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Inspection on 24/08/09 for Beechbrook Residential Home

Also see our care home review for Beechbrook Residential Home for more information

This is the latest available inspection report for this service, carried out on 24th August 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Provides a very good standard of care that is individually tailored to residents needs. Residents benefit from a core of established, well trained and caring staff. The home is well furnished, is homely and has extensive grounds for the benefit of residents. The health and safety systems operating in the home protect residents and staff. Plans of care clearly detail the needs of residents and ensures staff know how to meet those needs. The service listens to the views of residents to ensure that the home is run in their best interests.

What has improved since the last inspection?

Improvements have been made to the fabric of the home for the benefit of residents and includes a newly laid drive, paved pathways, new lounge curtains and a new large plasma television. The range of staff training has improved and will benefit residents by the provision of a well trained staff team. The provision of food has improved and was overall well regarded by residents.

What the care home could do better:

The manager has plans to nominate a member of staff experienced in health and safety matters to oversee systems and make improvements for the benefit of residents and staff. There are plans in place to ensure that all visiting professionals write in plans of care to ensure staff know what changes if any have been made to residents needs.

Key inspection report Care homes for older people Name: Address: Beechbrook Residential Home The Holt Hare Hatch Wargrave Berkshire RG10 9TA     The quality rating for this care home is:   three star excellent 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: Sally Newman     Date: 2 4 0 8 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: Beechbrook Residential Home The Holt Hare Hatch Wargrave Berkshire RG10 9TA 01189403987 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: beechbrookcarehome@hotmail.com Mrs Catherine Seagrim,Mr Michael Paul Seagrim care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 15 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Beechbrook provides accommodation and care for up to fifteen service users, who have care needs associated with old age. The home is not registered to provide care to people with needs associated with dementia or require full time nursing care; this would require additional registration categories. Accommodation is available on the ground and first floors of the home, with access to the first floor by staircase or passenger lift. All bedrooms have private bathrooms. One bedroom is separate to the main building. The current scale of charges range between £700 and £1100 per Care Homes for Older People Page 4 of 24 Over 65 15 0 Brief description of the care home week. There are additional charges for chiropody, physiotherapy, newspapers, hairdressing and toiletries. 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: three star excellent 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: This was an unannounced inspection that was conducted over the course of three days and included a visit to the service of 8 hours duration. The last inspection of this service was undertaken on 25th September 2007. Information provided by the service and a range of records were seen and were used to formulate the outcome of this inspection. In addition, time was spent with the manager, the deputy manager, two staff, the chef and the 11 residents in the home at the time were all spoken to in private. In addition, a visiting relative was spoken to in private. All bedrooms and communal areas of the home were seen and observation of care practice was undertaken throughout the course of the visit. The provider has a range of polices and procedures relating to equality and diversity. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to meet the needs of individuals with various religious, racial or cultural backgrounds. No complaints about this service have been received by the Commission since the last inspection. This home is very well managed and continues to provide a good quality of Care Homes for Older People Page 6 of 24 care to the residents living there. Residents are satisfied and are confident their views will be listened to. No requirements or recommendations have been made on this occasion. Care Homes for Older People Page 7 of 24 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 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 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 9 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. Prospective service users and their representatives can be confident that they will be provided with the information necessary to determine whether the service will meet their needs. Evidence: Evidence was provided from examination of documentation, from information provided by the service prior to the visit and from discussion with the manager, staff and residents. 3 files were seen that were used to document information for the most recent residents admitted to the service. These were detailed and provided sufficient information to enable staff to meet their needs. Each were individually assessed as to their needs and preferences to ensure that the process of admission was as smooth as possible and caused the least anxiety. Residents spoken to confirmed that they were able to visit the home with relatives if they wished in order to look around, meet staff and other residents and ask any Care Homes for Older People Page 10 of 24 Evidence: questions or queries they might have. 