Care Home: Beverley Court Residential Home

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What the care home does well People who are thinking about moving into the home have their needs thoroughly assessed before they move in by both the home and the Local Authority. This means that the staff are well informed about the persons needs and these can be properly met. Peoples needs are recorded in a care plan, these contain information about how the staff are to effectively meet the needs of the person. The care plans contain lots of information about the person and they are involved with the formulation. This means that the person is receiving the care they need and it is of their choosing. People are able to join in activities which are provided at the home. Entertainers are invited into the home and people told us they enjoyed this. Wholesome and nutritious food is provided for the people who live at the home and there is choice at all meal times. People can choose where to eat their meals and many have their meals in their rooms. Visitors are welcomed to the home and people are helped to keep in contact with relatives and friends. This means that people can take part in activities which are right for them and can exercise choice in their daily lives. There are procedures in place to make sure that people know they can complain and who to complain to. If any complaints are received the manager makes sure these are recorded properly and investigated, the complainant is asked if they are happy with the outcome of the investigation done by the home. If they are not they are given information about who else they can complaint to. All of the staff have received training about what abuse is and how to recognise it. They have also been given training on how report any instances of abuse to proper authorities. This means that people are protected by the way the home handles complaints and they are protected by the procedures in place about how to handle any allegations of abuse. The homes environment is clean and tidy. Areas are decorated when needed and there is an ongoing programme of redecoration and renewal. People are encouraged to bring any personal items, pictures or photographs with them when they move in which remind them of home. All of the equipment is checked at the right intervals. This means that people live in safe well maintained environment. All staff have had the proper checks done before they started working at the home. Staff are provided with training which gives them skills to care for the people who live at the home properly and safely. This means that people are not exposed to staff who may be unfit to work with vulnerable people and are cared for by staff who have the right skills to meet their needs. What has improved since the last inspection? At the last inspection it was noted that there were some discrepancies in way the medication had been recorded. This has now improved and no discrepancies were found. The way that views of people who live at the home an other stakeholders influence the way the home runs has improved. The homes Quality Audit now includes the opinions of Doctors and nurses and other visiting health care professionals.  What the care home could do better: Sometimes people need to have bedrails fitted to their beds which protect them from falling out and injuring themselves, however we did not see any risk assessments about the use of bedrails. The risk assessments should be based on information which has been provided by the Department of Health, and should be in place to make sure this is the right course of action and the person is safe from harm. The manager should give consideration to keeping a record of when staff have undertaken training so she could see at glance when this needed updating. Key inspection report Care homes for older people Name: Address: Beverley Court Residential Home 334-336 Beverley Road Hull East Yorkshire HU5 1LH     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: George Skinn     Date: 1 0 0 9 2 0 0 9 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 24 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 24 Information about the care home Name of care home: Address: Beverley Court Residential Home 334-336 Beverley Road Hull East Yorkshire HU5 1LH 01482449296 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: dawn@hestoncourt.karoo.co.uk Heston Court Limited care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The home must increase its communal space to a minimum of 30 times 3.7 square metres per person within three years of registration. The home must meet the requirements of the residential staffing forum. Date of last inspection Brief description of the care home Beverley Court Residential Home is a purpose built home comprising of 3 floors and registered to care for 30 older people. It is situated on the corner of Sculcoates Lane and Beverley Road, which is one of the main roads leading into the centre of Hull. The Home is well served by public transport and nearby there is a good range of shops and a local park. On the ground floor there is one dining area, a lounge and a small number of single rooms. On the first floor there is a further lounge / dining room and additional bedrooms. The remaining bedrooms are situated on the second floor. Access to the Care Homes for Older People Page 4 of 24 Over 65 30 30 0 0 Brief description of the care home first and second floors is via two staircases or a passenger lift. To the rear of the home is a car park and to the side and front, overlooking Beverley Road, are garden areas. Care Homes for Older People Page 5 of 24 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 quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The key inspection has used information from different sources to provide evidence. These include reviewing information that has been received about the home since the last inspection, information provided by the registered person on an Annual Quality Assurance Assessment (AQAA) and comment cards returned from people who live at the home and staff. We sent out five (5) comment cards for the people who live at the home to complete and five (5) staff comment cards; we received back four (4) comment cards from the people who live at the home and two (2) staff comment cards. We undertook a visit to the home which lasted five (5) hours. We spoke with the Care Homes for Older People Page 6 of 24 people who live at the home and staff. We looked at records relating to the people who live at the home, staff and the management activities of the home. During the visit care practices were observed where appropriate, and time was also spent watching the general activity within the home. