Latest Inspection
This is the latest available inspection report for this service, carried out on 17th June 2010. CQC found this care home to be providing an Adequate service.
The inspector found no outstanding requirements from the previous inspection report,
but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.
For extracts, read the latest CQC inspection for Bentley House Nursing Home.
What the care home does well The home has made improvements in a number of areas since the last key inspection. The Statement of Purpose and Service User Guide have been reviewed and updated to ensure that prospective new residents have access to current information about the services that can be provided by the home. The new care plan format is detailed and informative, ensuring that staff are able to meet individuals assessed needs. Staff recording has improved with the introduction of daily record books that are linked to each care plan. Care plans and risk assessments pertaining to challenging behaviours are in place where necessary and staff are familiar with these. The safeguarding policy and procedures have been reviewed and safeguarding training has been provided for staff to ensure that they are able recognise potential abuse and report it accordingly. Staffing levels have been reviewed to ensure that there is a minimum number of staff onduty which is dictated by the number of people resident in the home. In addition, a team of staff has been identified for `The Lawns` to ensure that there is consistent care for people with dementia from a dedicated group. The home is clean and tidy with a warm, comfortable atmosphere that people appreciate. What the care home could do better: Although work has commenced on transferring peoples` information to the new care plan format, this should continue to ensure that there is a unified system throughout the home. Four requirements and one recommendation have been made by the pharmacist inspector with regards to medication management following this inspection, the detail of which can be found in the relevant section of this report. The manager has provided us with an action plan to address the requirements and recommendations that have been made. Random inspection report
Care homes for older people
Name: Address: Bentley House Nursing Home Twenty One Oaks Bentley Atherstone Warwickshire CV9 2HQ one star adequate service 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: Justine Poulton Date: 2 4 0 6 2 0 1 0 Information about the care home
Name of care home: Address: Bentley House Nursing Home Twenty One Oaks Bentley Atherstone Warwickshire CV9 2HQ 01827711740 01827712901 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Angela Hadley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Bentley House Ltd care home 47 Number of places (if applicable): Under 65 Over 65 0 47 dementia old age, not falling within any other category Conditions of registration: 9 0 The maximum number of service users to be accommodated is 47 The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) 47 Dementia (DE) 9 Date of last inspection Care Homes for Older People Page 2 of 12 Brief description of the care home Bentley House Nursing Home offers personal and nursing care for up to 47 older people. Service users in this home can be accommodated for long or short term care. Bentley House was originally the Merevale Estate Colliery managers house and has been converted for use as a care home. The original country house has been converted to lounge areas and offices on the ground floor with a Day Centre on the first floor. The old stables were converted to kitchen and dining room. A purpose built new wing houses residents bedrooms, bathrooms and offices for nurses and manager. The home provides accommodation on two floors in 47 single bedrooms, nine of which are acomodated within The Lawns for people with a diagnosis of dementia. All areas of the home are accessible by wheelchairs and there are two passenger lifts for the use of residents. There is ample parking in the homes car park to the side of the main house. Bentley House is situated in a rural location on the border of Warwickshire and Leicestershire about two miles from Atherstone and offers panoramic views over the countryside. The location of the home does not offer easy access to local shops, local transport services and other community amenities. Care Homes for Older People Page 3 of 12 What we found:
We, the Care Quality Commission (CQC) undertook this random inspection visit to monitor standards of care at the home, which was rated as adequate at the last key inspection on 8th September 2009. We do not reassess quality ratings following random inspections. This inspection was a random inspection visit that took place on two days by two inspectors, one of which was a pharmacist inspector. It was unannounced which means that the home did not know we were going. The inspection was undertaken to check compliance with the requirements made at the previous key inspection and to ensure that people are not being placed at risk by the service they are receiving. Prior to the visit we looked at information we have about the home. This included any complaints we have received, the homes annual quality assurance assessment and any completed surveys that we received. The service sent us their annual quality assurance assessment (AQAA) when requested. The information in the AQAA was clear and provided us with all of the