Inspection on 05/02/07 for Beach House

This inspection was carried out on 5th February 2007.

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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beach House 09/01/09

Beach House 06/12/05

Beach House 27/06/05

Beach House 25/01/05

Beach House 10/08/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Beach House Beach House 1 Beach Avenue Birchington Kent CT7 9JS Lead Inspector Clair Brown Key Unannounced Inspection 5th February 2007 10:45 Beach House DS0000023359.V307011.R01.S.doc Version 5.2 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 Beach House DS0000023359.V307011.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 Adults 18-65. 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. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beach House Address Beach House 1 Beach Avenue Birchington Kent CT7 9JS 01843 845922 01843 845657 beachhouse@fsmail.net 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) Mr Christopher Dennis Page Mr Stephen David Walden, Mrs Gillian Barbara Page, Mrs Jacqueline Patricia Walden Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th December 2005 Brief Description of the Service: Beach House provides residential care for up to 8 ladies and gentlemen (all of whom are currently male) with mental health problems. The home does not provide specialist services but is able to access all necessary specialist services within the community. The home comprises of a semi-detached house over three floors in a residential area of Birchington. There is no lift access and would not be suitable for someone with limited mobility. The home is within easy walking distance of amenities such as rail and bus stations, leisure, shops and churches and a short car journey to colleges, sport centres, cinemas and concert halls. The homes ethos is based on providing a family style environment. Staffing comprises of the registered persons and other family members. Mr & Mrs Walden live in the adjoining premises. All have a high level of input into the home. The fees are £336.78 per week. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection consisted of an unannounced key inspection visit to the home on the 5th February 2007 by one inspector, duration approximately 6 hours. The inspection takes account of information received from a variety of sources including written information from the registered provider / manager, service users and staff. All key standards were inspected. The inspector spent time observing interaction between staff & service users as well as talking with them. A tour of the premises was conducted. Documents and records were seen and service users files were case tracked. What the service does well: What has improved since the last inspection? There were no requirements made following the last inspection. Staff have continued to attend training courses and the registered provider/manager has completed the registered managers award. The medication policy needs to be update to include self-medicating practices and for taking medication out of the home on days out. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 6 What they could do better: 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. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 234 This judgement has been made using available evidence including a visit to this service. The home has the necessary tools for conducting a pre-admission assessment. The views and expectations of the existing service users are valued and sought in relation to a new admission. EVIDENCE: The registered providers have a pre-admission assessment tool for assessing the needs of prospective service users. The home currently has one vacancy, the registered providers were able to demonstrate the procedures they would follow, if they filled this. The Homes policy for the admission of a new service user includes, the views of the existing service users and the prospective service user, having multiple visits and short stays to gradually introduce them. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care planning system is a good foundation but does not provide staff with sufficient information to satisfactorily meet the service users needs. Service users are involved in some of the decision making about their routines & care. Confidential information is recorded and stored appropriately. EVIDENCE: All of the service users are male and have lived at the home for some years; the average being for 3-5 years, another 8 years and one for 27 years. This and the low turnover of staff, has resulted in the registered providers and the staff knowing the service users needs very well. Two care plans were case-tracked; these provided good basic information about them and their needs. The elements of care that were identified in the care plan were well written and provided clear instructions on how to meet Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 10 these needs. However all of the service users have mental health needs and this element of care is not included in the care plan. When case-tracking the files, in sections named “doctors visits”, it would be apparent that there had been a change in a service users state of health, and the doctor may have changed some of their medication. However from the daily records it was not clear what had occurred to require the doctor to visit. These changes in caring for the service user had not been cross-referenced to the care plan. One service users reviews of the care plans stated that their condition had remained stable. However, the medical records showed there had been changes to his treatment and was being reviewed by the GP. From the records it was not possible to identify what had occurred, what was wrong with the service user and why the GP was changing their medication. The daily records vary in the quality of recordings, some are very brief and use phrases such as “slept well”, and others give quite a clear picture of the service users daily routine and moods. However the records rarely refer to the care needs identified in the care plan. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 16 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to participate in activities of their choice and to do voluntary work. A nutritious and varied diet is provided. EVIDENCE: All of the service users have needs that impact on their ability to find appropriate employment and to attend further education. However, one service user enjoys gardening and is supported to attend a gardening club and to occasionally be paid to cut grass for people. A service user does voluntary work in the local charity shop. An older service user enjoys watching television and likes to go to the corner shop to buy their newspaper and the home’s bread & milk for the day. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 12 Other activities include; trips in the car, visits to the café, cinema, coastal walks, supermarket shopping, concerts and watching the carnival, this information was provided in the pre-inspection questionnaire. Service users were seen to be coming and going throughout the day, whilst others preferred to stay at home and watch the television. The only holidays the service users have is if a member of their own family takes them on holiday. One service user was met just after having their dinner. He stated he had enjoyed it and that the food was good. He also said that he didn’t get a choice but the staff knows what he likes to eat and just cook it for him. When this was discussed with staff they confirmed that they know each service users likes & dislikes and will provide a different meal if it is something they don’t like on the menu. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported with dignity and respect when personal care is provided. The health needs of service users are met and there is some evidence of good multi disciplinary working taking place. Everyday medication practices within the home are satisfactory but the medication policy does not provide up to date information on current practices. EVIDENCE: The service users files provides evidence that the home works closely with health care professionals including; GP’s, psychiatrist and community psychiatric nurses. The records do not always give a clear account of why a healthcare professional has been contacted but it is recorded and their instructions are entered in the medical records. The medication cupboard is not situated in the best place for storing medicines and consideration should be given to relocating it. A medication audit was conducted with a senior member of staff. No other errors or concerns with the staffs’ practices were identified. When discussing medication with the Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 14 registered provider he realised that he was incorrectly handling medication that is provided by a specialist. The practice he was undertaking actually resulted in him second dispensing medication, he had not previously realised what he was doing was wrong and stated that this practice would be stopped immediately. He was open and honest about his mistake and distressed by this. The home supports service users who are able to administer their own medicine. The homes policy for taking medication out of the home (for days out etc) and self-medicating has not been updated to current practices. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users feel that any concerns they have are listened to and that action is taken. The Home has procedures for the protection of service users. EVIDENCE: Service users stated that they were well looked after and that they knew they could talk to either of the registered providers or a carer if they had a problem. There have been no complaints received since the last inspection. The service users surveys also confirmed that they are aware of how to voice their concerns. The missing persons procedures were implemented within the last year and the adult protection co-ordinator judged that the home had followed these appropriately. Records of service users monies are kept, these included receipts and a single signature procedure. One service user is supported to manage their own finances via their own bank account. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 25 26 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The building is well maintained providing a homely environment for service users. Some hot surfaces are not guarded. EVIDENCE: The home is a semi-detached building providing accommodation over three floors. There is a fire escape to the back of the building, which can be accessed from each floor. There is no lift to access the upper levels and so would not be appropriate for those with restricted mobility. There is one double bedroom and six singles. All of the service users are male and this is reflected in their choice of décor. One service users loves to do gardening and despite his bedroom carpet having been replaced within the last 2 years, his muddy boots have taken its’ toll on it. There are two bathrooms situated on the first and second floor. The home has a lounge and a dinning room. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 17 The radiator in the lounge is unguarded and has chairs placed against it. The registered provider made a commitment to guard the radiator. The home was seen to be clean and there were no unpleasant smells. The home has a no smoking policy and the service users who smoke use the garden. The registered providers confirmed that they have signed a commercial waste contract but does not have a clinical waste contract, as they do not produce any clinical waste. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 33 34 35 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers of staff on duty vary according to the routines of the service users but their shifts are not recorded. No new staff have been recruited since the last inspection. Staff attend training courses but have not attend courses specific to the service users needs. EVIDENCE: The home is a family business with many of the care staff being family. There are no formal duty rotas’ to record the shifts the staff have worked and to evidence the numbers of staff on duty. The registered provider stated that staff will change their working times to accommodate the routines of the service users. At the time of the inspection visit there were two carers on duty in the morning and one in the afternoon being supported by the registered providers. Three of the service users go out during the day. No new care staff have been employed since the last inspection. At the last inspection, it was judged that the procedures for recruiting staff met this standard. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 19 Both the registered providers and the staff have attended a variety of training courses including: medicine administration, infection control and adult protection. The home is registered to care for those with mental health needs, but only some of the staff have attended a basic introduction course in this subject. Other mandatory subjects have not been updated as frequently as required. Two of the four carers have achieved a recognised care qualification, with the remaining currently studying for the NVQ qualification. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 38 39 40 41 42 43 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The registered provider has the skills and knowledge to continue to bring the home forward. There are limited quality assurance processes implemented within the home. The health & safety practices are satisfactory. EVIDENCE: The registered provider is qualified for the position and has the registered managers award. The home has been well managed with the homes ethos being maintained, despite the registered providers having to come to terms with personal ill–health. There were no requirements made following the last Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 21 inspection visit and the history of the home shows that the registered providers have worked to meet any requirements made. The registered provider stated that they have undertaken some quality assurance work by surveying some of the service users and relatives. The information gathered from these surveys has not been collated or a report produced. All of the environmental certificates were in date, showing that the building and equipment is serviced and maintained. Only the hot water on the baths have been regularly tested and the hand-wash basins do not have thermostatic valves fitted. The home has produced a variety of policies and procedures, which have been reviewed this year. See under “individual needs & choices” for information on the production records. Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 2 2 2 3 3 Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 12 13 15 Requirement Care plans must include the mental health needs of the service users. Care plans must be reviewed and be updated to include changes in the service users care needs. Service users must have the option of a seven-day annual holiday as part of the contract price. The registered provider must review the medication policy relating to self-medication and the procedures for medication being taken out of the home when a service user is on a day out or holiday. Records must be kept of the proposed and actual hours worked by care staff and the registered providers. The registered persons must collate the information gathered through surveys and internal audits and produce a report of the findings, as part of the quality assurance system. Timescale for action 31/07/07 2. YA14 16 30/09/07 3. YA20 12-14 16 17 23 sch 3 31/07/07 4. YA33 15 17 sch 4 10 12 15 24 31/03/07 5. YA39 31/07/07 Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard YA19 YA23 YA41 YA42 Good Practice Recommendations For service users aged 65years plus to have skin integrity assessments completed. To use a 2 signature procedure for the handling & recording of service users monies. Daily records should refer to the needs identified in the care plan as well as the service users personal routine. That the hot water temperatures are tested on the handwash basins and action taken if the hot water cannot be sustained at a maximum of 43’ Beach House DS0000023359.V307011.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Beach House DS0000023359.V307011.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. Re-publishing this information is in breach of the terms of use of that website. 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