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. Clear information is in place to enable staff to meet the health and personal care needs of residents. The arrangements for medication are robust and protect service users. Service users feel they are treated with respect. Evidence: A random sample of three care plans was seen. All contained comprehensive information about individual needs and provided staff with clear guidance on how those needs should be met. The home has introduced a well known plan of care system known as standex and the company were described as very helpful in providing additional material such as deprivation of liberty documentation. There was evidence of regular review from discussion with the deputy manager and all aspects of a persons lifestyle including their personal, health and social care needs are considered. End of life care plans were in evidence and both staff spoken to and the manager felt that this was an area of particular strength within the home. There was evidence in care plans that a wide range of health care professionals are called upon to meet the health care needs of individual service users. One relative spoken to Care Homes for Older People Page 12 of 24 Evidence: confirmed that she is always kept informed of her fathers welfare and health care needs. This relative also reported that the home had dealt with recent health care needs professionally and without delay. All residents able to provide an opinion confirmed that their personal and health care needs are well met and that staff provide a high standard of care and practice. There was evidence that mobility aids are utilised to assist service users and appropriate guidance is sought on their correct use. The arrangements for medication were discussed with the deputy manager. All homely remedies are clearly specified and have been signed as appropriate by the General Practitioner. The Primary Care Trust carried out an inspection of the medication arrangements in the home on 6.1.09 and concluded that the standard was met. All residents spoken to indicated that staff were always respectful and their right to privacy was always upheld. The manager confirmed that staff induction addresses issues of privacy and dignity and it is an area she discusses periodically within one to one supervision. Throughout the course of the inspection staff were observed interacting appropriately with residents and knocked on bedroom doors and waited before entering. 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. A range of activities is offered that provide opportunity for mental and physical stimulation. Residents are encouraged to maintain contact with their family and friends and are able to have visitors at any time. The home provides a varied and nutritious menu designed to meet the needs of its service users. Evidence: An activities planner is in place that provides information for residents about activities that have been organised. There is always at least one planned activity each day and includes a wide range of different events. These include walks, DVD film club, Music appreciation, which is run by one of the residents, a knitting group and various outside visits and outings. In June a very successful garden party was held and it was clear from discussion that this had been enjoyed by residents. Several of the residents spoken to were involved in knitting and advised that currently blankets were being made for babies born in deprived countries and the local baby care unit. It was observed that an exercise group was held in the sitting room prior to lunch being served. A newsheet is prepared approximately every 3 months that provides information on forthcoming events, general news articles such as the appointment of new staff and any other features of interest that residents are encouraged to contribute to. There are regular residents meetings and it was clear from discussion Care Homes for Older People Page 14 of 24 Evidence: with residents that some are very active and vocal with their views and opinions during these gatherings. All current residents have a range of visitors and many go out on regular short outings with their relatives and friends. This is actively supported and encouraged by the home and assistance with transport has been provided where needed. All residents are supported to attend church services and have the opportunity to vote if they wish. Residents are encouraged to bring personal items such as furniture etc when they move into the home. Whilst talking to residents in their bedrooms it was apparent that personal items were displayed and most residents had brought items of furniture. The chef was spoken to and provided information about her role and the food hygiene practises operating in the home. Although she does not hold a financial budget for the ordering of food she confirmed that she had never had a request refused by the manager. A range of documentation was seen but not examined in detail and these including food temperature checks, fridge and freezer temperature checks, cleaning logs and menus, which are drawn up on a fortnightly basis. The chef attends residents meetings and seeks feedback from residents about the food provided. In discussion with residents the food was highly complemented by the vast majority of those spoken to. Many stated that the food had improved overall since the appointment of this chef. An environmental health food safety inspection was carried out on 23.5.08 where no significant issues were found but the home wanted to improve on their good rating and had since this inspection refurbished one of the food storage areas. 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. The home has a complaints procedure, which is clear and accessible. Residents views and comments are listened to and acted upon. Residents are protected from abuse and exploitation by well-trained and competent staff who demonstrate knowledge of the homes abuse of vulnerable adults and whistle-blowing policies. Evidence: There is a robust complaints policy and associated procedures that residents are encouraged to utilise. There had been two complaints recorded since the last key inspection. Both were made by the same resident and these were both dealt with appropriately and the outcomes were clearly recorded. It was apparent from evidence obtained on the day that residents are actively encouraged to voice there views and concerns and all those spoken to who were able to offer a view were confident that their opinions and observations are taken seriously. There was evidence in staff files that all staff receive training in the safeguarding of vulnerable adults as part of their formal induction and NVQ training in which it is a core module. Refresher training courses are also offered at regular intervals. Two staff spoken to confirmed that they had attended protection of vulnerable adults training and they were able to demonstrate good understanding of the principles and the action they should take if an allegation was made to them or they witness abuse. 