Inspection on 11/06/05 for Beau Sejour

This inspection was carried out on 11th June 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 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

Beau Sejour 24/05/07

Beau Sejour 09/12/05

Beau Sejour 20/12/04

Beau Sejour 14/07/04

Beau Sejour 05/09/02

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Beau Sejour 12-14 Castle Road St Albans Herts AL1 5DL Lead Inspector Hazel Wynn Unannounced 11 June and 25th July 2005 th 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 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 Stationary 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. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Beau Sejour Address 12-14 Castle Road, St Albans, Herts, AL1 5DL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01727 859948 01727 753842 Mr Brijanund Rutnah Mrs Janeeta Rutnah CRH Care Home 10 Category(ies) of LD-10 registration, with number of places Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20 December 2004 Brief Description of the Service: Beau Sejour is a privately owned service providing personal care, social care and accommodation for 10 people who have a learning disability. The property consists of two houses converted into one property, with a large conservatory added in 2004. There is a beautifully landscaped rear garden with a waterfall, this was designed to be safely accessible and was re-landscaped following the addition of the conservatory. The property remains in keeping with the other houses in the road and is in a quiet residential area of St Albans. St Albans is an historic town, which boasts a lively town centre with various and wide ranging amenities. The town centre is a short car journey from the home. The home provides single accommodation personalised bedrooms with hand basins and adequate bathing and toilet facilities. The home provides residential care in a family style environment for younger adults who have a learning disability. It also has its own mini-bus to support service users to access their community. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted in two parts: the initial visit was on 11th June 2005 when the home was celebrating its 10th anniversary and gave the inspector the opportunity to meet with all of the service users and staff, relatives, friends, care managers and other professionals involved and gain their views of the service. The second visit on 25th July 2005 was for the purpose of inspecting records and to inspect the premises. During both visits the inspector found that all of the National Minimum Standards had been met; feedback gained on the 11th June was excellent. Everyone spoken to spoke very highly of the proprietors, the staff team and the service provided. What the service does well: Relatives and friends praised the service for the support given to develop social and daily living skills of the service users and also for the tremendous support they have been given themselves. One relative stated “Words cannot begin to express the gratitude I have and the love I feel for the proprietors, they have come to mean more to me than my own family – they are my family”. Staff said that they are extremely well supported both on a personal level and a professional level. The service has almost a 100 qualified workforce and plans to make this 100 after the newest member of staff completes NVQ level 2 which she plans to commence in September, this year. Care managers and other professionals involved stated that communication and cooperation/co-working is at an excellent level. The home’s care team works hard to ensure that the service users lead meaningful and fulfilling lives and that they are present both in and with their community. The proprietors have invested heavily to immaculately maintain and extend the accommodation and gardens. Records are well maintained and organisation is very good. Recruitment is robust and there is a very low turn over of staff. Recognised induction and ongoing training is provided. The home continues to consistently meet the National Minimum Standards. In renewing its Investors in People Award this year the home was nominated as a Champion in the Investors in People Award. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 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 standard(s) 1 - 5 Service users and their representatives are provided with information in order to make an informed choice about where to live. Assessments are thorough and the home meets the aspirations and needs of service users with enthusiasm both during and after the trial period. EVIDENCE: The Statement of Purpose and Service User Guide have been reviewed and updated; these provide the service users and their representatives with information about the home and what it will provide. These documents also contain the complaints procedure and the details of the Commission for Social Care Inspection. Thorough assessments are undertaken by the manager in consultation with the service user and all significant others; needs and aspirations are obtained at this time in order that the home can judge whether it can provide the service required. If the home is in a position to offer a trial placement, arrangements are made for the service user to visit the home on several occasions and also spend overnight stays prior to moving in. Contracts are with the local authority and agreements are drawn up between the provider and service user, a copy of this is maintained by the home with a copy provided to the service user. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 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 standard(s) 6 - 10 The service users, their representatives and their care managers are fully involved in care planning and decision-making and the home is run in a manner to best meet needs and to create service user ownership. Risks are managed to develop independence. Information about service users is handled appropriately and confidentiality guarded. EVIDENCE: The records show that service users are involved in their assessments and reviews; their personal goals and needs are reflected in their care plan and these are kept tracked and reviewed. Records are maintained of the decisions service users make and clear guidelines are drawn up together with risk assessments in order to fully support the service user to achieve their aspirations/goals. One example in how the home consults with service users about how the home is run is the vast expense and planning that has gone into re-landscaping the garden to a design that meets the needs of every service user. At least one of the service users is very interested in birds and she has an aviary at the bottom of the garden. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 Page 10 On the visit of the 11th June the inspector made several observations of the gentle manner of support given to individual service users to decide what they wanted to do and how they wanted to participate in the celebrations. Risk Assessments on service users’ files provide evidence that each service user is supported to take risks in order to develop their skills in a safe manner, yet in a way that does not impede their development. All staff receive training in confidentiality and a policy is in place to further support the keeping of a confidence. All information about service users is securely stored and this is only shared on a right to and need to know basis. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 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 standard(s) 11 - 17 Opportunities are provided for personal development in age, peer and culturally appropriate activities that encourages them to be part of their local community. Various leisure opportunities are provided both in and out of the home. Relationships with family and friends are very much supported. Rights are respected and responsibilities are recognised in the service users’ daily lives. The food served at the home is healthy and enjoyed at mealtimes to suit the service users. EVIDENCE: The care plans seen provide evidence that opportunities are provided for personal development; they further provide evidence that various leisure opportunities are provided in accordance with the choices and preferences of the service users. The progress notes provide evidence that these have taken place. Most of the leisure opportunities provided are in the local community and neighbours and friends from the church are invited along with friends and relatives to various events at the home throughout the year; this enables the service users to be part of their community. Various people at the 10th year anniversary celebration praised the proprietors and care team for the care given and efforts made by the team. Relatives praised the personal development that they have witnessed in their relative. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 Page 12 The inspector witnessed staff supporting service users to respect their peers rights to enjoy their own space and activity and supporting one service user to have time alone to express his anxieties about his sick mother and being given encouragement and support to do so in a quiet corner. The care plans and progress notes provided evidence that service users are expected and supported, one-one, to develop independence by maintaining and developing daily living skills. A dietician visits regularly and her advice in menu planning is combined with the service users preferences in meal planning. Relatives told the inspector that they are freely invited to come for a meal when they want and that the food served is of a very high quality and ‘beautifully’ served. One relative stated that because she is alone at Christmas she is always encouraged to come for the Christmas dinner and celebrations and feels very much that she is part of one big family; she said “words just cannot express what the proprietors and the care team mean to me”. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 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 standard(s) 18 - 21 Personal support, healthcare, physical and emotional support is given to fully meet the needs of the service users. Medication is well and safely managed. Respect and dignity is evident in respect of ageing, illness and death. EVIDENCE: The personal support needs of each service user are set out in the individual care plan as are physical and emotional needs. All of the care plans seen had been kept tracked and reviewed on a very regular basis and there are clear guidelines for staff to enable the meeting of needs in accordance with both need and service user preference. The service users accommodated in this home have profound learning disabilities and are not yet able to manage their own medication. Medication was securely and properly stored in accordance with guidelines and policies and the medication administration records are neatly and correctly maintained. There were no gaps on the medication administration records. The local pharmacist had completed an audit service just prior to this inspection and had provided a good report on findings. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 Page 14 On the 11th June the relatives of a service user had joined the home for the 10th anniversary celebrations and they told the inspector of the tremendous support they had been given by the home during their son’s life at the home, during the time of death and thereafter; they spoke at length highly praising the proprietors and the care team for their efforts “far beyond the call of duty” on behalf of people who have a learning disability and for their families and friends. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 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 standard(s) 22 -23 Service users can feel confident that their views are important, listened to and acted on. Service users are protected from abuse, self harm and neglect. EVIDENCE: On the visit of 11th June 2005 the inspector witnessed a member of the care team supporting a service user who had concerns about his sick mother; he was being given support and plans were being made to respond to his wish to visit her. On the visit of the 25th July, the records showed that the service user had been taken to visit his mother as promised. Policies and procedures are in place together with training in abuse awareness as part of vulnerable adult protection protocols. Relatives spoken to stated that it would be unimaginable that any form of abuse could ever take place in the home, as “everyone is just so caring”. A complaints policy and procedure is in place and a clear version of this is made available to the service users and their representatives. Recruitment is robust; the latest recruit had a clear CRB and POVA check on her file, references and employment history together with other recruitment documentation and training records. There is a very low staff turnover at this home. Risk Assessments are in place to ensure that risk of harm is minimised and that all activities are safely supported. Actions on individual needs are kept tracked and changing needs are reviewed on a very regular basis. