Care Home: Benvarden

Similar services:

• Maple Lodge
• Heathlands
• Aston Court Nursing Home
• Breme
• Ravenhurst
• Bank House
• Inspirations
• Westmead

What the care home does well We found that all the people we spoke with were happy with the care and support they receive at Benvarden. There is a variety of communal areas available for people to spend their day. The home was warm, clean and had a welcoming, homely atmosphere and people seemed to be at ease in their surroundings. We observed good interaction between staff and the people who live at the home. People told us staff were kind and attentive to their needs. One person commented, "They do everything I need." What has improved since the last inspection? The registered manager and staff have worked hard to address the things that we highlighted at our last inspection visit as being inadequate or unsafe. This shows that the manager is keen to run a home that meets regulatory requirements and is run in the best interests of the people who live there. Staff recruitment is more thorough and staff are not being allowed to start work before the required checks have been done. This protects people because it helps to reduce the risk of unsuitable people gaining employment in the home. Staff training has improved and staff training in mandatory subjects is up to date. Induction training is now based on the national `skills for care` standards so that staff receive suitable training from the very start of their employment. People are assessed prior to them living at the home so that their needs can be identified and a decision can be made on whether these can be met. Care plans have been improved so that staff have more information about how to meet people`s needs. The home has improved its complaints procedures so that people know their views are listened to and acted on. Overall we found that there had been improvements in all aspects of the running of the home to the extent that all the requirements we had made during our visit on 13 August 2009 had been complied with. What the care home could do better: Action must be taken when staff identify that a person has lost weight. This is to make sure the risk to people`s health is appropriately managed. All staff should have training in the Mental Capacity Act and the Deprivation of Liberty Safeguards. This will ensure they know how this legislation may affect the people living there. A plan for the refurbishment of the home should be developed so that people can be sure it will be well maintained and be comfortable for them live in. Key inspection report Care homes for older people Name: Address: Benvarden 110 Ash Green Lane Exhall Coventry West Midlands CV7 9AJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Patricia Flanaghan     Date: 1 0 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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: Benvarden 110 Ash Green Lane Exhall Coventry West Midlands CV7 9AJ 02476368354 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: dorethdaly@tiscali.co.uk Ms Diane Hughes care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Benvarden may also care for the person named in the application for variation of registration dated 31 May 2006 Date of last inspection Brief description of the care home Benvarden is registered to provide residential care for up to 14 older people. Nursing care is not provided at Benvarden, community health care services and support are accessed through GP surgeries, district nurse services etc. The home is situated midway between the city of Coventry and the town of Bedworth and is close to the M6 motorway. Public transport is available from just outside the home; local shops and a post office are within walking distance. Benvarden is a converted large detached house providing domestic, homely accommodation. It has a dining room, two adjacent lounges and a large conservatory. There are 10 single bedrooms, six with en suite facilities and two double bedrooms with en suite facilities. There is a six-person lift, a laundry and domestic style kitchen. Care Homes for Older People Page 4 of 25 Over 65 14 0 1 3 0 8 2 0 0 9 Brief description of the care home The home has pleasant gardens with a patio overlooking a school playing field. There is car parking for visitors to the front and side of the home. At the time of this report the service user guide for the home stated that the weekly fees ranged from £380 and £400. This does not include extra services such as hairdressing, chiropody, toiletries or newspapers. The fee information given applied at the time of the inspection; persons may wish to obtain more up to date information from the service. 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 focus of inspections undertaken by us is upon outcomes for people who live in the home and their views of the service provided. This process considers the homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development This was the second full inspection of the home this year. This was because following our inspection on 13 August 2009 the home was rated by us as a 0 star service and we needed to go back to the home to check if improvements were being made. Following our inspection visit in August, the registered provider sent us an improvement plan which confirmed that they had begun to take action to deal with requirements. A person who had recently come to live at the home was case tracked. The case tracking process involves establishing an individuals experience of staying at the home, meeting or observing them, discussing their care with staff and relatives, Care Homes for Older People Page 6 of 25 looking at their care files and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. A range of evidence was used to make judgements about this service which included discussions with people using the service, the registered manager and staff. We also examined a number of records including care records of people living at the home, staff training, staff recruitment, complaints records and health and safety records. