Inspection on 31/01/08 for The Beeches

This is the latest available inspection report for this service, carried out on 31st January 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

The Beeches 29/09/05

The Beeches 19/04/05

The Beeches 09/11/04

The Beeches 06/05/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

Insight - Eastchurch

Southfields

Magenta

Seabourne House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Beeches (The) The Beeches Forty Foot Road Leatherhead Surrey KT22 8RN Lead Inspector Andrea Leverett Unannounced Inspection 31st January 2008 11:00 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 Beeches (The) DS0000013565.V357854.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. Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beeches (The) Address The Beeches Forty Foot Road Leatherhead Surrey KT22 8RN 01372 227540 01372 374564 wendy.buckmaster@anchor.org.uk sharon.blackwell@anchor.org.uk Anchor Trust 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) Manager post vacant Care Home 52 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies 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 categories: Old age, not falling within any other category - (OP) Physical Disability (PD) 2. Learning Disability (LD) The maximum number of service users to be accommodated is 52. Date of last inspection Brief Description of the Service: The Beeches is a purpose built care home providing care for up to 52 older people. The home can accommodate up to 24 people (over 65 years) who have dementia, up to 6 people with a physical disability (over 65 years), and up to 12 people (over 65 years) who have a learning disability. It is owned and managed by Anchor Homes and is situated close to Leatherhead town centre, which has a range of leisure and shopping facilities. The home consists of five separate units, four of which have a separate kitchen area and all units have separate dining and lounge facilities. All bedrooms are for single occupancy, with en-suite facilities. A courtyard area with wheelchair access is situated in the centre of the home. There is ample parking to the front of the building. Lowest fee £475.52 Highest fee £ 725.00 Cost of item (£) Items not covered by fee Newspapers, Hairdressers, Chiropody except residents covered under NHS. Various Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Key inspection took place on the 31st of January 2008. 7 people who use the service were spoken with as well as 3 members and the manager. A tour of the premises was undertaken during the site visit and 5 people who use the services files and staff files were inspected. Judgements about quality of life and choices were taken from direct conversations with and observations of people who use the service, followed by discussion with support staff and evidencing records held at the home. Feedback from people spoken to have been taken into consideration and comments have been reflected in this report. The inspector concluded that people are given a good service at The Beeches. A good standard of support and access to health services is provided and the range of activities provided are excellent. The Home has met all requirements and recommendations made at the last inspection and only 2 further recommendations have been made as a result of this inspection. What the service does well: Good health records were maintained and it was evident that residents had access to routine and specialist health services as needed. GP visits were recorded and access to dentists and opticians was good. Feedback from residents was positive about the activities provided and observation on the day of the site visit showed that a range of activities are provided including pub visits, theatre outings, exercise classes, music, cake making, gardening and reminiscence. Religious services are also facilitated in the Home and several schools in the local area visit the Home regularly. One group of school children visit the Home weekly and spend time talking to residents and joining in activities. Residents are also invited to school drama productions. An inspection of the homes kitchen and food stocks showed that a very good range of varied and nutritious food was provided including real butter, a choice of full fat or semi skimmed milk, a range of fresh vegetables and fruit and free Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 6 range eggs and chicken. In addition to meals, Home made cakes and biscuits are served in the afternoons and drinks and snacks can be had at any time. The cook encourages feedback from residents regarding food provided and keeps a comments book to record these and show what action has been taken if needed. What has improved since the last inspection? What they could do better: Feedback from residents suggested that some were not happy with evening medication administration times and a recommendation has been made that the Home ensure that residents are consulted on this matter and subject to risk assessments their wishes are upheld. A recommendation has been made that residents are consulted regarding their views on the limited amount of money they are able to keep in their bank accounts managed by the home and consideration should be given to using bank accounts that pay interest. Beeches (The) DS0000013565.V357854.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. Beeches (The) DS0000013565.V357854.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 Beeches (The) DS0000013565.V357854.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. Residents can be confident that their needs will be assessed before they move into the Home and that these will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five residents assessments and care plans were inspected as part of a case tracking process. Residents have their needs comprehensively assessed prior to moving into the Home and information included local authority care manager assessments were appropriate. Assessments included mobility, personal care incontinence, Nutrition and social, cultural and religious needs. Risk assessments were also in place for all key areas of need and care assistance required and this information was reflected in the residents care Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 10 plans. Information was detailed and showed that the Home worked hard to understand people’s needs before they moved in. Beeches (The) DS0000013565.V357854.