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Date of last inspection 10th September 2007 and there was annual service review undertaken on the 16th September 2008. The assistant manager was available to assist throughout the day. Current weekly fees range from 359.50 GBP to 372.00 GBP there is no top up charge. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? At the last inspection it was noted that there were some discrepancies in way the medication had been recorded. This has now improved and no discrepancies were found. The way that views of people who live at the home an other stakeholders influence the way the home runs has improved. The homes Quality Audit now includes the opinions of Doctors and nurses and other visiting health care professionals. Care Homes for Older People Page 8 of 24 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 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 24 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 24 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. Peoples needs are assessed before they move into the home. Evidence: We looked at a sample of files which belonged to the people who live at the home. We saw that these contained copies of assessments undertaken by the placing authority and the home. This assessment information is then used to write a care or support plan describing what staff need to do to look after each person. The home does not provide intermediate care, which is a specialist service aimed at maximising peoples independence and return home after a hospital admission. Care Homes for Older People Page 11 of 24 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 a detailed plan of care which instructs staff on how best to care for them. The lack of risk assessment regarding the use bedrails could put people at risk of harm. People are protected by the homes procedures for handling medication. Evidence: We looked at four (4) care plans, which belonged to the people who live at the home. We saw that personal support is provided in accordance with the care plan and these contained risk assessments around the area of falls, tissue viability, nutrition and diet. We did not see risk assessments which had been formulate using the Department of Health guidance with regard to the use of bedrails. We saw that people who live at the home can access healthcare professionals like doctors and nurses when needed, some people also have input from specialist nurses like community psychiatric nurses. Some people have involvement with psychiatrists, specialist social workers, physiotherapist and dieticians. When we spoke with the staff they were clear about how to maintain someones Care Homes for Older People Page 12 of 24 Evidence: dignity and uphold their rights. We saw that the staff were sensitive to peoples needs when undertaking any personal tasks and were sensitive and patient when caring for those people who have dementia. We looked at the way the home handles and stores medication. We saw that the way this was done ensures the safety of the people who live at the home. The medication was stored in the proper cabinets and secured. The staff make sure that correct medication has been supplied by the pharmacist when it is delivered and any mistakes are quickly rectified. The staff make sure that the recording of the medication is up to date and gives a clear indication that the medication has been administered. The recording also indicates when the medication has not been given and why. All of the staff who give out medication have had the proper accredited training and we saw certificates which confirmed this. Care Homes for Older People Page 13 of 24 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 are supported to lead a life style of their own choosing, and are enabled to keep in contact with relatives and friends. People are provided with food that is wholesome and nutritious. Evidence: When we spoke with the people who live at the home they said they could make choices about daily activities, what food they preferred to eat, how to spend their time and when to get up and go to bed. The home encourages contact with relatives and friends. We saw that visitors were made welcome and had good relationships with the staff. We saw that a wide selection of activities are arranged for the people who live at the home to take part in if they wish these included reminiscence, one to one discussions, bingo, quizzes, table games dominoes, crosswords and nail care. Advertisements around the home told us that that entertainers visit regularly and during the summer months trips out are booked weather permitting. When we spoke with the people who live at the home about the food they told us it was very good. The people who live at the home are asked what they would like for Care Homes for Older People Page 14 of 24 Evidence: lunch and tea as a choice is available for both. We saw that the food provided on the day of the visit was nicely presented and looked wholesome and nutritious. Staff helped those people who required assistance when eating in a relaxed, unhurried manner. Care Homes for Older People Page 15 of 24 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 protected by the way the home handles complaint and the procedures in place for handling any allegations of abuse. Evidence: We saw that one (1) complaint had been received by the home since the last inspection. We saw that this had been fully recorded and investigated and appropriate action taken. The CQC have received no complaints about the home since the last inspection. The home has not been the subject to any safeguarding referrals or investigations by the Local Authority Safeguarding Team. We asked the people who live at the home if they knew who to complaint to they told us that they did and were aware they had the right to make complaints telling us they would talk to their