Inspection on 09/10/08 for Beaumont

This inspection was carried out on 9th 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beaumont 23/04/08

Beaumont 03/05/07

Beaumont 09/05/06

Beaumont 12/01/06

Beaumont 15/12/04

Beaumont 25/05/04

Beaumont 02/03/04

Beaumont 01/02/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Townley Road, 2-3

Orchard House Nursing Home

St Josephs Rest Home

Foxley Lane (121a)

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: Beaumont 2 Church Rise Forest Hill London SE23 2UD     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: Mohammad Peerbux     Date: 1 5 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: Beaumont 2 Church Rise Forest Hill London SE23 2UD 02086992310 02086991550 m.rekhi@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs T K Rekhi Type of registration: Number of places registered: Mrs T K Rekhi,Mr P S Rekhi care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: This home is registered for 12 persons of whom up to 12 may be elderly, up to 2 may have a mental disorder and be over 55 years, up to 5 may have dementia, up to 1 may have a physical disability and be over 55 years and up to 1 may have a physical disability and be over 65 years up to 5 may have dementia, up to 1 may have a physical disability and be over 55 years and up to 1 may have a physical disability and be over 65 years old Date of last inspection Brief description of the care home Beaumont is a care home providing personal care and accommodation for 12 older people. The home is a family concern. Mr P.S Reikhi is the owner whilst Mrs T Reikhi is Care Homes for Older People Page 4 of 25 12 12 0 12 Over 65 0 0 12 0 Brief description of the care home the registered manager and their son Mr M.S Reikhi is the deputy manager. It is aimed that Mr M.S Reikhi will take over as the registered manager although there is no timescale as yet for when this will occur. The premises consists of a three storey detached Victorian property. Accommodation is provided on the ground and first floors with eight single and two double bedrooms none of which have en-suite facilities. There is no lift available and the home would not be suitable for individuals with restricted mobility. There is some car parking at the front and a rear garden. The home is situated in a quiet residential area in Forest Hill. There are local shops and public transport facilities. Potential residents are given information about the home once an initial visit has been completed in the form of an information pack kept at the entrance of the home. Also potential residents are informed that copies of reports issued by CSCI are available on request within the service user guide. Copies of CSCI reports are also placed in a dispenser in the lobby. The monthly fees of the service range from £350 -£500. The key inspection was carried out on 20/10/2008. Care Homes for Older People Page 5 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: This unannounced visit to the home was undertaken as a part of the inspection process for the year 2008/2009. In writing the report, consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. The deputy manager facilitated this inspection. They are all thanked for their time and all of those who provided feedback for their support in the inspection process. A tour of the building was also carried out. Care Homes for Older People Page 6 of 25 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. Prospective residents have the information they need to make an informed choice about where to live and admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective person. Evidence: The home has reviewed and updated its statement of purpose. This sets out the aims and objectives of the home, and contains all the information required by Regulation 4 and Schedule 1. This is in line with a statutory requirement notice served on the home. Residents are only admitted to the home after a full assessment of their needs has been carried out by the home and the Placing Authority for individuals referred through Care Management, involving the prospective resident/recognised representative. Admissions to the home only take place if the service is confident staff Care Homes for Older People Page 9 of 25 Evidence: have the skills, ability and qualifications to meet the assessed needs of the prospective resident. 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. Generally, residents care plans include detailed information about their needs and personal goals. This helps staff to know the residents needs and how to meet them. Evidence: Three care plans were sampled at random and it was noted they generally included information necessary to deliver care.Each resident has a plan that where possible has been agreed with them.This is written in plain language, is easy to understand and considers all areas of the individual life including health, personal and social care needs.The plan is reviewed by care staff in the home at least once a month, updated to reflect changing needs and current objectives for health and personal care, and actioned.The plan also includes a risk assessment where applicable.Areas have been identified where staff are willing to support residents to take some risks,which may have an impact on their rights.However the risk assessments are not always comprehensive and this could have an impact on the care the residents are receiving.This was discussed with the deputy manager who agreed that improvements were needed in some areas of the risk assessments.This will ensure that all the Care Homes for Older People Page 11 of 25 Evidence: residents needs would be met. The home actively promotes the residents right of access to the health and remedial services that they need, both