Inspection on 03/11/05 for Beacongate

This inspection was carried out on 3rd November 2005.

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

Beacongate 21/11/07

Beacongate 10/04/06

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Beacongate Beacon Road Crowborough East Sussex TN6 1AZ Lead Inspector Jon Wheeler Announced Inspection 3rd November 2005 09:30 Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 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 Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 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. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beacongate Address Beacon Road Crowborough East Sussex TN6 1AZ 01892 669579 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) East Sussex County Council Vacant Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is five (5). Service users must be aged between thirty (30) and sixty-five (65) years on admission. Service users with a learning disability only to be accommodated. Date of last inspection 26 May 2005 Brief Description of the Service: Beacongate is a detached house in Crowborough, providing residential care to five adults who have learning and physical disabilities. The home has five single bedrooms, which are attractively decorated to suit the preferences and needs of the individual service users. There is a spacious bedroom, with en-suite facilities, in the attic. All other rooms are on the ground floor and are accessible, as is the large garden to the rear of the property. The home is close to the shops and facilities in Crowborough town centre. The home is one of the East Sussex Social Services group homes. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place on the 3 November 2005, starting at 9.30am and lasting for about three hours. The inspection process included talking to the acting manager and her line manager; to two other staff and getting written feedback from three relatives of service users living in the home. One service user was able describe his experiences of the service. Due to their learning disabilities, the three other service users in the home on the day were not able to clearly communicate their views of the service. However, they were observed receiving care and support from the staff. The process also included a tour of the premises, reading care plans, documentation, policies and records. The storage, administration and recording of medication was viewed. The service is in the process of recruiting a manager, having had two changes of manager in the last five months. An experienced and skilled senior carer is acting manager, supported by a line manager from East Sussex Social Services. What the service does well: What has improved since the last inspection? Care plans had been reviewed and updated to identify the needs of the service users and to provide clear support guidelines for staff. Risk assessments had also been reviewed and updated to reflect changes in needs. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 Page 6 Medication was stored securely and had been recorded accurately in line with the home’s policy and procedure. Policies were accessible in the office and staff were aware of how policies operated in practice. 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. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 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 Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4. There are robust procedures in place to ensure comprehensive pre-admission assessments are taken prior to ensure the home can meet the identified needs of service users before they move in. Service users are able to visit the home prior to moving in to enable them to make informed choices. EVIDENCE: There was documentary evidence of policies in place to ensure that there are thorough pre-admission assessments taken to assess prospective new service users. There was documentary evidence of those assessments having been completed for a service user who moved in earlier this year. The pre-admission assessments demonstrated that the home was able to identify and meet the needs of the prospective new service user, who subsequently moved in. The service user said that he had visited prior to moving in to the home. Documentation demonstrated that he had made several visits, to meet the service users and staff, prior to moving in permanently. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9. Service users’ needs and their required support are clearly documented in their care plans, enabling staff to meet those needs. Service users are consulted about the home and are supported, where possible, to make decisions in their lives. Clearly assessed and managed risks enable service users to undertake a wide range of activities. EVIDENCE: There was documentary evidence that care plans had been reviewed and updated to reflect any changes in needs for the service users. They also contained clear support guidelines to enable staff to meet the needs of the service users. Staff support service users to make choices in a variety of aspects of their lives, including what food they eat, what activities they do and where possible which staff support them for specific activities or daily routines. Staff were observed using a variety of communication methods to enable service users to make choices, including pictures, makaton and gestures. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 Page 10 There are regular tenants meetings, where issues affecting the home are discussed. They are asked their opinions about the way the home operates, what changes they would like to make and the things they like to do. It was reported that one of the service users helps with the house shopping. There was documentary evidence of risk assessments to enable service users to undertake various activities in the home and in the community. Risk assessments had been reviewed and updated to reflect any changes in needs. