Inspection on 27/10/08 for Beacon House

This inspection was carried out on 27th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beacon House 07/12/07

Beacon House 13/06/07

Beacon House 01/08/06

Beacon House 23/01/06

Beacon House 02/02/05

Beacon House 17/08/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Beacon House Victoria Hill Road Fleet Hampshire GU51 4LG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kathryn Emmons     Date: 2 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Beacon House Victoria Hill Road Fleet Hampshire GU51 4LG 01252615035 Telephone number: Fax number: Email address: Provider web address: JanetDeavilleN@aol.com Name of registered provider(s): Name of registered manager (if applicable) Ms J Deaville Type of registration: Number of places registered: Wilton Rest Homes Limited care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Beacon House is a care home providing care and accommodation for 20 older people, two of whom may have dementia, and is owned by Wilton Rest Homes Ltd, which is a private organisation. The home is located on the outskirts of Fleet and is within access of local shops and other amenities. The home has a large garden maintained to a high standard with seating provided that is accessible to the service users. The fees range from #520 to #650.00 per week. 20 0 Over 65 0 20 Care Homes for Older People Page 4 of 25 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The visit to the service was undertaken by one inspector who spent six and a half hours at the home. The care received by three residents was looked at in detail. This is a method called case tracking. This included looking at their personal records a range of general records and staff details. This forms part of a key inspection and focused on the standards in the key areas that most effect the quality of life for the residents. Information already held such as a service history and the providers self -audit which is called an AQAA (Annual Quality Assessment Audit) were used to plan the visit. The commission is trying to improve the way we engage with people who use services, so that, we can gain a real understanding of their views and experience of social care services. We are using a method of working where the Expert by Experience is an Care Homes for Older People Page 5 of 25 important part of the inspection team and helps the inspector to get a picture of what it is like to live in or use a social care service. The Expert by Experience spoke with 16 residents and 5 staff on their own, contributed to the inspection process and provided a separate report. Comments and observations are reflected in this report. During the visit the inspector spoke to the person in charge, the responsible individuals representative who is also one of the directors and three staff. We also sent comment cards for staff and residents to complete and we also considered the comments these contained when writing the report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 25 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 8 of 25 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. Through pre admission assessments residents can be confident that their needs can be met by the service. Up to date information enables residents to make an informed choice regarding living at the service. Contracts provide residents with confidence that their rights are upheld in respect of purchasing their care. Evidence: As part of case tracking three residents admission details were looked at, including the newest person to be admitted to the service. We could see that information regarding the residents needs had been obtained before the resident had been offered a place at the service. This had normally been done by the manager but for the newest person admitted an assessment had been completed by the deputy manager. There are two documents in place which provide information to prospective residents and their relatives to help them reach a decision about living at the service. These two documents are called the service user guide and the statement of purpose. These Care Homes for Older People Page 9 of 25 Evidence: documents were up to date but they need to be amended slightly to reflect the changes in the management structure . This means that residents would be clear who to speak with if they needed more information about any of the services provided by the home. We saw contracts in place and these had been signed by the residents and the manager. We did not see any letters on files which should be sent to prospective residents confirming that their assessed needs could be met. The responsible individuals Representative said these letters are sent and they would ensure these were placed on files. Care Homes for Older People Page 10 of 25 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. Care plans and risk assessments which are regularly reviewed give residents confidence that their individual needs are known. Ensuring all medication is signed for will enable residents to be confident that they will receive their medication correctly. Systems in place provide good access to health care professionals. Residents dignity and privacy is respected. Evidence: Using case tracking we looked at three residents service user plans . These have improved since the last inspection and contained more information regarding risk assessments and physical needs. A little more information is still needed to evidence what activities residents have been involved in recently as the notes we looked at only recorded up to July. The plans contained admission information, details of medications, care needs ,weight and nutritional needs. We could see the resident had been included in the production of their care plans and reviews were taking place. We could see that daily records were maintained which staff are able to use to monitor the progress and welfare of the residents. Care Homes for Older People Page 11 of 25 Evidence: Residents who spoke with the expert by experience gave examples of how they felt their needs were being met such as having their hair set and being assisted with meals and moving around the service. We saw many interactions between staff and residents. All of these interactions were appropriate and valuing of the resident. Staff have an awareness of individuality and one carer said Its good we have the time to sit and listen to the residents and know what we can do for them. This is their home. Privacy and dignity was upheld and staff were seen to knock on residents doors before entering. Residents confirmed through comment cards that they were satisfied with the arrangements for seeing doctors and other health care professionals. We could see from records when the district nurses had visited and any changes in treatment had been recorded. Medication records were seen for all of the residents. Generally