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: Action must be taken when staff identify that a person has lost weight. This is to make sure the risk to peoples health is appropriately managed. All staff should have training in the Mental Capacity Act and the Deprivation of Liberty Safeguards. This will ensure they know how this legislation may affect the people living there. A plan for the refurbishment of the home should be developed so that people can be sure it will be well maintained and be comfortable for them live in. Care Homes for Older People Page 8 of 25 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 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 9 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 10 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. An assessment of peoples needs is carried out prior to them moving in to the home to ensure these needs can be met effectively. Evidence: We looked at the care files belonging to a recently admitted person. Copies of the preassessment records were available to confirm these assessments had been carried out. Information obtained at the assessment stage had been transferred into care plan records to ensure staff support to meet these needs could be arranged. We spoke with the person who confirmed that the manager had visited the person in hospital to discuss their care needs. They also said that their relative had visited Benvarden twice to make sure that they could be happy living there. The person said, I am content here, the staff are all very kind. A comprehensive pre-admission assessment helps to make sure that the specific care needs of each person are identified and can be used to complete a plan of 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 living in the home have a detailed care plan to ensure their needs are identified and can be met by staff. Evidence: At our previous inspection visit we found that care planning needed to improve and that people did not always get the care they needed or in a way that they prefer. Care files are now well organised and have up to date information about peoples needs. There is improved communication between staff on shifts to ensure staff have up to date information about each person in their care. The manager has introduced a daily handover log for each person, whereby staff record concerns that arise on each shift about the persons health and personal care needs. They also record what action has been taken, or should be taken to address these concerns or needs. This information is also transferred to the persons individual care planning documentation with details of any action taken. We looked at the care files belonging to a recently admitted person. Care plans and daily records were available for the persons needs. For example, a care plan Care Homes for Older People Page 12 of 25 Evidence: described in detail the equipment to be used to support the person to move. This should mean people are moved safely. A care plan was available describing how the person needed to be supported to maintain their personal hygiene describing which tasks they could do for themselves to promote their independence. Falls risk assessments had been carried out. Staff were recording any falls that people had sustained in the daily records and there was also an additional sheet kept on care files for staff to record falls so that these could be monitored on a monthly basis. Making sure that people living in the home have risk assessments completed will give staff the information they need to help people and staff manage the level of risk identified safely. We saw that daily recording about the care given to the person and how they had spent their day had improved. Signing, dating and entering the time daily reports were made will help to show the accuracy of care and information provided by staff responsible for ensuring the individual care needs of people in their care have been met. Evidence was seen that staff weigh people regularly, and undertake nutritional assessments. This ensures people get the diet they need. We saw that the person had lost a significant amount of weight over one month. There was no evidence of action taken to investigate or increase the frequency of monitoring their weight. We discussed this with the manager who advised that the person had been in hospital for much of this period and had lost weight during this time. We saw that visiting healthcare professionals had been involved in the care of the person. The reasons and outcome of these visits had been recorded. For example, records showed that the GP and district nurses had been contacted to help support the care of the person who needed their leg dressed. We spoke with the person who told us they are very comfortable in the home. They told us they enjoyed meals and ate well. They confirmed that staff help them to settle comfortably in their chair in the quiet lounge, with their legs elevated. We saw a call bell had been put by the side of the chair so they could quickly call for assistance if necessary. We saw that medication was stored in a locked medicine trolley and locked cupboard which means that medication is safe. Storage of the medication was neat and tidy Care Homes for Older People Page 13 of 25 Evidence: which meant that it was easy to locate peoples medication. We checked the medication belonging to the person we case tracked and found it to be correct. Medication records were neat and clearly documented. Medication administration records (MAR) if medication was not given. People living in the home were observed to be treated with respect and their dignity maintained. For example, personal care was provided in private and people were spoken to respectfully. During observation of working practice it was evident that staff are knowledgeable about the likes and dislikes of people living in the home and were kind, caring and attentive towards them. Peoples personal care needs appeared to be well supported by staff. People were evidently supported to choose clothing appropriate for the time of year which reflected individual cultural, gender and personal preferences. People we spoke with were positive about the care they received. Comments included: They do everything I need. I think Ive improved since I moved in. Im well looked after here. Care Homes for Older People Page 14 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 have access to social activities and are able to exercise choices regarding their care and meals to maintain their independence and wellbeing. Evidence: We did not inspect this outcome group at this inspection. At our last inspection visit we found that people experienced positive quality outcomes in this area. 