Care Home: Bymead House

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What the care home does well People living at the home told us they were well cared for by competent, well trained staff. Residents are supported to maintain contact with family and friends, enabling people living in the home to continue to enjoy relationships that are meaningful to them. People told us that they enjoy the activities provided and that the food is very good. The menu offers choice and staff are aware of the likes and dislikes of those living there. The complaints and adult protection procedures ensure that residents and their representatives well-being and comfort is important to the home and that any concerns raised will be properly investigated and resolved. Sufficient numbers of staff are on duty throughout the day and night to be able to meet the care needs of people. Recruitment procedures are good ensuring that staff are suitable to work in the home and residents are well protected. Financial procedures within the home also ensure that residents interests are protected. What has improved since the last inspection? This is the first inspection of this home under the new registration. What the care home could do better: This is a well run home. During discussion with the Ms Blacklock and Mrs Manners it was agreed that there could be some minor improvement in care documentation so that staff had all the up to date information they need to be able to meet the needs of the residents. However people living in the home told us that they were very well cared for and staff were very kind and caring. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bymead House Axminster Road Charmouth Bridport Dorset DT6 6BS     The quality rating for this care home is:   two star good 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: Amanda Porter     Date: 1 9 1 2 2 0 0 8 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 25 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Bymead House Axminster Road Charmouth Bridport Dorset DT6 6BS 01297560620 01297560732 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) : Bymead House Limited care home 30 Number of places (if applicable): Under 65 Over 65 30 0 old age, not falling within any other category physical disability Additional conditions: 0 10 The maximum number of service users who can be accommodated is 30. The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Physical Disability (Code PD) - maximum of 10 places Date of last inspection Brief description of the care home Bymead House is a detached property on the outskirts of Charmouth.The home is owned by Bymead House Limited and Mrs Blacklock is the responible individual . Mrs Blacklock frequently attends the home and is in charge of financial administration; both she and and the new manager, Mrs Manners, are experienced nurses. There are thirty single rooms including 27 with en suite toilet facilities. Accommodation is provided at ground and first floor levels; there is a passenger lift. There is a lounge leading to a dining room on the ground floor and an additional lounge on the first floor. Bymead House can accommodate 26 service users requiring nursing care (including Care Homes for Older People Page 4 of 25 Brief description of the care home three NHS funded places), and 4 service users requiring residential care only. At least one trained nurse is on duty in the home at all times.The grounds are attractive and well maintained and views of the surrounding countryside and the sea are a feature of this home. There are a number of car parking spaces, a large rear garden and an enclosed courtyard garden onto which the glass doors of many ground floor bedrooms open. The fee range quoted in the service user guide at the time of inspection was £545 to £720 per person per week. Up to date fee information may be obtained from the service.Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link:www.oft.gov.uk 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 quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection took place on the 19th December 2008 and took approximately five hours. The purpose of the inspection was to assess all of the key standards. This is the first inspection of the home under the registration of Bymead House Limited. The inspection was carried out by one inspector however the term WE is used throughout the report to reflect the findings of the Commission for Social Inspection, CSCI. The newly appointed manager, Mrs Manners and the Responsible Individual, Ms Care Homes for Older People Page 6 of 25 Blacklock, were on hand throughout to aid the inspection process. We gathered information in a variety of ways, which included reports made to CSCI by the home; the annual quality assurance assessment completed by the Registered Provider; a tour of the premises and discussion with those people living and working at the home. We also reviewed a number of care records, recruitment and training records and maintenance documentation. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 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 9 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. The admissions procedure enables prospective residents, and or those acting on their behalf, to make informed decisions about admission to the home and ensures that only residents whose needs can be met by the home are offered places there. Evidence: The care files for new residents were inspected. These showed that the home had a good admissions procedure in place. Prior to anyone moving into the home a full assessment of needs was undertaken with the prospective resident. Sufficient information was obtained so that a care plan could be drawn up and made available to staff. Residents spoken with confirmed that they or a family member had visited to the home and were given sufficient information about the home before making a decision as to whether to stay. Care Homes for Older People Page 10 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. Systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice. Evidence: The home continues to provide a good standard of care to the residents living at the home. Residents expressed a high level of satisfaction with the service provided.Three care files were reviewed and they contained most of the relevant assessments and care plans needed so that staff had the information to be able to give a very good standard of care. However there were some shortfalls in documentation. There was no evidence that residents had been assessed for the use of bedrails; one resident had a diagnosis of dementia but no associated care plan was in place; generally the daily written statements in the care files lacked detail about what sort of day the resident has had, how they have been occupied and whether they were in a state of well or ill being. The lack of relevant information could mean that needs would not be responded to appropriately and the resident concerned would not get relevant care in a timely Care Homes for Older People Page 11 of 25 Evidence: fashion.Where the need for specialist equipment was identified it was provided. It was clear from discussions with staff and residents that they have access to the health services they need. There was evidence to show that residents get support from General Practitioners, district nursing services, chiropodists and other health care professionals. The home has a good medicines policy and procedure in place. Examination of records indicated that medicines are properly administered in accordance with the prescribers instructions. Medicines were stored securely. However there was no clear audit trail to identify how much