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 and 10 People who use the service experience good quality outcomes in this area. Residents benefit from having comprehensive health, personal and social care needs set out in an individual plan of care, which are followed. The home has a medication policy and medication records are up to date and Medication systems follow good practice. Residents feel they are treated with dignity and respect and their right to privacy is upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 12 Care plans for five residents were inspected and all contained up to date comprehensive information that reflected resident’s needs as detailed in their assessments. Good health records were maintained and it was evident that residents had access to routine and specialist health services as needed. GP visits were recorded and access to dentists and opticians was good. Social needs are comprehensively reflected in the care plans and records also showed that care plans and risk assessments were regularly reviewed. The Home has introduced a more person centred approach to care planning since the last inspection and information seen and discussions with residents showed that this has promoted individual choices and enabled residents to take informed risks to improve their quality of life. An inspection of the homes medication administration and storage procedures was undertaken. Medication administration records are properly maintained and medication is stored safely. Only staff that have undergone medication administration training administer medication and the manager also carries out in house competency tests on staff as part of their medication induction. Feedback from residents suggested that some were not happy with evening medication administration times and a recommendation has been made that the Home ensure that residents are consulted on this matter and subject to risk assessments their wishes are upheld. Feedback from residents and observation on the day of this site visit showed that staff treat residents with respect and dignity. Typical comments included: “ I think this is the best care Home I’ve seen, it is very organised.” “ I’ve had a couple of falls and such and I couldn’t fault them” “ I don’t like medication too late after 10pm.” Beeches (The) DS0000013565.V357854.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 excellent quality outcomes in this area. Resident’s find the lifestyle experienced in the Home matches their expectations and preferences and they can maintain contact with family and friends and contact with the local community as they wish. Residents receive a wholesome appealing balanced diet in pleasing surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Home has a full time activity co coordinator who is trained to provide a range of activities. Feedback from residents was positive about the activities provided and observation on the day of the site visit showed that a range of activities are provided including pub visits, theatre outings, exercise classes, music, cake making, gardening and reminiscence. Religious services are also Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 14 facilitated in the Home and several schools in the local area visit the Home regularly. One group of school children visit the Home weekly and spend time talking to residents and joining in activities. Residents are also invited to school drama productions. The Home has a small cinema room with a large screen TV, which has recently been opened. The Home is also working with specialist dementia health professionals to improve activities and ways of working for people with these needs. It was generally noted that people living at the Beeches are encouraged to be as independent as possible and good risk assessment systems are in place to ensure and protect peoples right to take responsible risks in order to improve the quality of their lives. Residents stated that family and friends are welcomed in the Home and confirmed that they were able to visit at any time. Feedback regarding food was positive. It was evident that a choice of good quality food was provided in a clean and welcoming environment. Residents felt their preferences were respected and special dietary needs catered for. An inspection of the homes kitchen and food stocks showed that a very good range of varied and nutritious food was provided including real butter, a choice of full fat or semi skimmed milk, a range of fresh vegetables and fruit and free range eggs and chicken. In addition to meals, homemade cakes and biscuits are served in the afternoons and drinks and snacks can be had at any time. The cook encourages feedback from residents regarding food provided and keeps a comments book to record these and show what action has been taken if needed. Typical comments included: “ I’m happy here, the food is good and you get a chance to do activities if you want to.” “I think it’s a very good place, I have no trouble with the food and we have very good activities.” “I think it is very good on the whole, there are lots of activities but I prefer to go out with my daughter and watch TV.” Beeches (The) DS0000013565.V357854.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 and 18 People who use the service experience good quality outcomes in this area. Service users are confidant that their complaints will be listened to, taken seriously and acted upon and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Home has a complaints procedure, which includes all the information required by this standard and information seen during the inspected showed that concerns and complaints were managed effectively. Residents and families spoken to felt able to go to staff with concerns and were confident that action would be taken to resolve any issues. The commission has received one complaint regarding the Home in the last 12 months and the Home is properly investigating this under its own complaints procedures. Staff records showed that staffs undergoes adult protection training and discussion with staff demonstrated a good understanding of adult protection issues and the procedures to follow. The Home has an appropriate adult protection policy and procedure, which includes whistle Blowing. Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 16 Examples were seen of the Home acting quickly and openly to protect people from abuse and working effectively with social services to protect the interests of residents. Beeches (The) DS0000013565.V357854.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 and 26 People who use the service experience good quality outcomes in this area. The Home is decorated, furnished and maintained to a high standard and is clean and free from offensive odours throughout. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises showed that it is spacious, well maintained and decorated. Resident’s bedrooms seen were spacious and homely. The garden areas are well kept and have a range of garden furniture for the benefit of Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 18 residents. The Home has its own cinema and entertainments room and a newly refurbished hair salon. The home has been purpose built as a care home and is divided into four smaller units, each for twelve residents. Residents are provided with individual bedrooms on their units, which also have a communal lounge, dining room and kitchenette. Each bedroom has an its own toilet and basin, and bathroom facilities are easily accessible on each unit. Each unit has its own lounge, separate dining room, kitchenette and bathrooms and toilet facilities. Additional seating is available in the communal entrance area to each unit and in the main entrance hall. A large courtyard garden with seats is available in the centre of the building. The home is spacious and light and comfortably furnished to meet the needs of residents. It was evident that the home was clean and free from odours. Hand-washing facilities with liquid soap and paper towels are provided in all appropriate places to maintain hygiene. Beeches (The) DS0000013565.V357854.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 and 30 People who use the service experience good quality outcomes in this area. Resident’s benefit from being supported by appropriate numbers of staff with the skills to meet their needs. The Home ensures that service users are supported by staff that are trained and competent to do their job. Service users are supported and protected by the homes recruitment policy and practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observation on the day of the site visit, an inspection of the homes rota’s and feedback from Residents and staff demonstrated that staffing levels are appropriate to meet resident’s needs. In addition to the manager and deputy manager the Home employs 8 care staff and 1 team leader per shift, 3 cleaners and a laundry person and 2 cooks. The Home also employs 3 waking night staff including a night staff team leader. Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 20 It was clear from staff records and discussion with staff that training was given a high priority in the Home. A sample of staff records demonstrated that comprehensive training was provided and over 50 of staff have NVQ level 2 or above and there is a rolling programme to ensure that all staff can undertake this training. In addition records showed that staff undertake a full range of mandatory and service specific training. A sample of staff files were inspected including the most recently employed person. Records showed that recruitment practices were to a good standard, with files including all the appropriate checks and information to ensure the safety of residents. It was also evident that the Home ensures that new staff under go proper induction training. Typical comments included: “ I’m happy enough here the staff are really nice.” “The staff are always helpful and will come and chat to you and have a laugh” Beeches (The) DS0000013565.V357854.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 and 38 People who use the service experience good quality outcomes in this area. Residents live in a Home that is run in their best interest, with good leader ship and management. On the whole residents financial interests are safeguarded but more could be done to improve the banking arrangements. The health, safety and welfare of service users and staff are promoted and protected. This judgement has been made using available evidence including a visit to this service. Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 22 EVIDENCE: The Home has a new manager who is qualified and competent in her role. She has experience of managing services and has overseen significant improvements to the quality of care provided since the last inspection. The manager works hard to promote good relations with the local community and celebrate diversity in the home for the benefit of residents. In addition the Home benefits from having a deputy manager. There are clear lines of accountability within the Home and external management. It was evident from discussion with staff and observation on the day of the inspection that the manager communicates a clear sense of direction and leadership, which staff and residents can understand. A sample of residents financial records were seen and these showed that resident’s monies are kept safe and are properly accounted for. However it was noted that resident’s bank accounts do not pay any interest and only a limited amount of money can be kept in the account. A recommendation has been made that residents are consulted regarding their views on the limited amount of money they are able to keep in these accounts and consideration should be given to using bank accounts that pay interest. The Home has a range of quality monitoring systems in place and evidence seen showed that this information is used to improve the quality of the service. Discussion with staff evidenced that formal staff supervision is being undertaken and staff and residents spoken to felt very supported by the management team. Records viewed, a tour of the premises evidenced that the homes facilities and equipment were appropriately maintained. Beeches (The) DS0000013565.V357854.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 X 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 4 13 4 14 4 15 4 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 4 X 3 X 2 X X 3 Beeches (The) DS0000013565.V357854.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. Standard Regulation Requirement Timescale for action 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 Refer to Standard OP9 Good Practice Recommendations Feedback from residents suggested that some were not happy with evening medication administration times and a recommendation has been made that the Home ensure that residents are consulted on this matter and subject to risk assessments their wishes are upheld. A recommendation has been made that residents are consulted regarding their views on the limited amount of money they are able to keep in their bank accounts managed by the home and consideration should be given to using bank accounts that pay interest. 2. OP35 Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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 Beeches (The) DS0000013565.V357854.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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