information we asked for. We also received fifteen completed surveys from people living in and working at the home. During the visit we spoke to people who live at the home, staff who work at the home and the manager. We sampled peoples information which included their care plans and medication records. We looked at other procedures and documentation including staff rotas, safeguarding procedures and staff recruitment records. We did this to check that staff have information necessary to meet individuals care and support needs, to check that people are supported by sufficient numbers of staff who have been recruited appropriately and are aware of their responsibilities with regards to safeguarding vulnerable adults. We also looked around the home to ensure that it was comfortable, clean and safe. The home has appointed a new manager who commenced work in January of this year. The AQAA tells us that the new manager has the required qualifications and experience to run the home and meet its stated aims and objectives .... She has many years of experience in this sector and has a particular interest in Dementia Care. The AQAA also tells us that An application to be appointed as the registered manager has been submitted to CQC. At the time of writing this report the manager has successfully been registered with us. The home is registered for 47 people, which includes nine with a specific diagnosis of dementia. The home is divided into two areas comprising the larger main house and The Lawns which is specifically for the people with dementia. We looked at the homes Statement of Purpose and Service User Guide to determine whether the information they contained was up to date. We saw that both of these
Care Homes for Older People Page 4 of 12 documents had been reviewed in March 2010 and were next scheduled for review in March 2011 or sooner. We asked one person if they had been provided with a copy of the Service User Guide. They pointed us to it and told us its useful, Ive looked through it We saw that the home provides a comfortable living environment for people. The manager told us that a refurbishment programme had been implemented throughout the home, which has resulted in a number of bedrooms, corridors and communal areas having been decorated. She told us that peoples bedroom doors have been painted in bright colours which has proved to be of particular benefit in The Lawns for supporting people to recognise which is their bedroom. We were shown newly installed ceiling hoists in two downstairs toilets, which staff told us have made a real difference for people. The manager told us that following comment from a resident during a recent monthly visit by the provider about how hot the dining room gets when the sun is shining, she is sourcing quotes for blinds to be installed. She told us that there is still work to be done to improve the environment but she feels that getting the care right is her main priority. The manager told us that she has started to introduce a new format for care planning. The intention is for this to make the whole process easier for staff to complete, understand and record into. We looked at the care plans of three people, and saw the transition from the existing plans to the new format was in progress. Staff we spoke to told us that the new format was much easier to use. The manager told us that all new residents have the new format care plans in place, and staff are working towards transferring the information on the remaining peoples plans into the new documentation. A requirement from the last key inspection report was for all areas of risk to be identified and appropriate plans in place to minimise any risks. This relates specifically to supporting people with behavioural needs. We saw care plans and risk assessments for people who may display challenging behaviours in two of the files that we looked at. These contained clear information about managing, controlling and diffusing potential behaviours. We saw a a clear trail of regular reviews. We spoke to staff about the behaviours that may be displayed by one person whose records we looked at. They were able to explain the types of behaviours and how they were managed, which reflected the information in the care plan and risk assessments. Where it had been deemed necessary to apply for assessment under the Deprivation of Liberty Safeguards (DOLS), we saw that all of the necessary documentation had been completed from point of referral to point of decision by the local authority. The pharmacist inspector looked at the way in which medicines are handled and stored, and watched medicines being given to people at lunch-time. We learned that some members of staff have recently attended medicines training. We saw that a new medicine policy, which explains how medicines are ordered and used in the home, has been written. However, there was no self-medication policy. We learned that one person administers their own inhaler but this was not recorded in the persons care plan. We found that some medicines were not stored safely. The door of the room where medicines are kept was open and medicines that were no longer required and awaiting collection were placed in open boxes on the floor. We found that controlled drugs were recorded and used correctly, but the locked cupboard in which they were kept did not meet legal requirements. We found that the temperature of the medicine fridge was not being recorded properly.