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. People can be confident that any complaints or allegations of suspected abuse are taken seriously and managed appropriately. Evidence: The home has a formal complaints policy which encourages people to raise any concerns with the staff on duty. People were observed to be familiar with staff and appeared at ease to make requests of them. This suggests people would be confident in raising concerns with staff. The manager told us that they home have not received any complaints since our last inspection visit. She showed us a complaints log she has implemented to record any grumbles, concerns or complaints. A person told us that they knew how to raise any concerns they had. They said, I would speak with the manager or the senior on duty. I could also tell my daughter if necessary. I have no concerns though, I am very happy here. Staff at the home have received training in safeguarding people from abuse and refresher training is also scheduled. At our last key inspection we found that some staff had only basic understanding of safeguarding procedures. To help improve staff knowledge safeguarding procedures have been discussed with them at staff meetings. A staff member spoken with was aware of what abuse is and of the action to take if she suspected or witnessed abuse. Care Homes for Older People Page 16 of 25 Evidence: The manager told us that staff at the home have not yet received training in the Deprivation of Liberty Safeguards (DoLS) Legislation. All staff should be aware of this legislation and the implications it has for the people living there. These safeguards are part of the Mental Capacity Act legislation and ensure that the care and treatment that people who live in care homes receive does not deprive them of their liberty. Care Homes for Older People Page 17 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Benvarden live in clean and homely surroundings which are being improved to make the building safer and more comfortable for the people who live there Evidence: The house is clean and has a welcoming atmosphere. People are encouraged to make their rooms feel personal to them by having their own belongings such as pictures, photographs, books and furniture, where this is possible. The manager told us that she had not commenced refurbishment of the home, but had addressed all the health and safety issues we raised at our last inspection. She said that she is developing a refurbishment programme for the home. This will ensure people live in comfortable surroundings. 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. There are sufficient staff who are appropriately trained and recruited to meet peoples needs and keep them safe. Evidence: The homes staffing levels currently are two care staff throughout the daytime shifts with management hours in addition and two care staff on duty at night. The home also has support from a cook, cleaner and maintenance person. Discussion with staff and our observations indicate that this level of staff is generally sufficient given that the home is not at full occupancy. When the number of people living in the home increases again, care will need to be taken to keep staff numbers at a level that means they can provide the same level of attention. Staff files inspected at the last inspection showed some shortfalls in obtaining Protection of Vulnerable Adults checks prior to employment and ensuring two written references were always obtained. One person has been appointed since the last inspection. The file showed that appropriate checks and references had been obtained prior to the person commencing duties. Turnover of staff at the home is minimal with the majority of staff having worked at the home for several years. This means that people know the staff who support them. Care Homes for Older People Page 19 of 25 Evidence: We looked at records and spoke with staff and the manager about the training available for staff. We were given an up to date matrix showing all the training that has been done by staff and were able to cross check this with certificates in staff files. Staff have undertaken training since our last visit that has included moving and handling, fire safety, food hygiene and safeguarding. As stated earlier in this report staff have not yet had any training in the Deprivation of Liberty Safeguarding Legislation. The homes training plan for the coming twelve months shows that training is arranged in dementia, safeguarding, infection control, food hygiene, health and safety, fire and first aid. 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 manager has ensured that the home is run in the best interest of the people who live there. Evidence: The registered manager is also the owner of the home. Our last inspection visit demonstrated significant shortfalls in the overall running of the home. These have now been addressed and we found improvements had been made in the majority of areas we highlighted at the last visit. Staff spoke positively about how the home is managed and told us they are encouraged to work as a team to benefit people living at the home. We saw written records which show meetings are held on a regular basis to keep staff informed of changes within the service, implementing good practice and where changes to practice are needed. The home does not have meetings for people living at the home, but chooses to speak Care Homes for Older People Page 21 of 25 Evidence: with people individually. We found this seems to be effective, and both staff and people we spoke to were happy with the arrangement. We found at the last inspection visit that procedures relating to the management of peoples money were robust. We saw that the home had now met the requirements of the health and safety report from the local authority. This should mean that people live in a safe and comfortable environment. The home has kept us informed of the occurrence of accidents and incidents and now knows when to inform other agencies. 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 1 8 Systems must be developed to make sure appropriate action is taken when people lose weight. This should make sure staff are alerted to increased risks so they can take appropriate action. All staff should have training in the Mental Capacity Act and the Deprivation of Liberty Safeguards. This will ensure they know how this legislation may affect the people living there. A plan for the refurbishment of the home should be developed so that people can be sure it will be well maintained and be comfortable for them to spend time in. 2 18 3 19 Care Homes for Older People Page 24 of 25 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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. 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!