Care Home: Winnie Care (Beverley Lodge) Limited

What the care home does well Beverley Lodge generally provides a good standard of care for people who live in the home. One person wrote on a survey,`This is by far the best home I have ever been in. My relative was in two previous for respite and hated them, but since coming here she is happy and content, always clean. The staff seem to answer the patients every whim. Never too busy for family, so friendly and that is every member of staff from the cook, cleaner to nursing staff. It`s like home from home. I go all hours during the day and I am always made welcome, offered a cup of tea`. What has improved since the last inspection? The last inspection report contained a requirement that the Registered Provider should consult with the Fire and Rescue Service with regard to self closing devices on bedroom doors. The Registered manager confirmed that this issue has now been addressed. What the care home could do better: The registered person should review the current arrangements for the provision of activities to make sure that the social needs of people are met. The Registered Person must consult with the Environmental Health Officer with regard to the provision of an appropriate smoking facility for the people who live in the home. This is to make sure that the health of the people who live in the home, staff and visitors is protected. The Registered Person must keep staffing levels under review to make sure that they meet the changing dependancy needs of the people who live in the home. This is to make sure that the planned care of people is delivered and that all of all of their needs are met. The Registered Manager must spend a proportionate amount of time in Beverley Lodge. This is to make sure that the home is appropriately managed. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Winnie Care (Beverley Lodge) Limited Beverley Lodge Saltersgill Avenue Saltersgill Middlesbrough TS4 3LD     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Lowther     Date: 1 4 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Winnie Care (Beverley Lodge) Limited Saltersgill Avenue Beverley Lodge Saltersgill Middlesbrough TS4 3LD 01642828977 01642828977 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Winnie Care (Beverley House/Lodge) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 17 Number of places (if applicable): Under 65 Over 65 17 dementia Additional conditions: 0 That the Registration of Beverley Lodge be varied to permit one named resident under the age of 65 years to reside in the home. That the number of service users shall not exceed 17 over the age of 65 years and suffering from a dementia. Date of last inspection Brief description of the care home Beverley Lodge is a purpose-built home for the care of 17 older persons suffering from a dementia. The home is single-storey, comprising two units of bedrooms, a shared lounge and a dining room. All bedrooms have en-suite toilet and washbasin, and rooms can be furnished according to the personal choice of service users. The home is situated approximately two miles from the centre of Middlesbrough and is within easy walking distance of a small parade of local shops. Bus services are accessible from the home. Care Homes for Older People Page 4 of 26 Brief description of the care home Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This unannounced inspection of this home took place on the 24th April and 14th May 2009. Records were examined and a tour of the building took place. Time was spent talking to staff and the people who live in the home. The manager supplied some written information to the CQC before the inspection. The inspection focused on key standard outcomes for people who live in the homes and to check whether requirements from the previous report had been met. Care Homes for Older People Page 6 of 26 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. The fees charged at the time of the inspection was 420 pounds per week. This does not include the cost of hairdressing, newspapers, chiropody and toiletries. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 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 26 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. Sufficient information is available for people to decide whether they would like to live in the home. Assessment procedures are in place to ensure that the home can meet all of the needs of the people who go to live there. 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. All of the people who responded to the survey said that they had received enough information about the home before they went to live there. Care Homes for Older People Page 10 of 26 Evidence: The home does not admit people for intermediate care therefore assessment of standard 6 is not required. Care Homes for Older People Page 11 of 26 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. Good systems are in place to ensure that health care needs of service users are met. Service users can be confident that their privacy and dignity is protected and that they are treated with respect. 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. Three were examined during the inspection. These were in the main comprehensive and contained individual plans of care. Due to the level of communication it was difficult to establish from people how they felt about the care, however 3 surveys returned indicated that people are happy with the care. One person had written on a survey in response to question Do you receive the care and support you need?, Always staff are very supportive in fact they treat my relative and myself like friends, always asking if we are ok. Records examined showed that people receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. Two Care Homes for Older People Page 12 of 26 Evidence: professionals who were visiting at the time of the inspection said, The home is always clean and tidy and the staff are nice. Clients looked well cared for and looked after. The standard of care is definitely good. Medication is administered by people who have been appropriately trained. The home has a comprehensive medication policy. Accurate records of all medicines received, administered and those leaving the home are maintained. People who returned surveys indicated that staff always treat them with dignity and respect. Care Homes for Older People Page 13 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activities are limited, but do provide recreation for some of the people living in the home. Family and friends can visit the home at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and service users are given a choice. Evidence: Activities are organised by staff within the home. People who responded to the survey indicated that activities are usually suitable. However one of the inspectors who observed the lounge area saw little interaction between staff and the people who live in the home. Staff spoken with felt that they did not have a lot of spare time to concentrate on activities However they also said that they try to give people a choice about how they like to spend their day. People can also choose what time to get up and go to bed and when they would like to have a shower or bath. Relatives said that they could visit at any time and that they are always made welcome. The lunch looked nice. Evidence was seen in care plans to confirm that nutritional Care Homes for Older People Page 14 of 26 Evidence: needs are assessed and other professionals consulted if required. People who returned surveys indicated that the food is good and that people get a choice. One person said, Meals are lovely. If my relative is unwell they will cook anything she asks for. Care Homes for Older People Page 15 of 26 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 can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. 