Care Home: Bethany House

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What the care home does well We spoke to most of the residents and they were happy with their home. People told us the staff were `lovely` and that everything was `grand`, `very good`, `we all get along`. We met some visitors who were also extremely satisfied with the arrangements in place. We read care plans and daily notes and saw for ourselves how staff carried out the care provision. The care plans set out clearly the arrangements needed for personal and health care and give staff strategies to follow if people challenge the service. We saw a staff team who were constantly alert to the needs of people with dementia and who responded to these needs. On several occasions we saw staff pre empting needs where people found it difficult to express themselves. All of this was carried out in a friendly and calm way. Staff used humour and gently reorientated people to time, place and person. We looked at medicines in the home and we found that these were ordered, stored, administered and disposed of correctly. We saw people being given medication appropriately. Staff receive regular training on managing medicines. The home does not rely on sedative medicines and any strong drugs are only prescribed by a psychiatrist andare kept under constant review. We saw evidence to show that peoples` medication is often reduced once they settle in the home. The daily notes and people themselves told us they saw the doctor or the nurse when they needed to and that they had visits from people like opticians and chiropodists. We also saw evidence that people have regular input from the psychogeriatrician and the specialist dementia care nurse. Other health professionals like dietitians and speech therapists have been used in the past when people are not eating well. Everyone ate well at lunchtime and the staff are keeping a careful eye on one or two peoples` weight. No one needed nutritional planning but the staff were confident that they could do this correctly. One or two people need help with their mobility and we saw staff help someone who needs to use a hoist. This was done gently and patiently and the person was happy to be moved this way. People who live in the home were well groomed and dressed according to their own style preferences. They could choose to join in with conversations and activities or to simply sit and observe. One or two people spent time in their rooms. People could tell us that they went out and were reminded by staff and each other of the trip they had the day before. They were happy with their own bedrooms and we were invited to look at these by individuals. Rooms were personalised, clean and orderly. People told us they felt safe in their rooms and that they could spend time alone when they wished. We asked residents about making complaints and several people found this quite a humerous question as they told us they complained `as much and as often as I want`. They also told us that any complaints were dealt with straight away. A number of people could tell us (despite the problems related to their memory loss) exactly who they would complain to. A lot of residents knew the manager`s name and understood her role in the home. They also related very well to the provider and it was clear that the providers knew them and their needs. We spoke to residents and staff about any potential or actual abuse. Residents said they had `never heard a cross word`. Staff told us they were confident in the manager and the company but knew how to report to external agencies. Everyone had received annual updates to their training on safeguarding and were able to talk at length about how important this is when people have dementia. There had been no formal complaints or safeguarding referrals made. The company has good policies and procedures on these matters that are regularly updated. Copies of the complaints procedure is in the welcome pack given to new people. The home has extended the environment since our last visit and now has two substantial conservatories. The largest of these is used as additional sitting space and has been used for parties, activities and entertainments. The smaller is now the smoking area. Both of these lead out to the garden which has been repaved. The downstairs toilet has been refurbished with new ventilation. Residents told us they thought these changes had improved their lives. They also said the home`s transport was a good idea as it got them `out and about for a runaround to see things.` Generally we judged that this service continues to give excellent care to people who havevery complex needs and do so in a manner that protects their rights and dignity. People in this service are treated as individuals and their mental health needs are met. We judged that the approach taken by the team focussed on strengths rather than the problems mental ill health brings. Bethany House is a very positive place where people have high levels of satisfaction. What the care home could do better: There was nothing of concern we wanted the service to do at this time. Random inspection report Care homes for older people Name: Address: Bethany House 20 Front Corkickle Whitehaven Cumbria CA28 8AA three star excellent service 20/09/2007 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: Nancy Saich Date: 0 4 0 5 2 0 1 0 Information about the care home Name of care home: Address: Bethany House 20 Front Corkickle Whitehaven Cumbria CA28 8AA 01946695556 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Kathryn Lisa Taylor Type of registration: Number of places registered: Conditions of registration: Category(ies) : Bethany House Limited care home 18 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 18 18 The registered person may provide the following category/ies 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: Dementia Code DE Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 18 Date of last inspection Brief description of the care home Bethany House is situated in the Whitehaven conservation area. It is near to all the amenities of the town. The property is a converted Victorian vicarage that has been extended and adapted to accommodate up to eighteen older people with dementia or Care Homes for Older People Page 2 of 9 Brief description of the care home mental health problems. Accommodation is in single ensuite rooms. The company is owned by Mr and Mrs Ditchburn who also own a domiciliary care company in the area. Kathryn Taylor manages the home on their behalf. Care Homes for Older People Page 3 of 9 What we found: This was the first time we had visited this service since the last key inspection on 20/09/2007. We have received annual updates about the service and have completed Annual Service Reviews. Some weeks before this unannounced visit we sent the manager a form called the Annual Quality Assurance