm with a pharmacist or general practitioner if medicines identified at this Inspection are suitable to be taken together at the same time. The security of the medication room should be considered. The review of daytime lighting should be completed and improvements to the heating system should be completed which include options for residents to vary the temperature in their own bedrooms. Random inspection report Care homes for older people Name: Address: Beddell House Sherburn House Sherburn House Durham DH1 2SE three star excellent service 02/10/2008 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Steve Tuck Date: 0 4 0 8 2 0 1 0 Information about the care home Name of care home: Address: Beddell House Sherburn House Sherburn House Durham DH1 2SE 01913720421 01913720035 admin@sherburnhouse.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Joanne Lisa Carr Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Corporation of the Master and Brethren of Christ`s Hospital care home 62 Number of places (if applicable): Under 65 Over 65 62 old age, not falling within any other category Conditions of registration: Date of last inspection Brief description of the care home 0 0 2 1 0 2 0 0 8 Beddell House provides personal care and accommodation for up to 62 people who are older. The home cannot provide nursing care although community based nurses will visit the home to give treatment if this is needed. It is in a very attractive old building, with an interesting history, that has been adapted for its present use. It is set in 15 acres of its own large well maintained grounds, complete with a woodland walk and copious wildlife,with a church and sheltered housing on the same site just outside the city of Durham. So that people can get Care Homes for Older People Page 2 of 12 Brief description of the care home around he home has its own minibuses which provides transport to shopping centres, Durham city centre and visits to places of interest. The home is owned by The Corporation of the Master and Brethren of Christ`s Hospital which is a Registered Charity run for the benefit of the people whom it supports. As well as personal care, the home offers people a range of events and activities that people can take part in if they wish. These include concerts, music evenings, video nights, bingo and coffee mornings. Just a few yards from the home, the charity has its own Chapel and there is a Chaplain on-site, who regularly conducts religious services both in the Chapel and in the Care Home itself should people wish to attend. At the time of this inspection (August 2010) the fees charged to live at this home were £453 per week . Fees can vary depending on peoples circumstances, further details can be found in the homes Service User Guide. Care Homes for Older People Page 3 of 12 What we found: The reason for this Random Inspection was to assess the services ability to meet the personal and health care needs of the people who live at the home and to look at how the premises is managed and maintained. This inspection took place over a period of one day and was carried out by two Compliance Inspectors. Before this Random Inspection visit: We looked at: Information we have received since the last Key Inspection on 2nd October 2008. How the service has dealt with any complaints and concerns since the last visit. Any complaints that have been brought to the attention of the Care Quality Commission. Any instances where people living at the home have needed to be supported to make sure that they are not being neglected or abused. Any changes to how the service is run. We asked the manager to carry out a self assessment and give us evidence to demonstrate how the service is working. The visit: An unannounced visit was made on 4th august 2010 and lasted for 7 hours. During this visit we: Talked to people living at the home and their visitors. Talked to the senior manager, registered manager, and the buildings manager. Talked to senior and care staff. Talked to visiting District Nursing staff and specialist Nurses who were at the home to support people who have, or are at risk of developing skin pressure damage. Inspected some of the communal areas and some bedrooms. Checked staffing rotas. Looked at information about the people who use the service and how well their needs are met. Care Homes for Older People Page 4 of 12 Looked at other written records which must be kept at the home. Checked that staff had knowledge, skills and training to meet the needs of the people they care for. Observed how staff support people who live at the home. We told the manager what we found at the end of the visit. There were no outstanding requirements from previous inspections. Personal and Healthcare support All people who live at the home have a plan of care which gives a description of how their needs are to be met. However care plans, particularly for those people who have complex care needs, were not detailed enough to describe how staff are to support them or demonstrate how their care had taken place. Staff have a variety of knowledge and experience of caring for people living at the home but this information is not successfully combined in the care plans so that these can be used to consistently provide fully coordinated care. All of the staff interviewed could describe peoples needs, preferences and histories however the potential areas of good practice were not written down in care plans so that they could be properly shared with colleagues. The manager and senior manager agreed that improving the quality of care plans was one of the objectives for this service. There were few records in place which show that the manager have considered how to protect people from risks. However Inspectors noted some significant risks where an assessment had not been completed. For example Staff at the home could describe how they decide how to support people who are at risk from skin damage but their assessments are not written down. And while people are supported to use equipment which maintains their fitness, mobility and independence around the home these risk assessments and judgements are not recorded. Staff also help people to remain independent and use community facilities without the support of staff when they are able, but the ways that the manager makes sure that they are as safe as possible is not written down in their care plan either. The home is not registered to provide care for people whose main need is their Dementia type illness. However some people who are residents at the home have also developed these needs. At present care planning arrangements for people who have Dementia type illness does not yet reflect current best practice. For example care plans do not specify how people who have an altered sense of time or reality are to be supported or