records had been completed correctly however we did see that there were a couple of signatures missing . We discussed this with the person who was in charge during our visit who said that action would be taken to address the matter. Medications were stored safely and we could see from staff records that any staff who was involved in medication arrangements had received the necessary training. Care Homes for Older People Page 12 of 25 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. Residents are able to lead a lifestyle similar to what they had before living at the service. Appropriate activities are provided and individuality is respected. Dietary choices and preferences are catered for. Evidence: The residents were attending a music afternoon during the visit and we could see a list on display of forthcoming activities. Records in care notes recorded what activities were available these included carpet golf, quizzes, discussion groups and trips out of the home. One resident said there is always something going on even if its going through the paper with one of the staff and another said I really enjoy the chair exercise class. Cultural and religious needs of residents are respected and clergy from various denominations visit the service to provide worship services. Residents are also assisted to attend local worship in the local community. There is a resident meeting held every month and we saw minutes from these meetings . Residents told us they were able to chose how they spend their days and were given choice regarding when they got up and when they went to bed,when they took a bath or shower and what meals they ate. Staff were seen speaking with residents and offering them choice in all aspects of the care they were receiving. Staff Care Homes for Older People Page 13 of 25 Evidence: told us that even though some residents were a little confused on occasion it was still very important for them to make their own choice where they can. Residents told us that they could chose when they received visitors . There were areas around the home for residents to meet with visitors if they didnt want to use their rooms. Residents are safe from unwanted visitors by the entrance to the home being locked by a security code locking device. We received a comment that sometimes the food was not sufficient or appetizing. We did not find this on the day of the visit and residents who spoke with the expert by experience all expressed their appreciation for the variety and quality of the meals. Residents were able to serve themselves vegetables and they were seated at tables made up of couple or individual tables. The expert by experience noted that the eating alone layout did seem to be the residents preferred choice. Lunch is also attended by some of the people who live in the bungalows within the grounds of the service. Care Homes for Older People Page 14 of 25 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. A complaints policy enables residents and visitors to the service to raise any issues. They can be confident that their concerns will be listened to and dealt with. A correct record needs to be maintained to evidence that concerns have been dealt with. Staff receive safeguarding adult training . Evidence: We received information from one person on three different occasions regarding the running of the home. These were that there were not enough staff on duty, there was not a good food service and that the service lacked management and examples given were lack of resident and staff meeting minutes and the attitude of one of the staff. We looked at all of the issues raised as part of the visit and have reported upon them in the relevant sections of the report. We did not find any evidence to confirm any of the allegations surrounding the management of issues , food service or lack of sharing of meeting minutes.There are changes to the management of the service and these are outlined in management of the home section of this report. There was a complaints policy on display and also contained within the service users guide. We did not see any concerns or complaints from residents or relatives in the complaint record but in staff meeting minutes we saw a relative had made an allegation regarding some mislaid jewellery. We spoke with the responsible individuals representative who said this issue had been resolved and would ensure the recording Care Homes for Older People Page 15 of 25 Evidence: of concerns was placed in the correct record. There was one issue raised from a staff member and we could see that this was being addressed by the deputy manager and the responsible individuals representative. Staff we spoke with said they were satisfied that any issue they raised would always be addressed. Residents spoken with did not express any dissatisfaction with the care and support they receive. We saw in staff records, and two staff confirmed that they had received training in safe guarding adults. We did not look at the services safegurading adults policy on this occasion. Care Homes for Older People Page 16 of 25 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. Residents live in a clean and pleasant service. Decor and furnishings are residents choice and specialised equipment enables then to be as independent as possible. Evidence: We took a tour of the premises and found them to be clean and tidy and fresh throughout. There are domestic staff employed seven days a week and their duties include cleaning carpets and ensuring infection control measures are in place. We saw that staff were wearing different aprons depending on what activity they were doing and wore gloves when delivering personal care. Residents said they liked their rooms and we could see that they had personalised them . Rooms varied in size and most had a bathroom located across the corridor for individual residents use. A maintenance person is employed and any repairs are reported and are addressed promptly. During the visit the maintenance person was carrying out PAT (Portable Appliance Testing) to ensure all electrical items used in the home were safe. Bathrooms were clean and tidy and adaptations had been fitted to enable staff to assist residents with bathing in a safe way.We saw in staff records that staff had received training in moving and handling including using bath hoists . We saw that the communal areas had a variety of furniture and this was all in good Care Homes for Older People Page 17 of 25 Evidence: repair. The decor was of a very good standard and residents invited the expert by experience to have morning coffee with them in one of the lounges. The expert by experience found the lounge area to be light and well decorated. Care Homes for Older People Page 18 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An enthusiastic and trained care team cares for residents. The organisations recruitment