Assessment (the AQAA). It is a legal requirement that registered services complete one of these annually. It asks for detailed information and statistics about how the service is operating. This was received, with plenty of good information, within the given timescales. We also sent out ten surveys for residents and ten for staff. We had a good response to these and we quote from these below. The information we received was of such a high quality showing positive outcomes that we decided that we did not need to complete a full key inspection. Instead we concentrated on the core National Minimum Standards for Health and Personal Care (NMS 7-10) and those for Complaints and Protection (NMS 16 and 18). We made an unannounced visit on the above date. We spent time with the people who live in the home talking and observing the life of the home. We visited some, but not all areas of the building, spoke to all of the staff on duty and spent time talking to the manager and to David Ditchburn one of the directors of the company. We looked at a sample of care files and spent time on the homes new computer system. We checked medicines in the home.We read daily notes and observed activities and were there when lunch was served. We discovered a care home that delivers high standards of care to people with dementia or other mental health needs. People are listened to and protected from harm. The atmosphere in the home was warm and welcoming and people were calm and satisfied with the arrangements for daily living in their home. What the care home does well: We spoke to most of the residents and they were happy with their home. People told us the staff were lovely and that everything was grand, very good, we all get along. We met some visitors who were also extremely satisfied with the arrangements in place. We read care plans and daily notes and saw for ourselves how staff carried out the care provision. The care plans set out clearly the arrangements needed for personal and health care and give staff strategies to follow if people challenge the service. We saw a staff team who were constantly alert to the needs of people with dementia and who responded to these needs. On several occasions we saw staff pre empting needs where people found it difficult to express themselves. All of this was carried out in a friendly and calm way. Staff used humour and gently reorientated people to time, place and person. We looked at medicines in the home and we found that these were ordered, stored, administered and disposed of correctly. We saw people being given medication appropriately. Staff receive regular training on managing medicines. The home does not rely on sedative medicines and any strong drugs are only prescribed by a psychiatrist and Care Homes for Older People Page 4 of 9 are kept under constant review. We saw evidence to show that peoples medication is often reduced once they settle in the home. The daily notes and people themselves told us they saw the doctor or the nurse when they needed to and that they had visits from people like opticians and chiropodists. We also saw evidence that people have regular input from the psychogeriatrician and the specialist dementia care nurse. Other health professionals like dietitians and speech therapists have been used in the past when people are not eating well. Everyone ate well at lunchtime and the staff are keeping a careful eye on one or two peoples weight. No one needed nutritional planning but the staff were confident that they could do this correctly. One or two people need help with their mobility and we saw staff help someone who needs to use a hoist. This was done gently and patiently and the person was happy to be moved this way. People who live in the home were well groomed and dressed according to their own style preferences. They could choose to join in with conversations and activities or to simply sit and observe. One or two people spent time in their rooms. People could tell us that they went out and were reminded by staff and each other of the trip they had the day before. They were happy with their own bedrooms and we were invited to look at these by individuals. Rooms were personalised, clean and orderly. People told us they felt safe in their rooms and that they could spend time alone when they wished. We asked residents about making complaints and several people found this quite a humerous question as they told us they complained as much and as often as I want. They also told us that any complaints were dealt with straight away. A number of people could tell us (despite the problems related to their memory loss) exactly who they would complain to. A lot of residents knew the managers name and understood her role in the home. They also related very well to the provider and it was clear that the providers knew them and their needs. We spoke to residents and staff about any potential or actual abuse. Residents said they had never heard a cross word. Staff told us they were confident in the manager and the company but knew how to report to external agencies. Everyone had received annual updates to their training on safeguarding and were able to talk at length about how important this is when people have dementia. There had been no formal complaints or safeguarding referrals made. The company has good policies and procedures on these matters that are regularly updated. Copies of the complaints procedure is in the welcome pack given to new people. The home has extended the environment since our last visit and now has two substantial conservatories. The largest of these is used as additional sitting space and has been used for parties, activities and entertainments. The smaller is now the smoking area. Both of these lead out to the garden which has been repaved. The downstairs toilet has been refurbished with new ventilation. Residents told us they thought these changes had improved their lives. They also said the homes transport was a good idea as it got them out and about for a runaround to see things. Generally we judged that this service continues to give excellent care to people who have Care Homes for Older People Page 5 of 9 very complex needs and do so in a manner that protects their rights and dignity. People in this service are treated as individuals and their mental health needs are met. We judged that the approach taken by the team focussed on strengths rather than the problems mental ill health brings. Bethany House is a very positive place where people have high levels of satisfaction. 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 6 of 9 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 7 of 9 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 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 Care Homes for Older People Page 8 of 9 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. 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