Care Home: Bethany Homestead

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What the care home does well The home circulates a newsletter to everyone each month which gives details of all the activities planned as well as other information to keep people up to date with what has been happening at Bethany Homestead. People who live at the home are part of a committee which coordinates activities and entertainment. Bedrooms seen had been made very personal with people being encouraged to bring in their own furniture and personal items. Staff were observed caring for people in a kind and sensitive manner, showing a good understanding of their needs and preferences. A number of recent thank you cards were seen which praised the staff, one stated that "you have an exceptional staff there and they deserve all the praise they get." The staff team is generally static which helps to make sure that the staff knew the people who live in the home well. Surveys conducted by the home for people who live at the home and their relatives showed a good level of satisfaction. One person comments, "I was very frightened on coming into the home. All aspects of my care were explained. From the moment I came in I was made to feel welcome and cared for." What has improved since the last inspection? Risk assessments have been developed to assess any risks to people`s health and well being so that measures can be put in place to avoid any unnecessary risks. Detail about people`s preferences were included in their care plans making them personal to each individual. What the care home could do better: The service user guide should be made available in suitable formats for the people who live in the home or may want to move to the home. Where people use reclining chairs an assessment must be carried out to ensure that this is in their best interests. Pre-recruitment checks must be completed on all staff prior to their employment within the home to ensure that staff are suitable to work with older people. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bethany Homestead Kingsley Road Northampton NN2 7BP     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Catherine Perrins     Date: 2 6 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Bethany Homestead Kingsley Road Northampton NN2 7BP 01604713171 01604716315 kathycoxhill@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Trustees of Bethany Homestead care home 40 Number of places (if applicable): Under 65 Over 65 0 40 dementia old age, not falling within any other category Additional conditions: 40 0 The Registered Person may provide the following categories of service only: Care Home only - Code PC 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 - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is 40 Date of last inspection Brief description of the care home The home is situated in a purpose built facility close to the town centre and local amenities. The home is a registered charity and is run by a board of trustees. It admits people who are members of non-conformist churches within the local area. People are accommodated over three floors with lift access for those with mobility problems. The majority of rooms are single with two double rooms available if required. All of the bedrooms have en-suite facilities. The home is set within a complex of sheltered housing and also has its own chapel. The current fees range from 520 to 540 pounds with additional costs for extras such as Care Homes for Older People Page 4 of 27 Brief description of the care home hairdressing, newspapers, transport, chiropody and testing of portable electrical appliances belonging to service users. Information about the service can be found within the Statement of Purpose and service users guides available on request from the home. Care Homes for Older People Page 5 of 27 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This was an unannounced key inspection which means that we focused on the key national standards. The key standards are those considered by the Commission to have the most impact on outcomes for residents. As part of the preparation for this inspection a period of three hours was spent reviewing the information that CQC has about this service. We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. Care Homes for Older People Page 6 of 27 This included: Surveys returned to us by people using the service and from other people with an interest in the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. The inspection visit lasted five hours during the morning and afternoon of a weekday with a short second visit lasting an hour to check staff files. These had not been accessible on the first day due to the registered manager being on leave. Because people with dementia are not always able to tell us about their experiences we also used observations of peoples state of well being and how they interacted with staff members and others. A sample of staff files were also viewed as part of the inspection. The registered manager was only present during the one hour visit on the second day of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 Care Homes for Older People Page 8 of 27 7535. Care Homes for Older People Page 9 of 27 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 27 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. The homes admission procedure ensures that people can be confident that their needs will be met when they move into Bethany Homestead. Evidence: The home has a statement of purpose and service user guide which give people good information about the home and the services it offers. The service user guide is not available in any other formats such as large print to make them easier for older people to read. Records show that peoples needs are fully assessed before they move to Bethany Homestead to make sure that the home is right for them. Staff explained that people are able to visit the home before they move in to help them decide if it is the right move for them. If they are not able to visit, their relatives Care Homes for Older People Page 11 of 27 Evidence: or friends can do so on their behalf. Care Homes for Older People Page 12 of 27 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 have their health and personal care needs well met at Bethany Homestead. Evidence: Each person who lives at Bethany Homestead has an individual plan of care. This contains their care plans and other information that staff need to care for people in the right way. Care plans seen covered areas such as communication, eating and drinking, personal care, mobility, spiritual needs, health and continence. Detail about peoples preferences were included in their care plans making them personal to each individual; For example it was noted that one person likes to have a port and lemon and someone else likes to wear lipstick and face powder and another person likes to have a glass of water close by at night. There was some evidence of people being helped to make choices such as what clothes they wanted to wear. Records show that any risks to peoples health and well being are assessed so that Care Homes for Older People Page 13 of 27 Evidence: measures can be put in place to avoid any unnecessary risks. A relative told us that her mother in law moved to the home because following a number of falls but since moving to the home she had not fallen at all. Staff told us that there is a good atmosphere here, people are happy. The administration of medication is generally well managed with all entries on the medication record being signed to show that people are receiving their medication as prescribed. Care Homes for Older People Page 14 of 27 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 enjoy a variety of activities and entertainment and are kept up to date with what is happening in the home. Evidence: Peoples individual plans of care contain some information about their interests and hobbies. One person who lives at the home told us that she is on the homes entertainment committee so is responsible for helping to plan activities and entertainment. People told us that there was a good range of activities on offer. The home circulates a newsletter to everyone each month which gives details of all the activities planned as well as other