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. However people indicated on surveys that they would know who to speak to and were confident that their concerns would be acted upon. 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. Care Homes for Older People Page 16 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. Evidence: During a tour of the building the inspector saw that many of the rooms are decorated to the persons 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. A good standard of decor and furniture is provided throughout the home. 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 in the main free from offensive odours. One person wrote on a survey,There is always a lovely fresh smell in the home. My relatives room is lovely and clean and nothing is out of place. However the inspectors saw that the smoking area is not a separate room and is only offset from the main lounge. Although the manager said that few people smoke there, Care Homes for Older People Page 17 of 26 Evidence: this area does not meet with current regulations and poses a risk to other people who live in the home, visitors and staff. The Environmental Health Officer has been made aware of the situation by the inspector and has confirmed that contact will be made with the home to offer further advice. Care Homes for Older People Page 18 of 26 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. Staff are appropriately recruited and trained the needs of the people who live in the home. Staffing levels have recently been reduced and need to be kept under review to make sure that they meet the changing dependancy needs of people. Evidence: From the rota supplied at the inspection there was 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. One person wrote on a survey, Staff are always quick to come, never have to wait if my relative needs them. They look after her as I did myself and I have never seen one without a smile even when things are hectic. It is rare to find a home where every member of staff are as pleasant as in this home. I cannot sing their praises enough. I recommend this home to anyone who listens. However another relative wrote, The staff are very kind and caring but sometimes there are not enough on duty. For instance when there are only two staff in the evening and residents have to be helped to get ready for bed. The floor is without staff for quite long periods as it takes two staff for most residents to get washed. Some staff spoken with were concerned that staffing levels had recently been reduced to two throughout the day. They felt that they would be unable to meet all of the needs of the people who live in the home, especially with regard to activities. Other staff were confident that this would not pose any problems. The Registered Care Homes for Older People Page 19 of 26 Evidence: person must keep staffing levels under review to make sure they meet the assessed needs of all of the people who live in the home. The home had staff files in place, which provided evidence that the appointment of a new staff member is in the main 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. As well as mandatory training, recent training has also taken place in adult protection 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 There is always plenty of training going on and you can ask for additional training if you want to. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People cannot be assured that the home is well managed under the current arrangement. Policies and procedures in the main safeguard the safety of people. However the current smoking arrangements potentially place the health and wellbeing of people at risk. Evidence: The manager is currently registered to manage both Beverley House and Beverley Lodge Care Homes. These homes are owned by the same person and are a short distance from each other. She has completed an appropriate management course, but has yet to undertake the recommended NVQ Level 4 in care. On the first day of the inspection she was at Beverley House when the inspector arrived and came to the home within a few minutes when alerted by staff of the inspection. The manager told the inspector that Beverley Lodge has a Principal Senior Carer who monitors care plans, undertakes supervision and generally monitors the day to day activity within the Care Homes for Older People Page 21 of 26 Evidence: home. On the day of the inspection this person was not on duty. The Registered manager could not access records with regard to training and supervision, although these were located on the second day and found to be in order. Staff spoken with were mixed in their comments with regard to the management arrangements. Some felt that it was acceptable as she is only a phone call away, where as others said they felt unsupported in their role. Quality assurance systems within the home are limited. Although some visits are undertaken by the Registered Provider to assess the quality of care delivered and environmental issues, the reports available were indicated that these visits are not done on a monthly basis as required by the regulations. Consultation with relatives is informal, however people indicated on surveys that this is not a problem. Personal finances are kept in the home for people who request this. Signatures are obtained and receipts are kept to ensure peoples financial interests are safeguarded. There was evidence in staff files to show that supervision was taking place and that the staff were being appraised. Staff confirmed that supervision takes place on a regular basis and that they are well supported. The manager confirmed that all equipment in the home is regularly checked. The maintenance certificates that were seen at this inspection were found to be in order. Health and Safety checks are carried out regularly to safeguard people living and working at the home. However as previously stated the smoking area does not comply with the current legislation and potentially places people at risk. Care Homes for Older People Page 22 of 26 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 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 The Registered Person must 31/08/2009 keep staffing levels under review to make sure that they meet the changing dependancy needs of the people who live in the home. This is to make sure that the planned care of people is delivered and that all of their needs are met. 2 19 23 The Registered Person must 31/08/2009 consult with the Environmental Health Officer with regard to the provision of an appropriate smoking facility for the people who live in the home. This is to make sure that the health of the people who live in the home, staff and visitors is protected. 3 31 9 The Registered Manager must spend a proportionate amount of time in Beverley Lodge. 31/08/2009 Care Homes for Older People Page 24 of 26 This is to make sure that the home is appropriately managed. 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 12 The registered person should review the current arrangements for the provision of activities to make sure that the social needs of people are met. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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