Care Homes for Older People Page 5 of 12 We checked the medicines belonging to some people with the record of administration on their medication chart, and found a small number of discrepancies. One person had been prescribed a short course of a medicine. The pharmacy label stated that 15 capsules had been dispensed but the chart showed that 16 capsules had been administered. We found that another person had not received one of their medicines for eight days as the home had none in stock. We found gaps in the administration record of another person; the number of tablets left suggested that the medicines may have been given but not signed for. This person was also prescribed eye drops; there were a large number of missing signatures in the record of administration of these eye drops. We watched medicines being given at lunchtime. We saw that people were treated in a kind and friendly manner, but the medicine chart was sometimes signed before the person took their medication, rather than immediately afterwards. One person requested a medicine that was prescribed for them when required. This medicine had run out six days earlier and a dose was taken from the homely remedies stock. We saw that this was written down in the homely remedies record book. Another requirement from the last key inspection relates to ensuring that safeguarding policies and procedures are followed by staff. The manager showed us an updated safeguarding policy and the AQAA tells us that the home plans to Introduce safeguarding as an ongoing agend item in supervision. One staff member we spoke to told us that she had recently attended a safeguarding session and was due to attend another. A nurse on duty told us that the safeguarding team had provided training for all staff which had been very good. A staff member in the Dementia Unit told us that she is currently working through the workbook on protecting vulnerable adults, provided by Warwickshires Safeguarding Adults Board entitled Recognising and Responding to Adult Abuse and Neglect and is finding it interesting and good. She was able to explain what safeguarding was, and what she would do if she thought it was happening. There was a good atmosphere throughout the home with friendly and warm relationships existing between staff, people who use the service and visitors. We spoke to two visitors who told us Im very comfortable with the place, the staff are approachable and friendly, weve settled really well, and Im happy that I can bring the dog as he means a lot to my wife and Its first class here. The manager told us she has succcessfully recruited a number of new staff since she commenced in post in January. We looked at the files of two of these new staff to determine whether the home has robust recruitment procedures in place. We saw that relevant employment checks which included Criminal Records Bureau (CRB) checks, a full employment history and and written references had been undertaken. We noted however that in one file there was only one reference rather than two. We brought this to the attention of the manager who told us told that she thought there was a second reference and undertook to locate it. We have subsequently been informed that the second reference for this particular person had been located as it was misfiled. The manager told us that she has introduced minimum staffing levels that are dependant on the number of residents in the home. These range from a minimum of 15 staff for less than 40 residents to a minimum of 17 staff for 43 to 45 residents. We looked at the rotas for staff which confirmed that these minimum staffing levels were being adhered to. On the day of the inspection visit we noted that during the morning shift staffing levels were
Care Homes for Older People Page 6 of 12 above the minimum number specified for the number of people resident in the home. We were told by the manager that she had reviewed the staff team, and had formed a small dedicated team for The Lawns to work with the people who have dementia. She told us that she had asked the whole staff team about their interest in dementia care, and was happy that the current team was comprised of people who demonstrated a genuine interest in caring for and supporting these residents. Staff we spoke to in The Lawns told us that the new formation of a dedicated staff team has made a difference to the care provided. The AQAA tells us how the service ensures that equality and diversity is promoted within the service. This includes things such as: The Preadmission Assessment identifies peoples Religious and Spiritual preferences. Steps would be taken to provide appropriate diets and religious facilities on an as required basis. A new wing has been opened to provide care for people with dementia, which was an area of disability which we did not specifically cater for previously Staff would be given the necessary information and training to meet the individuals needs. As a means of raising awareness of the various diverse elements of our community today we are planning to introduce theme days as part of our activities programme. What the care home does well:
The home has made improvements in a number of areas since the last key inspection. The Statement of Purpose and Service User Guide have been reviewed and updated to ensure that prospective new residents have access to current information about the services that can be provided by the home. The new care plan format is detailed and informative, ensuring that staff are able to meet individuals assessed needs. Staff recording has improved with the introduction of daily record books that are linked to each care plan. Care plans and risk assessments pertaining to challenging behaviours are in place where necessary and staff are familiar with these. The safeguarding policy and procedures have been reviewed and safeguarding training has been provided for staff to ensure that they are able recognise potential abuse and report it accordingly. Staffing levels have been reviewed to ensure that there is a minimum number of staff on
Care Homes for Older People Page 7 of 12 duty which is dictated by the number of people resident in the home. In addition, a team of staff has been identified for The Lawns to ensure that there is consistent care for people with dementia from a dedicated group. The home is clean and tidy with a warm, comfortable atmosphere that people appreciate. 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 8 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 9 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 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 9 13 Medicines must be securely stored at all times. For safety reasons, for security reasons and to meet legal requirements. 29/07/2010 2 9 13 Controlled drugs must be stored in a cabinet that complies with the Misuse of Drugs (Safe Custody) regulations. For security reasons and to meet legal requirements. 29/07/2010 3 9 13 Medicines must be administered as prescribed. This must be demonstrated by record keeping practices. for the health and well being of people living in the home 29/07/2010 4 9 13 People who self - administer any of their own medicines must be supported and protected by a self medication policy and risk assessment 29/07/2010 Care Homes for Older People Page 10 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 so that people are enabled to take their medicines as prescribed by the doctor. 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 9 The temperature of the medicines refrigerator should be accurately monitored over a 24 hour period. 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. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 12 of 12 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