within the home and in the community. Records show that the home arranges for health professionals to visit residents in the home and provides facilities to carry out treatment. The home has a medication policy which is accessible to staff, medication records are generally up to date for each resident and medicines received, administered and disposed of are recorded.The allergies of the residents are now recorded on their medication record sheets.A cupboard has also been purchased to keep medication including controlled drugs. A weekly stock checks of all medication that is not kept in blister packs are being carried out in line with a recommendation made at the last inspection. Staff in the home are aware of the need to treat residents with respect and to consider dignity when delivering personal care. The home arranges for residents to enjoy the privacy of their own rooms. Residents who were spoken to stated that they are happy with the way that the staff deliver their care and respect their dignity. One resident stated, Its ok here. Another resident stated, Staff are ok. Observation of the staff team interacting with the residents showed that the carers were mindful how they addressed residents, and they were seen to be polite and friendly.It was previously recommended that the registered person should try to make sure that ways are identified to support service users in need of new or additional clothing to obtain this.The deputy manager informed us that this is ongoing. It was previously recommended that the registered person should try to sensitively consult with all service users about their wishes around death and dying and obtain more information on this matter. Again this in ongoing. 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 being provided with a range of opportunities for recreational and social activity that is in accord with their needs. They are assisted to maintain contact with family and friends, and links with the local community are encouraged. Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. Evidence: Staff are aware of the need to plan the routines and activities of the home in a way, which meets the choice, and wishes of residents. The home tries to be flexible and attempts to provide a service, which is as individual as possible by using its staff and resources effectively. As far as possible, the residents are consulted on how the home can work to provide them with a flexible lifestyle, and to achieve their wishes. The home has open visiting arrangements and residents know they can entertain their family and friends in their own room. If they prefer they can use communal areas of the home to talk to visitors. Maintaining independence and enabling residents to make their own decisions about Care Homes for Older People Page 13 of 25 Evidence: how they wish to live is a key objective of the home. Residents have the choice to bring personal possessions with them on admission to the home and are encouraged to keep personal items, which are important to them in their own room. It was clear from the menus that a wide variety of different food options were available in the home with a lot of consideration given to the nutritional value of the meals provided. Staff are ready to offer assistance in eating where necessary, discreetly, sensitively and individually, while independent eating is encouraged for as long as possible. The deputy manager consults with residents and tries to meet the preferences and suggested dishes when preparing the menu.During the inspection it was noted that a number of food products have passed their use by dates. This might have an impact on the health and welfare of residents. All food products must be checked on regular basis for their use by date so that people using the service are not put at risk. 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. Complaints are generally managed well, which should ensure that residents and relatives concerns are listened to. Evidence: The home has a complaints procedure that generally meets the national minimum standards and regulations. It keeps a full record of complaints and this includes details of the investigation and any actions taken. Unless there are exceptional circumstances the service always responds within the agreed timescale. The home understands the procedures for safeguarding adults and will always attend meetings or provide information to external agencies when requested. Staff receive regular training in vulnerable adults protection.It was previously required that the registered person must ensure that all staff working at the home including management receives training in adult protection and the mental capacity act as part of increasing awareness and knowledge about safeguarding service users from abuse. Most of the staff are up to date with adult protection training. Training has been arranged for all staff regarding mental capacity act for beginning of December. Presently there is a safeguarding investigation being carried out by the local social services. We will continue to monitor the situation.A copy of Lewishams Interagency Guidelines for Adult Protection has been obtained for staff information as recommended at the last inspection. Care Homes for Older People Page 15 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical environment of the home is generally well maintained. This environment therefore facilitates the health and emotional well being of residents. Evidence: The home provides a physical environment that meets the specific needs of the people who live there. The home is comfortable and has a programme to improve the decoration, fixtures and fittings. The deputy manager stated that all the communal area would be redecorated. Some areas have already been