key worker or the manager. The home has a policy and procedure in place for Safeguarding Adults, the staff interviewed were aware of this and all had received training about the Protection Of Vulnerable Adults (POVA). Staff were able to describe what they would do if they suspected any abuse was occurring. Care Homes for Older People Page 16 of 24 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 live in a well maintained and clean environment. Evidence: We saw that the home was generally clean and tidy and both communal and private areas are well maintained and welcoming. The bedrooms are all single and some have en-suite facilities, all of the rooms have a TV and some contain many items of personal belongings which people are encouraged to bring with them. Lots of the people who live at the home spend a lot of time in their rooms and when we spoke with them they were satisfied with this arrangement and told us they were comfortable and happy. There is a programme of refurbishment and rooms are re-decorated and refurbished as and when required. There is limited access to the outside of the home but people can sit in the small garden at the front of the home in nice weather. This is accessible via a ramp so people who use a wheel chair can access this area easily. There is a small designated smoking area at the back of the building. Care Homes for Older People Page 17 of 24 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. People are cared for by staff who are properly trained and provided in enough numbers to meet their needs. People are protected by the homes recruitment and selection procedures. Evidence: The people who live at the home are cared for by staff who are provided in enough numbers to meet their needs. The home has a robust recruitment procedure which keeps people safe. We looked at staff recruitment files and saw that these contained evidence of references being taken from previous employers and evidence of enhanced Criminal Records Bureau (CRB) checks being undertaken before someone starts working at the home. Recently recruited staff confirmed that they did not start working at the home until all of the proper checks had been undertaken. This means that people are not exposed to staff who may not be fit to care for vulnerable people. We saw that staff files contained information and copies of certificates of training undertaken. The training ranged from mandatory training like health and safety, basic food hygiene, fire, first aid and moving and handling to more specialised training based on the more complex needs of the people who live at the home. We saw copies of applications made to the Local Authority training department for new staff to attend Care Homes for Older People Page 18 of 24 Evidence: training. It would be good practice to record the dates when this training had been undertaken on a separate sheet so the manager could see at glance when it needed updating. We saw that when staff are first employed they undertake a basic induction then go on to do NVQ level 2 or 3. Currently more than 50 of the staff are trained to NVQ level 2. We saw that staff receive regular supervision and during these sessions their training needs are discussed. This means that the staff training is always up to date and they can access training which relevant to the needs of the people who live at the home. Care Homes for Older People Page 19 of 24 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. People live in a home which is well managed and run in their best interests. Evidence: The manager is registered with the CQC and has the relevant qualifications and experience for this role. People who live at the home told us that the management are approachable and they have confidence in them. Staff told us that the management is supportive and provides them with good leadership. The home continues to have a well developed quality assurance (QA) system that involves the people who live at the home, families, staff and other health care professionals giving their views about the home. Surveys are completed throughout the year and an annual report is produced explaining the outcome of the surveys and any relevant action to be taken. This means that the running of the home is transparent and the home takes the view of all stakeholders seriously. People who live at the home and or their families continue manage their own financial Care Homes for Older People Page 20 of 24 Evidence: affairs some personal monies are kept by the home. We saw that this was well maintained and protected people. The home has a fire policy and a fire risk assessment and the fire alarm is tested on a regular basis. Tests on equipment are undertaken and fire drills are carried out on a monthly basis. The home has a nurse call system fitted to ensure that all the people who live there are able to request assistance when needed. We saw that all of the equipment used at the home is serviced at regular intervals as recommended by the manufacturer and the gas and electricity supply has been tested. This means that people live in a safe well maintained environment. We saw that the staff have undertaken mandatory training which includes health and safety, basic food hygiene, moving and handling, fire and first aid this is up dated when required. This means that the people who live at the home are in safe hands and are cared for by staff who have received appropriate training. The AQAA which was returned prior to the site visit, it was well completed and told us about areas for improvement. Care Homes for Older People Page 21 of 24 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 22 of 24 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 7 15 Risk assessments which have been formulated using the Department of Health guidelines must be in place for all those people who have bedrails fitted to their beds. This will ensure they are properly protected and not place at risk of harm. 01/12/2009 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 30 The manager should consider a method of recording the dates when staff have undertaken training so they can see at glance when this needs up dating. Care Homes for Older People Page 23 of 24 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. 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