what their personal timescales actually are. Care plans which place the person at the centre of a network of support for their needs and lifestyle requirements are yet to be put in place at this home. This can be particularly important for people who become increasingly reliant on staff as their level of needs increases. Due to their levels of need some people who live at the home are not able to organise Care Homes for Older People Page 5 of 12 their own medicines and appointed staff therefore help in this area. There are no risk assessments in place which show that people who have the capacity to manage their own medications are able to do so safely. There are staff who are trained to administer medication at the home. Medication is stored in two rooms and records are kept which should help staff to make sure that people living at the home have the medication that they have been prescribed. The following medication issues were brought to the attention of the manager. Some medications which may not be administered at the same time had been prescribed and needed further clarification from the pharmacist or general practitioner. One minor error was noted where medication had been administered but had not been signed for. Although the medication room and storage cupboards are locked, the window appeared to be insecure. Domestic refrigeration is being used to store temperature sensitive medications. These fridges are not in the medication room, had significant ice build up and no records of temperature monitoring were available to demonstrate that their storage is effective. At the inspection we were notified that bedrails were being used to support one person at the home and on further telephone discussion the following day, the manager informed us of a second person who was using bedails. On the day we inspected, the manager confirmed that she was unaware of the associated dangers of using bedrails, safety alerts and risk reduction measures which should be in place to protect people using them from serious injury. Bedrails that were seen on the day of the inspection did not fit the bed frame and had become detached leaving a space between the rail and the bed which could have resulted in the occupant becoming trapped. The manager confirmed that there was no risk assessment in place, no instructions about the safe use of bedrails available, no instructions about how the specific bedrails were to be used, no maintenance plan for them and the staff had not been trained fit, maintain or use them safely. The manager was issued with an Immediate Requirement to put Bedrails safety measures in place and we were informed that measures had been taken to make sure that safe use of bedrails was now taking place at the home. Inspection of records at the home identified that there has been circumstances affecting the well being of residents where a notification should have been sent to the Care Quality Commission. For example where people had left the home and were unaccounted for, and where people had become injured and needed hospital treatment. A tour of the building and discussion with the buildings manager identified that changes to the heating system had taken place to help to stop the home from becoming uncomfortably warm during the summer. Although not all of the changes had been fully installed, the heating system was effective in maintaining a comfortable and safe temperature for all communal and bedroom areas. However the buildings manager is aware that some people may have a need or prefer their rooms to be warmer and is investigating a way of programming the heating system to do this. Care Homes for Older People Page 6 of 12 The buildings manager also demonstrated that a review of the daytime lighting at the home had taken place and adjustments were to be made to make sure that corridor areas near to peoples rooms have their preferred levels of lighting. What the care home does well: 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 2. Care Homes for Older People Page 7 of 12 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 12 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 1 38 13 Fitting and Maintenance of Bedrails Where bedrails are in use there must be instructions for their safe use including how they are to be maintained by suitably trained and qualified persons. This is to make sure that people are using equipment that is safe for them to do so. 18/08/2010 2 38 13 Staff Training Where staff are using bedrails they must be suitably trained in their use by competent and qualified persons. This is to make sure that staff who are using bedrails are properly trained to do so safely. 18/08/2010 3 38 13 Use of Bedrails 18/08/2010 Risk assessments must be in place which demonstrate that the use of bedrails is required and measures have been taken to reduce the likelihood of harm. This is to make sure that people are using equipment that is safe for them to do so. Care Homes for Older People Page 9 of 12 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 Where people who live at the 30/09/2010 home are taking risks there must be an assessment in place which demonstrates that measures have been taken to reduce the likely hood of harm. This is to make sure that people who live at the home do so safely and their independence is promoted. 2 7 15 Everyone who lives at the 30/09/2010 home must have a care plan which describes their care needs and the actions that staff are to take to support them. Peoples needs must be reviewed and care plans evaluated regularly. This is to make sure that people living at this home have their care needs met. 3 37 37 The Care Quality Commission 19/08/2010 must be notified of a death illness or any event which adversely affects the wellbeing or safety of any service user as described in this Regulation. This is to make sure that people living at the home are safe. Care Homes for Older People Page 10 of 12 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Where people have additional dementia care needs, then care planning arrangements should be in place which will effectively describe their support and follow current best practice. The manager should confirm with a pharmacist or general practitioner if medicines identified at this Inspection are suitable to be taken together at the same time. The security of the medication room should be considered. Methods of maintaining the refrigerated storage of medication should be improved. The review of daytime lighting should be completed. Improvements to the heating system should be completed and include options for residents to vary the temperature in their own bedrooms. 2 9 3 4 5 6 9 9 25 25 Care Homes for Older People Page 11 of 12 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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