redecorated. The home is not suitable for wheelchair users and it does not have a chair lift or a passenger lift and therefore first floor rooms would not be suitable for anyone with restricted mobility.It is recommended that the worn chairs in the lounge are replaced. It was previously recommended that the registered person should consider ways that service users can be supported to make their bedrooms more personalised. This is ongoing. The home was clean and hygienic on the day of the inspection. The home has suitable laundry facilities sited away from the preparation of food. Care Homes for Older People Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has the skill mix of staff to meet residents needs and ensure their safety. There is a staff training and development programme in place. This ensures that staff fulfil the aims of the home and meet the changing needs of residents. Evidence: Copies of staff rotas show well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the residents. However the manager must consider extra staffing where necessary for the preparation of food. The deputy manager informed that more than 50 of staff have an NVQ level qualification at level 2. Recruitment procedures seemed appropriate. Two new staff files were examined at random and found to contain all the information required by the Care Homes Regulations 2001 including a completed job application, terms and conditions of employment, an enhanced CRB check and proof of their identity. The home recognises the importance of training, and tries to deliver a programme that meets any statutory requirements and the National Minimum Standards. The deputy Care Homes for Older People Page 18 of 25 Evidence: manager is aware that there are some gaps in the training programme however these are being addressed and further training sessions have been arranged. All staff must be up to date with their mandatory training to ensure residents continue to receive care as is reasonable to meet their needs. Care Homes for Older People Page 19 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. The home management generally provides guidance and direction to staff to ensure residents receive consistent quality care. There is a quality monitoring system and this ensures the home is run in a way that is in the best interests of the residents. Evidence: The registered manager has delegated the day to day running of the home to the deputy manager who is also her son with the aim that she would eventually resign from the position and the deputy manager would take over the position. It was recommended at the last inspection that a timescale should be set for when the registered manager would resign and the deputy manager would submit an application to become the registered manager as the long term arrangements for the management of the home needed to be clarified. This has not been addressed at this inspection although the deputy manager reported he is considering submitting an application for registration. Care Homes for Older People Page 20 of 25 Evidence: The deputy manager has achieved a NVQ Level 4 in management and was advised by CSCI that he should also obtain a NVQ Level 4 in care as a way of addressing gaps in knowledge and skills as apart from working at the home as he has not had any other experience of working in the care field. The deputy manager reported that he had started the course in November 2007 however the institution where he was doing the course is no longer operating. The deputy manager is looking into alternative arrangement to complete the course. It was positively noted that the deputy manager has taken actions to address identified shortfalls in respect to the service provided by the home to ensure the home meets with National Minimum Standards. With regards to effective quality assurance and quality monitoring systems, the deputy manager stated that there is now a system in place based on seeking the views of residents to measure success in meeting the aims, objectives and statement of purpose of the home. The deputy manager informed that small amounts of money are kept in separate envelopes for each resident with a running balance sheet appropriately maintained for sundries, such as hairdressing costs. A sample of these was seen and was accurate and well maintained. Receipts of transactions had also been maintained. Staff supervision records were sampled and it was noted that progress has been with regards to the frequency that staff are being supervised. Records with regards to health and safety are of a good standard and are routinely completed. Certificates relating to health and safety were up to date servicing certificates. However a number of fire doors were wedged open. Fire doors must not be wedged open unless held open by a magnetic door holder that responds to the fire warning system for the safety of staff and residents. Care Homes for Older People Page 21 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 22 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 7 12 Residents risk assessement must be comprehensive. To ensure that the needs of residents are being met. 20/11/2008 2 15 13 All food products must be checked on regular basis for their use by date so that people using the service are not put at risk. For the health and wellbeing of residents. 20/11/2008 3 30 18 All staff must be up to date with their mandatory training. To ensure residents continue to receive care as is reasonable to meet their needs. 31/01/2009 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 Care Homes for Older People Page 23 of 25 1 19 It is recommended that the worn chairs in the lounge are replaced. 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. 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!