Care Home: Winnie Care (Beverley House) Limited

What the care home does well A good standard of care is provided for the people who live at the home. People said they enjoyed living there, and that the staff were kind and helpful. Comments received were very positive about the care. There were written care plans in place for each person. This helps staff make sure that each person gets the support and assistance that is needed for them to live safely and comfortably. People living at the home were comfortable and well cared for and all of them said that the food was good. The environment was in the main nicely decorated and well maintained. Staff were motivated and enthusiastic about their work. Comments from staff included, "We create a friendly environment for our residents and make them feel comfortable and safe at all times". Another said, "We always do activities with residents and have a laugh". What has improved since the last inspection? The manager said that since the last inspection two new assessments have been introduced. One was a nutritional assessment to identify whether people may be at risk of malnutrition. The second was a tissue viability assessment. This is to find out if people are at risk of developing a pressure sore. The last inspection report recommended that the provider consult with Cleveland Fire Brigade about the fitting of self-closures to bedroom doors. The manager confirmed that this had been done. The last inspection report contained one requirement about induction. It said that manager must ensure that all newly appointed staff receive induction training to Skills for Care specification within the first 12 weeks of appointment. The manager confirmed that this now takes place. Records viewed also confirmed this to be the case. Regular supervision sessions have been introduced as recommended in the last report. Staff confirmed that these take place and that they are well supported. What the care home could do better: CARE HOMES FOR OLDER PEOPLE Winnie Care (Beverley House) Limited Beverley House Beverley Road Saltersgill Middlesbrough TS4 3LQ Lead Inspector Sue Lowther Key Unannounced Inspection 29th August 2008 10:00 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Winnie Care (Beverley House) Limited Address Beverley House Beverley Road Saltersgill Middlesbrough TS4 3LQ 01642 828383 F/P 01642 828383 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Winnie Care (Beverley House/Lodge) Ltd Mrs Lynne Atterton Care Home 18 Category(ies) of Dementia - over 65 years of age (18) registration, with number of places Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users shall not exceed 18 older people (over the age of 65 years) and suffering from a dementia. 5th September 2006 Date of last inspection Brief Description of the Service: Beverley House is a purpose built single storey home for the care of 18 older people suffering from a dementia. The home is divided into three, six bed units, sharing two lounges and a dining room. There is a small-enclosed garden for the use of residents. Accommodation is provided in single rooms and residents are encouraged to bring with them furniture and other items from their own homes. Beverley House is close to a local shopping area and has transport links to all areas of Middlesbrough. The fees charged are currently between £405 and £409 per week. This does not include the cost of hairdressing, chiropody and toiletries. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the 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 of Beverley House took place on the 29th August 2008. Records were examined and a tour of the building took place. Time was spent talking to people living at the home, staff and visitors. The manager supplied some information prior to the inspection on a form called an AQAA. This is an annual quality assurance assessment for home’s to provide information about their service. The inspection focussed on key standard outcomes for people living at the home. We also checked whether requirements from the previous report had been met. 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. What the service does well: A good standard of care is provided for the people who live at the home. People said they enjoyed living there, and that the staff were kind and helpful. Comments received were very positive about the care. There were written care plans in place for each person. This helps staff make sure that each person gets the support and assistance that is needed for them to live safely and comfortably. People living at the home were comfortable and well cared for and all of them said that the food was good. The environment was in the main nicely decorated and well maintained. Staff were motivated and enthusiastic about their work. Comments from staff included, “We create a friendly environment for our residents and make them feel comfortable and safe at all times”. Another said, “We always do activities with residents and have a laugh”. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: It is recommended that the bedrail assessment be reviewed so that it complies with the Health and Safety Executive guidelines. It is also recommended that written evidence be kept to confirm that bedrails have been checked weekly. This is to make sure that they are safe. The drug fridge temperature was recorded on some occassions to be outside of the recommended levels. Regular checks must be made to make sure that the temperature is maintained between 2° and 8° celcius. The temperature of the room in which the drugs are stored should also be monitored. The temperature should be below 26°celsius. This is to make sure medications are stored safely. The manager should apply to to do an National Vocational Qualification in care to level four. The manager confirmed that monthly Regulation 26 audits by the owner take place, however there was no recent written evidence to confirm this. Up to date reports must be available for inspection purposes. The certificates to confirm that the emergency call system and the heating and gas appliances had been checked were not available. The manager said that these checks had been carried out but the certificates are held at head office. Copies of the certificates must be supplied to the CSCI. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. People who use the service experience good quality outcomes in this area. Assessment procedures are in place to ensure that the home can meet the needs of the people who live there. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: People are only admitted after a full assessment of need is carried out by an appropriately trained person. This is usually the manager. This is to make sure that the home can meet the care needs of the people who go to live there. The family of one person who had recently gone to live in the home confirmed that they had looked around the home and had been supplied with all of the information they needed to make a decision about whether or not their relative would like to live there. Most of the people who responded to the survey said that they had received enough information about the home before they went to live there. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 10 The home does not admit people for intermediate care therefore assessment of standard 6 is not required. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. People who use the service experience good quality outcomes in this area. People’s health care needs are well managed by the home. People living at the home say that they are treated well and that the standard of care is good. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager said that all of the people who live in the home have care plans so that staff know how to look after people on an individual basis. Two were examined during the inspection. These were comprehensive and contained individual plans of care. The manager said that since the last inspection two new assessments have been introduced. One was a nutritional assessment to identify whether people may be at risk of malnutrition. The second was a tissue viability assessment. This is to find out if people are at risk of developing a pressure sore. However it is recommended that the bedrail assessment be reviewed so that it complies with the Health and Safety Executive guidelines. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 12 People spoken to during the inspection said that they are happy with the care received and the level of information given. One relative said, “This home provides superb care in a homely environment”. Records examined showed that people receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. Two health care professionals returned surveys. Both indicated that they are happy with the standard of care at Beverley House. One said, “This is an excellent care home. The attitude of staff is always that the residents needs come first. I cannot see where it could improve”. The other said “Offers very individual homely feel. Carers really know residents well”. Medication is administered by care staff, who have been trained. The home has a comprehensive medication policy. Accurate records of all medicines received, administered and those leaving the home are maintained. However the drug fridge temperature was recorded on some occassions to be outside of the recommended levels. Regular checks must be made to make sure that the temperature is maintained between 2° and 8° celcius. The temperature of the room in which the drugs are stored should also be monitored. The temperature should be below 26°celsius. This is to make sure medications are stored safely. People spoken to said that staff always treat them with dignity and respect. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. People who use the service experience good quality outcomes in this area. The activities are varied and provide recreation for most of the people who live in the home. Family and friends can visit at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and people are given a choice. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The surveys returned indicated that activities are suitable. Everyone said that they enjoy sing a longs the most. The manager said that activities include bingo, gentle exercise, skittles, evening events and outings to the pub and theatre. People were asked about visiting arrangements, which are flexible. One of the comments from a visitor included, “We are made welcome into the home, its lovely”. Visitors can see people in their own rooms or in any of the communal areas available throughout the home. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 14 Menus are rotated on a four weekly basis. People are given a choice. The cook said that she always tries to provide a suitable alternative if people do not want what is on offer. Comments about the food were good. The lunch looked appetising and people said that it was tasty. Specialist diets are catered for and include menus for diabetics and soft menus. Since the last inspection the manager has introduced a nutritional screening tool. Staff were assisting people in a discreet and dignified manner where appropriate. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. People who use the service experience good quality outcomes in this area. The people who live in the home can be confident that their concerns and complaints are dealt with appropriately and sufficient safeguards are in place to protect them from abuse. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Information about complaints, how and who to make them to, is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the ‘Service Users Guide’. There have been no complaints recorded since the last inspection. One person said, “If I had a problem I would tell the staff and the manager”. One relative said, “I have never had any reason to complain. If I am unhappy about anything I approach any member of staff immediately and it is sorted as soon as possible”. The home had a comprehensive adult protection procedure. This gives staff the support they need to make a referral should this be required. The staff spoken to during the inspection were asked about abuse and what they would do if they saw or heard anything inappropriate. All said that they would tell someone, for example the manager, or make a referral themselves if this was more appropriate. Training is provided for all staff in adult protection. One member of staff said, “I would have no hesitation in reporting any concern”. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 16 Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. People who use the service experience good quality outcomes in this area. The home is clean and generally well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: During a tour of the building the inspector saw that many of the rooms are decorated to the person’s own taste and there was evidence to confirm that people can take in some personal items when they go to live there. This includes pieces of furniture as well as photographs and ornaments. The last inspection report recommended that the provider consult with Cleveland Fire Brigade about the fitting of self-closures to bedroom doors. The manager confirmed that this had been done. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 18 There was a range of equipment seen around the home to support people with bathing and mobility. The inspector found the building to be clean, tidy and free from offensive odours. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. People who use the service experience good quality outcomes in this area. The home has a settled and well-led staff team, in sufficient numbers to meet the needs of the people who currently live in the home. Training is provided for all staff. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: From the rota supplied at the inspection there was always sufficient care staff on duty to meet the assessed care needs of the people who were using the service. People said that staff were usually around and answered the call bells quickly. The home had staff files in place, which provided evidence that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. There is a commitment at the home to having a trained workforce with most of the staff having an NVQ at level 2 or above. Training is provided for staff. As well as mandatory training, recent training has also taken place in adult protection, dementia awareness and health and safety. Staff said that they are also supported with regard to personal training needs. Staff comments in this area were positive. Comments included “The manager is always encouraging staff to attend different courses”. The last inspection report contained one Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 20 requirement about induction. It said that manager must ensure that all newly appointed staff receive induction training to Skills for Care specification within the first 12 weeks of appointment. The manager confirmed that this now takes place. Records viewed also confirmed this to be the case. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. People who use the service experience good quality outcomes in this area. The home’s registered manager provides clear leadership, support and guidance to those living and working at the home. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager holds an appropriate management qualification. She has not as yet commenced the National Vocational Qualification (NVQ) level 4 in care or equivalent, but hopes to do this in the near future. There was an open and friendly culture between the manager and the staff working at the home. There was evidence in staff files to show that supervision now takes place on a regular basis. This was a recommendation in the last Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 22 report. Staff also confirmed that supervision takes place and that they are well supported. People living at the home and visitors who were spoken to during the inspection confirmed that the manager is approachable and that they would go to her if they had any concerns. Regular meetings are held and the company have a number of systems in place to consult with people living at the home. The manager confirmed that monthly Regulation 26 audits by the owner take place, however there was no recent written evidence to confirm this. Customer satisfaction surveys have also taken place and the manager said that comments are acted on and improvements made wherever possible. Personal finances are kept in the home for people who request this. Two signatures are obtained and receipts are kept to ensure peoples’ financial interests are safeguarded. The maintenance certificates that were seen at this inspection were found to be in order. However the certificates to confirm that the emergency call system and the heating and gas appliances had been checked were not available. The manager said that these checks had been carried out but the certificates are held at head office. Copies of the certificates must be supplied to the CSCI. Health and Safety checks are carried out regularly to safeguard people living and working at the home. It is recommended that written evidence be kept to confirm that bedrails have been checked weekly. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13(2) Requirement The temperature of the drug fridge must be checked regularly to make sure that it is maintained between 2° and 8° celcius. This is to make sure that medicines are stored safely. A copy of the Regulation 26 visit reports must be available for inspection purposes. Copies of the certificates to confirm the emergency call system and the heating and gas appliances have been checked must be supplied to the CSCI. Timescale for action 31/10/08 2. 3. OP33 OP38 26 13 31/10/08 31/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP9 Good Practice Recommendations The bedrail assessment should be reviewed so that it complies with the Health and Safety Executive guidelines. The temperature of the room in which the drugs are stored should be monitored. The temperature should be DS0000058599.V371347.R01.S.doc Version 5.2 Page 25 Winnie Care (Beverley House) Limited below 26°celsius. 3. 4. OP38 OP31 It is recommended that written evidence be kept to confirm that bedrails have been checked weekly. The registered manager should complete a qualification at NVQ level 4 or equivalent in care. Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Winnie Care (Beverley House) Limited DS0000058599.V371347.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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