information to keep people up to date with what has been happening at Bethany Homestead. Activities for this month included armchair areobics, prayer support, scrabble, skittles, chines brush painting, knit and natter and a forties evening. Details of the activities and forthcoming events are also available on the notice board in the entrance hall of the home. People told us that the home has a minibus which can take people who use Care Homes for Older People Page 15 of 27 Evidence: wheelchairs which makes it easier for people to go out. On the day of inspection a group of people were going to Glendon for afternoon tea. Staff told us that the following week a trip to Hunstanton had been arranged because one person really wanted to visit the coast. One person who lives at the home showed us the area of garden which she has developed. She explained that it had previously been a pile of rubble following some building work which had been done at the home. With the help of a friend she had transformed it into a really attractive flower bed which she tends on a daily basis. She also showed us her greenhouse where she grows tomatoes. Comments in the surveys that we sent out to people indicated that some people would like to see more activities aimed at people with higher care needs. People told us that the food is good. Menus seen were varied and contained fresh fruit and vegetables. The cook explained that people are given a menu sheet to chose meals each day. Lunch was observed during the inspection, staff were seen assisting people in sensitive manner, talking to them and explaining what the food was. Care Homes for Older People Page 16 of 27 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 are generally protected by the homes policies, procedures and practices. Evidence: The home has a complaints procedure which outlines what people should do if they wish to raise a concern about the home and the response that they can expect. Records show that the home has received three complaints since the last inspection all of which were investigated by the home and not substantiated. Staff spoken to knew how to raise any concerns that they may have. A number of people were observed sitting in reclining chairs. These chairs can be very difficult to get out of when reclined so assessments are needed to ensure that people are not having their ability to move around freely restricted. Staff told us that these assessments have not yet been completed. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a comfortable and homely living environment. Evidence: Bethany Homestead care home is set back from the road and accessed by a long driveway. The care home is surrounded by number of bungalows which are part of Bethany Homestead Domiciliary Care Service. There is also a chapel within the complex and extensive grounds. The care home is a three storey building. At the time of inspection the middle floor was not occupied and was being used as offices with two bedrooms set aside in case anybody living in the bungalows needed to move in to the home for an emergency short stay. On the ground floor there is a large conservatory, library and dining room. On the top floor there is a small lounge / dining room. There is a lift so that people can access the different floors. Communal areas had been made homely with pictures, plants and ornaments. There is also a room that is used for prayer meetings and services. Bedrooms seen had been made very personal with people being encouraged to bring in their own furniture and personal items. All bedrooms have an en suite toilet and wash Care Homes for Older People Page 18 of 27 Evidence: basin. Accessible bathrooms are available on each floor. The home was clean and generally well maintained throughout, although there were some signs of wear and tear such as the carpets being worn in places. The home employs a team of domestic staff to ensure the cleanliness of the environment and to do the laundry. Care Homes for Older People Page 19 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for by a committed and caring staff team but shortfalls in the prerecruitment checks puts people at risk. Evidence: Recruitment records for one member of staff show that not all of the necessary prerecruitment checks were carried out prior to her employment at the home. These checks ensure that staff are suitable to work with older people. Staff told us that they had an induction when they first started working at the home which included working alongside an experienced colleague to make sure that they had all of the information that they need to do their job in the right way. Records show that new staff are observed by their supervisor who makes sure that they are competent in each area of their work. Staff were observed caring for people in a kind and sensitive manner, showing a good understanding of their needs and preferences. A number of recent thank you cards were seen which praised the staff, one stated that you have an exceptional staff there and they deserve all the praise they get. Staff told us that the staff team was generally static which helped to make sure that Care Homes for Older People Page 20 of 27 Evidence: the staff knew the people who live in the home well. Staff explained that they attend training courses such as food hygiene, safeguarding of adults, dementia care, infection control, fire safety and moving and handling. Staff spoken to had a good knowledge of how to safeguard adults and their responsibilities to report any concerns that they may have. Care Homes for Older People Page 21 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in the best interests of the people who live there however gaps in the required pre-recruitment checks put people at risk. Evidence: The registered manager has worked at the home for over twenty five years. She is a qualified nurse and holds an NVQ 4 in management. Recruitment records for one member of staff show that not all of the necessary prerecruitment checks were carried in that a Criminal Records Bureau (CRB) and Protection of Vulnerable Adults List (POVA) check had not been completed prior to her employment at the home prior. These checks ensure that staff are suitable to work with older people. Records show that these checks have now been completed for this staff member. The registered manager stated that the staff member in question was supervised by other staff during the period when she had not had the necessary CRB and POVA checks. Care Homes for Older People Page 22 of 27 Evidence: Surveys conducted by the home for people who live at the home and their relatives showed a good level of satisfaction. One person comments, I was very frightened on coming into the home. All aspects of my care were explained. From the moment I came in I was made to feel welcome and cared for. another says that the home treat my father as individual. Records show that safety checks such as fire, portable appliance testing and checks on the water system are all up to date and that the lift and hoists have been serviced in line with manufacturers instructions. The whole of Bethany Homestead complex has a development plan aimed at redeveloping and improving the physical environment and various fundraising events are held to raise monies for the proposed work. Care Homes for Older People Page 23 of 27 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 24 of 27 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 1 18 17 Where people use reclining 31/08/2009 chairs an assessment must be carried out to ensure that this is in their best interests. To ensure that people do not have unnecessary restrictions on their liberty. 2 31 19 Pre-recruitment checks must 10/07/2009 be completed on all staff prior to their employment within the home. To ensure that all staff are suitable to work with older people. 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 1 The service user guide should be made available in suitable formats for the people who live in the home or may want to move to the home. Activities should be reviewed to ensure people with high care needs have access to a range of suitable activities. Page 25 of 27 2 12 Care Homes for Older People Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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