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 17. Service users are not always regularly supported to take part in meaningful activities at home and in the community, so the home cannot ensure the personal development of service users. Service users are supported to maintain positive relationships with their families and friends. Service users have access to a varied and nutritious menu, which meets their preferences and dietary requirements. EVIDENCE: Service users are supported to access activities and facilities to meet their individual needs, preferences and goals. Care plans and comments from staff and service users confirmed that activities and facilities used include going to a day centre, various trips out and a variety of leisure activities. One service user regularly goes carriage driving. Other activities included going to a garden centre, sensory room sessions, music, jigsaws trips to the theatre, shopping and during the summer, going to outdoor shows. Activities tend to reflect that some of the service users are approaching old age. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 Page 12 During the inspection, whilst two service users went out, two stayed in the home, both watching the television in the lounge. One service user was having a holiday, although as this was private arrangement, other service users are unable to have an annual holiday due to the costs involved and the policy of the organisation. As activity levels appeared to have remained the same since it was recommended to review the opportunities, it is now required that the home reviews the activities it offers to service users to provide interesting and stimulating activities that also meet their needs and preferences. Service users are supported to keep in regular contact with their families and friends. Staff help service users to keep in phone and letter contact with families as well as enabling visits in the home or for service users to go out from the home to see them. Feedback from three relatives of service users stated that staff enable service users to visit and keep in regular contact. Staff were described as being helpful, hard-working and supportive to relatives. There was documentary evidence of a varied menu offering nutritious and appealing meals. Staff were able to describe in detail the dietary requirements of the service users, which were also clearly reflected in the individual care plans. Service users were observed being offered choices about what they would like to eat. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Staff provide sensitive and dignified support to meet the individual needs and preferences of the service users. Service users are supported to access a range of health services to meet their physical and emotional health. The health and well-being of service users is safe-guarded by robust policies and medication being stored, dispensed and recorded appropriately. EVIDENCE: Staff were observed providing dignified and sensitive support to meet the personal needs of the service users. Staff were knowledgeable about the care and personal needs of each of the service users, as well as describing the importance of enabling them to be as independent as possible. One service user said that staff look after him very well. Three relatives all commented on the good quality care provided by a dedicated staff team. Staff were observed positively engaging with service users, including those who do not have verbal communication skills. Staff used a variety of communication methods, including makaton, gestures and visual prompts. There was documentary evidence that the health needs of the service users are met, by accessing a variety of services to meet their specific needs. Care plans indicated that service users are supported to access services including Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 Page 14 their General practitioner, Physiotherapy, Occupational Therapy and District Nursing. Staff were able to describe the individual health needs of each of the service users and how those needs are effectively met. The service uses a monitored dosage system to ensure the safe administration of medication. All medication is stored securely and had been recorded accurately, in line with the home’s policy and procedure. All staff who dispense medication have received suitable training. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Relatives are able to raise concerns and complaints on behalf of the service users. Staff are proactive in helping service users communicate any unhappiness with living in the home. Whilst service users are protected from abuse by robust policies and procedures, staff are do not have up to date information or training to ensure their safety. EVIDENCE: The service has a comprehensive compliant policy and procedure, which is made accessible to service users and their relatives. No complaints had been received at the home since the last inspection. One service user spoken with said he was able to raise any complaints he had. Two relatives fed back that they felt able to raise any issues or concerns with staff, who they felt would deal with it sensitively and swiftly. There was an Adult Protection policy and procedure in the office in the home, which staff were aware of. Whilst staff were generally able to describe how to raise any adult protection alerts or concerns they may have, staff who had been working in the home for a number of years had not recently attended any adult protection training. It is required that all staff attend update training about adult protection. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. The home offers a friendly, relaxed and clean environment, which is generally kept in good decorative order and offers sufficient communal space. There are sufficient bathroom and toilet facilities that meet the needs of the service users. EVIDENCE: The building provides a relaxed, homely and comfortable environment, which meets the current needs of the service users. Four service users have their bedrooms on the ground floor, whilst one service user has a bedroom, with ensuite toilet and shower facilities upstairs. There are sufficient bathing and toilet facilities, which comprise a large bathroom with an assisted bath and a shower room, which has a shower seat available. The home is in a reasonable decorative order. Service user bedrooms were attractively decorated to suit their individual tastes and preferences. Two service users have ceiling hoists in their bedrooms to enable staff to meet their individual needs. There is a large kitchen and a large lounge/dining room, which looks out on to the patio and large garden at the back of the house. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 Page 17 The large bathroom has a height-adjustable bath, with overhead tracking and ceiling hoist. There is a wall-mounted seat in the shower room and two of the service users have shower chairs to enable them to be supported effectively with their personal care. Two service users have specialised beds to meet their specific needs due to their physical disabilities. There was evidence that pressure mattresses are checked regularly to ensure they are on the correct settings. The home has a vehicle that is accessible for people in wheelchairs. At the time of the announced inspection, the home was clean and tidy. Staff are responsible for the cleaning in the home. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, 36. An effective, skilled and well-supervised staff team generally meets the needs of the service users, but would benefit from training in dementia. The lack of evidence of robust and complete employment procedures does not ensure the protection of service users. EVIDENCE: Staff spoken with confirmed that they had been issued with job descriptions when they started their employment. Staff were able to describe their roles and responsibilities and those of their colleagues. There is currently a vacancy for the manager and one for a care officer at the home. Vacancies, staff annual leave and sickness are covered by relief staff who regularly work in the home. There are generally sufficient staff on each shift, with usually three staff on during the morning and a minimum of two during the afternoon. There is one sleep-in staff at night. Employment records, including references, criminal records bureau checks, application forms and interview records are kept at the organisation’s head office. However, it is required that evidence is available in the home that correct recruitment procedures have been followed. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 Page 19 There was documentary evidence of staff attending a range of training courses. Staff had recently accessed training on Food Hygiene, Moving and Handling and First Aid. One new member of staff was undertaking the Learning Disability Award Framework qualification, whilst one other member of staff is doing an NVQ. One member of staff has an NVQ 3 in care. It is required that the organisation ensure more staff complete relevant NVQ courses. One service user was identified as showing signs of dementia. However, whilst staff were able to demonstrate sensitive care, they had not received training about dementia, which would enable them to clearly identify and meet the needs of the service user. There was documentary evidence that staff receive regular supervision, as well as attending fortnightly team meetings. All staff spoken to said that the acting manager is approachable and supportive. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 40, 41, 42. A range of monitoring systems and health and safety checks ensures the protection and well-being of service users. Up to date policies and records ensure the effective and efficient running of the home to meet the needs of the service users. EVIDENCE: One service user said he felt that he was able to raise any concerns with the staff team. There are regular team meetings, where staff support service users to raise concerns and also keep them, informed of any changes in the home. The service has monthly monitoring visits undertaken by the organisation’s Resource Officer as well as using a monitoring system based on identified standards. A sample of policies and records were seen in the home, which were up to date and accurate. Staff were able to describe how a range of the policies worked in practice. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 Page 21 There was documentary evidence of a range of health and safety checks, including quarterly environmental inspections; weekly fire system checks, emergency lightly checks monthly and a recent asbestos check. Potentially harmful chemicals were locked away. Care plans included recently reviewed fire safety plans for each of the service users. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 3 X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 2 12 3 13 3 14 2 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X 3 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Beacongate Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X 3 3 3 3 x DS0000063871.V249445.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? 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 2 3 Standard YA11 YA23 YA34 Regulation 16 (2) (m) Requirement Timescale for action 03/01/06 03/01/06 03/11/05 4 YA35 5 YA35 The home reviews the range and type of activities offered to service users. 13 (c) Staff receive up to date training in adult protection. 19 Sch 2, Information required under Sch 4 Schedule 4 to be made available in the home for inspection at all times. 18(1)(a)(c)(i) Arrangements must be made for staff to undertake relevant training with a view to providing a minimum of 50 trained to NVQ level 2. 18 (1) (c) (i) Staff receive training about dementia. 03/01/06 03/01/06 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 YA14 Good Practice Recommendations All service users are offered the opportunity to have an annual holiday away from the home. Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 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 Beacongate DS0000063871.V249445.R01.S.doc Version 5.0 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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