medication was held by the home. Where handwritten instructions are in place on medication administration charts they should be countersigned,Residents and the visitors spoken with were very happy with the care they or their relative received and confirmed that staff treated them with respect and were supportive and kind. Care Homes for Older People Page 12 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are supported to maintain their life skills and are encouraged to make choices as far as possible. Social, spiritual and recreational activities meet the needs of the residents very well. Evidence: The home continues to provide an excellent level of social, religious and recreational support to residents. Residents told us that they were very happy with the lifestyle that living at the home afforded them. Some chose to spend time on their own but knew they could join in with any organised activities if they so wished. Activities were based on the preferences of the residents and were recorded. A programme of events was distributed to each resident every month. During the inspection a musical entertainer came to play for residents and they appeared to enjoy it very much.Residents said that they could entertain their visitors in private and that they were always made very welcome.People told us that they were free to choose whether they wanted to handle their own financial affairs. Some preferred to have a family member to act on their behalf.All residents spoken with confirmed they enjoyed the food provided. Records showed that residents likes and dislikes with regard to food were known and residents were aware that alternatives to the main menu were always Care Homes for Older People Page 13 of 25 Evidence: available. Food was regularly discussed at meetings and alterations were made to the menu according to peoples wishes. Care Homes for Older People Page 14 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 who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. Protection from abuse is promoted. Evidence: People living at Bymead House told us that they knew how to complain and felt confident that if they had concerns or complaints they will be listened to and taken seriously. There had been no formal complaints made since the last inspection.The home had written policies and procedures for the protection of residents from abuse or neglect and provided all staff with training in the understanding of abuse and their role in protecting residents from abuse in its many forms, including neglect. Care staff told us that they had received such training. Care Homes for Older People Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment at Bymead House is good providing residents with an attractive, homely and safe place to live. Evidence: A tour of the premises and review of maintenance documentation showed the home is well maintained inside and out. There was evidence that equipment is serviced regularly. Residents have easy access to all communal areas. The well-tended garden is attractive and easily accessible. New paths had been laid to improve access for those residents using mobility aids. Residents rooms were of a good size and furnished appropriately. The home continues to refurbish various rooms as the need arises. Bedrooms were personalised with a variety of mementos, pictures and small items of furniture. All areas of the home seen during the inspection were clean, bright and free from any unpleasant odours. Surveys completed indicated that the home was always kept clean. The laundry continues to be well managed. Adequate supplies of clean linen were seen to be available. Care Homes for Older People Page 16 of 25 Care Homes for Older People Page 17 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient care staff are employed to meet the needs of residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home.Staff are given the training and support so that they can give a high standard of care to the residents living at Bymead House. Evidence: At the time of inspection staff rosters demonstrated that there are sufficient staff on duty at that time. During the inspection staff were on hand to meet the needs of the residents. People told us that staff were on hand when they needed them and they were not kept waiting. The home had an ongoing training programme, which included NVQ level 2 and 3 in care and over 50 of the care staff hold the minimum of a level 2 award in care. We reviewed the recruitment files for three new members of staff. The files were well ordered and contained all the information required by law. POVA first and enhanced Criminal Record Bureau checks had been obtained for all new staff. Training files showed us that staff were receiving induction training. Staff told us that they were encouraged to take up training opportunities provided. Recent training included fire safety; the protection of vulnerable adults;moving and handling; pain management and palliative care. Further information on available training can be accessed through the following Care Homes for Older People Page 18 of 25 Evidence: websites:www.picbdp.co.ukwww.skillsforcare.org.uk Care Homes for Older People Page 19 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 home is well organised and the daily management and running of the home centres round the care of residents.Good management practice, systems in place, and records kept, confirm the health and safety of all in the home. Evidence: Since the last inspection a new manager, Ms J Manners, has been appointed. At the time of inspection the home had not made an application to the Commission for Ms Manners to be registered. Therefore standard 31 cannot be fully assessed. However the home was running well and Ms Manners had a good knowledge of the residents needs and had the support of a competent staff team behind her.There is a quality assurance and quality monitoring system in place. The home has taken steps to review its performance regularly and residents views were sought and suggestions put forward were acted upon. The Registered Provider and residents spoken with confirmed that residents either deal with their own finances and the home does not hold any monies on behalf of residents. Records showed that staff had received recent Care Homes for Older People Page 20 of 25 Evidence: training in fire safety and manual handling updates. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. Accidents were recorded and appropriate action was taken as necessary. Care Homes for Older People Page 21 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 22 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 1 13 A risk assessment must be undertaken with any person living at the home who may need bedrails to be put in place. This will ensure that bedrails are appropriately used and people livng at the home are safe. 22/03/2009 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 2 3 7 7 7 A risk assessment should be undertaken prior to the use of bedrails for any individual in the care home. Daily records should reflect the wellbeing of the resident. Care plans should reflect all aspects of physical, psychological and social care. Where a diagnosis of dementia is made a relevant care plan should be in place. There should be a clear audit trail for all medicataions coming into and leaving the home. Where staff hand write instructions on medication administration charts they should ensure that these are Page 23 of 25 4 5 9 9 Care Homes for Older People countersigned by another member of staff. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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). 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