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. The home provides a safe, homely and well-maintained environment for service users. The home was clean, tidy and hygienic throughout. Evidence: The home throughout was clean and fresh smelling. The decor is homely and was complemented by the majority of residents. Maintenance is undertaken by a dedicated maintenance man and issues are dealt with promptly. This individual is now trained to undertaken portable appliance checks, which is very useful when residents first move into the home. The grounds are extensive and improvements have been in respect of a new drive and paved pathways. The laundry facilities were seen and although small staff indicated that it was an adequate space when considering that all sheets, duvets and table linen was laundered by an outside agency. Care staff were responsble for laundering towels and clothes with night staff undertaking ironing duties. Residents spoken to advised that their clothes were generally well cared for and they were encouraged to have them named. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff recruitment procedures are robust and protect residents from harm. Staffing levels are appropriate to meet the needs of the residents. Residents benefit from a well trained and competent staff team. Evidence: This service benefits from a longstanding and consistent staff team. Staff reported that the team work closely together and support each other. Residents advised that there are always enough staff on duty. Staff were described as marvellous, caring, kind, approachable and friendly. Several residents stated that they were so well cared for by staff that they felt lucky and privileged. The manager and staff spoken to confirmed that all staff receive regular one to one sessions in private and each has an annual appraisal. In addition, regular staff meetings are held and information handover meetings take place at the beginning of each shift. This ensures that the up to date needs of all residents is clearly understood. All staff are encouraged and supported to undertake National Vocational Qualifications. The two care staff members spoken to confirmed that they had completed NVQ 2. The manager confirmed that all but one member of staff has an NVQ qualification. A rolling programme of training is provided for the service, and this was described as an area of improvement by those staff spoken to. The manager confirmed that a range of training had been booked including Fire Awareness, Care Homes for Older People Page 18 of 24 Evidence: Deprivation of Liberty, Manual Handling, Medication, Diabetes Awareness and End of Life Care and this was in evidence in documentation seen. In addition Mental Capacity Act training was planned for all staff. Staff spoken to considered the training provided was of a good standard and any special requests for training were always considered. Four staff files were seen. All contained the required documentation and provided evidence that the service has a robust recruitment procedure. There was evidence in those files seen that staff have an individual training profile and a personal development plan. The manager stated that she had audited all the staff files recently. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a very well managed home and their views and those of their relatives are actively sought and acted upon. The systems for health and safety are robust and protect residents and staff. Evidence: The manager is well established in the home and is highly regarded by staff and residents. Staff described her as approachable and knowledgeable. She was also considered to be calm in a crisis. The relative spoken to also praised the manager for her professionalism and she felt confident in the managers ability to deal appropriately and effectively with any situations arising in the home. The manager is a qualified nurse and holds an NVQ level 4 and the Registered Managers award. The deputy manager is also a qualified nurse and has obtained an NVQ level 4 and Registered Managers award. The manager does conduct an annual service review with the use of questionnaires Care Homes for Older People Page 20 of 24 Evidence: that are supplied to all residents. This has provided useful feedback on the service and has resulted in some changes and adaptions being made. The manager, with the support of her staff, is very keen to continue the development of the service to ensure that residents receive the best possible care. The manager reported that she has been able to focus more on management issues since the introduction of the Croner Employment Law and Health and Safety Law system. This is a purchased system supports the administrative responsibilities in these areas and frees up management time. Several improvements have been made in the service including improvements in the grounds and the up-grade of food storage areas. New curtains have been purchased for the lounge together with a new Plasma Screen HD TV for residents. The manager reported that no monies are held for residents and that their financial affairs are managed by their relatives or representatives. Currently one resident manages their own finances. The health and safety systems are robust. A full fire evacuation of the building was undertaken at the end of July with no problems emerging as a result. A range of fire equipment checks are undertaken regularly. There are servicing contracts in place for all equipment used in the home and these were confirmed as up to date within information supplied by the service. The manager is in the process of appointing a member of staff with extensive prior experience as the health and safety representative. This role will involve the overview and ongoing improvement of all health and safety procedures and practises operating in the home. 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 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. 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. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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