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 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 standard(s) 24 - 30 The home is comfortable, safe and homely and provides individual and personalised bedrooms designed to promote independence. The toilets and bathrooms provide privacy and meet needs. There is a generous amount of shared space. Where appropriate, specialist equipment is provided to promote independence. The home is kept clean and hygienic. EVIDENCE: The inspector observed the home to be well maintained, comfortable with good quality furniture and very homely. Grab rails are in place to promote independence and safety where needed. Specialist equipment (a hoist) is provided and records showed that this is kept regularly serviced; training is provided in moving and handling and in particular the use of the hoist; certificates for moving and handling were on individual staff files. Since the last inspection two of the bedrooms had been redecorated and recarpeted in the individual service users favourite colours. A lot of work had gone into involving the service users to be at the centre of this decision making. The lounges, dining areas and hall, stairs and landing had also been redecorated and re-carpeted since the last inspection. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 Page 17 A large conservatory has been added and this has now been completed and this now adds to shared space making a very generous addition for activities and relaxation, looking out onto the gardens have been very attractively relandscaped following the building work. The gardens have been especially designed to meet the needs of the current service users, being completely level with guarded pond and access to the aviaries which is especially part of one individuals leisure time enjoyment. The inspector observed the home to be clean, fresh and hygienic. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 - 38 The staff team are competent, effective with a good skill mix, are qualified and know their roles and responsibilities. Recruitment is robust and provides for the protection of vulnerable adults. Individual and joint needs of service users are met by appropriately trained staff who are well supported and regularly formally supervised. EVIDENCE: A clear job description is provided to each staff member at the onset of employment and a copy is maintained in the office files; these define the role and responsibilities of the care staff at all levels. In renewing its Investors in People Award this year the home was nominated as a Champion in the awards. The home has almost 100 of qualified staff; some of the staff team have RNMH and others levels 2 to 4 in NVQ. The latest recruit is enrolled to commence NVQ level 2 training this September and when she completes this the home will have achieved 100 ; this is 50 above the National Minimum Standards. The latest recruit has had the necessary recruitment checks and her file held Criminal Records Check POVA (Protection of Vulnerable Adults Check) references and other employment documents. Policies and Procedures are in place in relation to recruitment and these are closely adhered to. The robust recruitment procedures provide protection for the service users. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 Page 19 Other staff files were seen at previous inspections and the home has a very low staff turnover. The home provides the Learning Disability Awards Framework training when inducting new staff and provides ongoing recognised training. Staff stated that they feel very well supported, have a strong team and receive very regular formal supervision as well as ad hoc supervision when the need arises. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 -43 The ethos, leadership and management approach of the home ensures this home is well run to the benefit of the service users. The views, needs, rights and best interests of the service users underpin all self monitoring, reviews and developments made by the home and its policies and procedures. The home maintains good records and keeps policies and procedures reviewed, The promotion of health, safety and welfare of service users and staff is protected. The service users benefit from the competent and accountable management of the service. EVIDENCE: Evidence that the service users benefit from a well run home was evidenced by: looking at records, talking to service users, service users relatives, care manager, other professionals involved and the care team. The proprietors were highly praised by everyone the inspector met with. The Investors in People Award organisation have nominated the home a Champion this year. Policies and Procedures are in place to protect the service users best interests and these are kept reviewed; changes to these are brought about by the changing needs of service users and or legislation. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 Page 21 The records show that protocols are in place to promote the health, safety and welfare of the service users and staff; these were evidenced by the care plans, records of tracking and reviews and risk assessments providing clear guidance to staff. Finance Records, Medication Administration Records, Fire Safety Records, Care Plans, Supervision Records, Staff Files, Maintenance Records all provided evidence of accountable and responsible management approach and in addition to this was the excellent feedback from the relatives, friends, care staff team and professionals involved with the home. Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 3 3 4 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 4 Standard No 31 32 33 34 35 36 Score 3 4 3 3 4 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Beau Sejour Score 3 3 3 4 Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 3 3 4 I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 Page 23 N/A 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. Standard Regulation None 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 None Good Practice Recommendations Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City, Herts AL7 3BQ 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 Beau Sejour I52 s19281 Beau Sejour v230262 110605 Stage 4.doc Version 1.30 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!