procedures need to be more consistent and robust to protect residents. Sufficient staffing levels enable residents needs to be met. Evidence: One of the concerns raised to us before the visit was the number of staff on each shift as the complainant felt there were not sufficient staff to meet residents needs. We looked at the duty rota and could see that there were always five staff on in the morning with one of these being in charge, four staff until 3pm , three from 4pm until 8pm then night time one sleeping staff and one awake staff.There had been a high volume of agency staff a few months previously but this was now very minimal as new staff had been recruited.The complainant also stated that the duty rota was not prepared in advance so it was difficult for staff to book in extra shifts at short notice. The person in charge said there had been occasion when the duty rota had been issued at short notice but that recently there were always two weeks in advance available. We evidenced this during our visit. Residents told us they had their needs met and we saw staff carrying out their work in an unhurried calm environment. Two staff spoken with said they continued to work at the service as they were Happy in my work and I love it here, if i thought anything Care Homes for Older People Page 19 of 25 Evidence: was wrong i would leave like a shot and Normally we all get on really well. In addition to the twenty residents living in the service, receiving care , a couple of the people who live in the bungalows receive personal care for one and a half hours a day which is provided by the care staff from the home. This issue is being addressed separately as the bungalows are not registered as part of the services registration.Interactions between residents and a couple of members of staff were observed and we could see that staff were patient and kind and had time to sit and talk with residents. We looked at three staff recruitment files. We could see the necessary checks such as written references, application forms and criminal record bureau checks had been completed for two of the staff but one member of staff only had one written reference in place and this had been provided by a care assistant they had worked with in a previous job.This means that residents may be at risk of being cared for by people who are not suitable. An induction process is in place and we saw induction books for a couple of staff but not for the newest member of staff. The person in charge thought the new staff member may have taken their induction book home with them as they had seen it a couple of days previously. We looked at training records and could see that training had been delivered in various areas such as basic food hygiene , infection control ,moving and handling and fire safety. Staff were supported to gain their NVQs in Care (National Vocational Qualification) and one staff told us they had been supported to do both their NVQ 2 and 3. This means that they have an increased skill and knowledge base which may mean they are able to deliver an increased quality of care. Another issue raised by the complainant was that staff meetings did not take place often and that minutes were not available . We saw a book which was available in the office which all staff have access to and this was marked staff meeting minutes. This contained minutes from meetings held in November 2007 and January,May and September 2008. We spoke to the responsible individuals representative who said that more frequent staff meetings would be taking place due to changes in the management structure of the service and that minutes of all meetings were available. Care Homes for Older People Page 20 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a service which has temporary management arrangements in place. However these do not seem to impact on the quality of service provided. Quality assurance systems are in place to improve the quality of the service and need to be maintained. Regular supervision sessions will mean that staff training needs can be identified and met. Health and safety arrangements keep residents, staff and visitors to the service safe. Evidence: The registered manager was on sick leave when we visited the service and had been away for 5 months. In her absence the deputy manager was in charge and support was being provided by one of the directors of the company that is registered in respect of Beacon House. This director is also currently in the role as the responsible individuals representative. We were informed that a decision will be made regarding the management of the home in the next couple of weeks. Staff we spoke with did not indicate that there were any issues with the absence of the manager as the deputy Care Homes for Older People Page 21 of 25 Evidence: manager and the director were holding regular meetings and were informing staff of what was happening. Residents did not indicate they had any worries and made comments to the expert by experience such as I may not know what is going on but i am sure they do and Those in charge know what to do so i dont worry about anything. We could see from the sample of records we viewed that polices and procedure were regularly updated. Health and safety tests were carried out by the maintenance person.Supervision sessions take place for staff but these need to be more frequent to meet the standard of six times a year. There is a quality assurance system in place which comprises of questionnaires sent to residents and their families annually. We saw that there were ten returned questionnaires for September but all of the other audits had not been completed for six months. The responsible individuals representative said that this was known to them and they were arranging for audits to take place and this would be reflected in the AQAA which was due the following month. There are monthly visits from the responsible individual and we could see that during these visits staff and residents were spoken to. These are required by the commission so the representative can report of the conduct and progress of the home. We did not look at residents finances on this visit. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 all staff must have two written references in place before they commence work within the service. One of these should be from a previous employer. Written references provide evidence of the staff members appropriateness to be employed to care for vulnerable peole. 30/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 Medication records need to be signed correctly so residents can be confident they will receive their medication correctly and staff can be sure the record is correct so they do not give medication incorrectly. Care Homes for Older People Page 24 of 25 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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