Inspection on 26/10/05 for Beck House

This inspection was carried out on 26th October 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beck House 21/11/06

Beck House 25/04/05

Beck House 08/11/04

Beck House 29/04/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Beck House 2 Manor Court Beckspool Road Frenchay South Glos BS16 1NT Lead Inspector Paula Cordell Unannounced Inspection 09:30 26th October 2005 and the 3rd November Beck House DS0000003349.V256845.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 Beck House DS0000003349.V256845.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. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beck House Address 2 Manor Court Beckspool Road Frenchay South Glos BS16 1NT 0117 9573177 0117 9566050 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) Mrs Marilyn Joan Clarke Mrs Wendy Elizabeth Newell Care Home 14 Category(ies) of Learning disability (14), Physical disability (14) registration, with number of places Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 14 persons aged 19 - 64 years Date of last inspection 26th April 2005 Brief Description of the Service: Beck House is located in the village of Frenchay approximately four miles from the centre of Bristol. It is in a semi rural location close to Frenchay Common and there are shops and other community facilities within one mile of the home. The home is one of four within the Manor House Organisation which also provides day care at the Bingham Centre. Beck House is adjacent to the Manor House and shares this site with the day centre and respite care service for children with learning disabilities, Alice House. The other home is Kendall House, which is in Warmley. Beck House is registered to provide accommodation and personal care to fourteen people with a learning disability. Presently the home has five vacancies. The home has three double rooms. There are plans for an extension of the home that could lead to the provision of all single rooms. The philosophy of the home and the organisation is concerned with dignity and respect, independence, participation, valuing people, equality, rights and working together. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The purpose of the visit was to review the progress to the requirements from the inspection in April 2005 and monitor the services provided to the residents living at Beck House. There have been no additional visits during this period. The home has been keeping the Commission for Social Care Inspection informed of the incidents that affect the wellbeing of the individuals living at Beck House and the provider has sent monthly appraisals of the service. The inspection was conducted over two days as there were no residents in the home on the first day of the inspection. The inspector had an opportunity to meet with four staff on the first day, the residents and the manager on the second day. Many of the residents accommodated at Beck House are non-verbal and communicate using gestures and sounds. This made it difficult for the inspector to seek the views of the residents living at Beck House. An opportunity was taken to view the home and a number of the records relating to the management of the home and plans of care for three of the residents. The home has demonstrated compliance with all the requirements and recommendations from the last inspection. What the service does well: The home has supported residents with a learning disability for many years. A number of residents have lived in the home for the past forty years since childhood. The service provided to them has grown and developed and moved with the changing needs of the residents and is based on current good practice and legislation. There is a strong commitment to provide residents with an individual life making full use of the community, living within a homely environment. Residents have a wide range of activities available to them. All residents have access to an external day centre in the community five days per week, demonstrating a commitment to providing residents with activities and occupation. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 6 There is a strong commitment to ensuring that staff have the core skills and competence to support the individuals in the home and these are continually built on. What has improved since the last inspection? What they could do better: There are three requirements and four recommendations from this inspection. The home must ensure that they are operating within their certificate of registration and apply for a variation to include one named person with dementia. A resident would benefit from having clear documentation in the plan of care on the risks identified in the care plan from Social Services. In addition the home must consult with Social Services on the recent bedroom change as this Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 7 is detailed in the Social Services care plan and forms part of the contract with the organisation. The residents would benefit from the kitchen being refurbished. Residents would benefit from having a dishwasher as part of the refurbishment of the kitchen. Residents and staff would benefit from manual handling assessments being clear and where amendments have been made these should be rewritten. Residents would benefit from the home seeking guidance from the prescribing doctor on homely remedies in respect of each individual living in the home further safeguarding the residents. 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. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 8 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 Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 9 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): 1,2,3,4,5 The home was meeting the assessed care needs of the residents and there is adequate information to enable individuals to make a decision about whether to move to Beck House. The home is operating outside of the conditions of registration and must make an application to include one named person with dementia. EVIDENCE: The home has a statement of purpose, a service user guide and individual contracts. This meets with the legislation. The statement of purpose has recently been reviewed and amended to include daily staffing in response to a requirement from the inspection in April. Information seen was available in plain English and the home has used photographs and symbols. Consideration should be taken whether this should be available in an audio or video format to capture a wider audience. The statement of purpose and the service user guide was accessible to individuals living in the home and displayed on a notice board in the hallway of the home. Staff stated that two of the residents from the Manor House were in the process of moving to Beck House. It was evident from records and talking with staff that the individuals concerned were visiting the home on a regular basis to ensure that the move was appropriate for the individuals and that the home Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 10 could meet their needs. Visits included afternoon, evening and overnight stays. Staff stated that this was being undertaken over a period of eight weeks. Relatives had been consulted on the move. Information was available to staff to ensure that the move was successful and ensure that the care was consistent including a care plan and risk assessments. The home has an established group of residents. The last resident to move to the home was in 1990. One of the residents has received a service since childhood, when they first lived at the Manor House. The home was evidently meeting the care needs of the residents presently accommodated at Beck House. Plans of care were being reviewed and adapted to meet the changing needs of the individuals, involving other professionals in the process. The home is registered to provide personal care and accommodation to individuals with a learning disability and physical disabilities. From discussion and an individual’s care records it was evident that one of the individuals had a clear diagnosis of dementia and this was a focus of the care provision rather than their learning disability. The home must apply for a variation to the conditions of registration to include one named individual with dementia. This will ensure that the home is operating within the conditions of registration. Staff confirmed that dementia and loss and bereavement training was planned to assist with supporting the individuals changing care needs. It was evident that the home could continue to meet the care needs of the individual, however, this must be kept under review to ensure that this does not compromise the care of the other individuals living in the home. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 11 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): 6,7,8,9,10 Care plans were in place for each individual detailing the support needs and how these were being met. Risk assessments were commendable in detail however the home failed to document how the home was reducing risks for one individual as per the Social Services plan of care. EVIDENCE: Care plans were seen for three of the individuals living in the home. These clearly described the support needs of the individuals. Care plans were being reviewed at regular intervals describing how the care needs of the individual were changing. Care plans were evidently derived from an assessment drawn up by the placing authority and the home. Care plan reviews were being completed by the home at least every six months by the resident and the care staff and then annually with relatives and day care placements. The home is responding to residents who are getting older and the associated issues. Other professionals were involved in the planning of the care complimenting the skills and the knowledge of the staff team. Assessments and management of risks arising from care plans and safety in and out of the home had been undertaken. The inspector commends the Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 12 service for the approach to risk assessments, which covered all activities undertaken. Documentation provided evidence that the risk assessment tool ensured the safety of residents but did not curtail or inhibit residents and encouraged independence and community participation. This is good practice. However, one individual had recently moved bedrooms. From reading the care plan from Social Services it was evident that additional risks, which were identified, were not documented by the home and strategies for reducing the risk. In addition the plan identified that the individual should be close to the sleep in staff and the change of bedroom had meant that the individual was further away down a corridor and through two fire doors. The change of room must be discussed with Social Services and a risk assessment completed on the individual’s new room. There was documentation on the use of a monitor in a resident’s bedroom this detailed the decision process and had been kept under review. The home has demonstrated compliance to a previous requirement. Residents had opportunities to voice their opinions at care reviews and at the regular resident’s meetings and via the quality assurance audit in the form of a questionnaire. The home uses communication aids to enable and encourage discussions in meetings and in the day-to-day activities in the home. Residents were observed returning from their day placements. Residents were keen to share with staff the happenings of their day. Conversations were inclusive of the residents. Some of the residents have limited communication and staff were patient and showed a willingness to assist residents and spend time to fully understand what was being said. The atmosphere in the home was relaxed and friendly. All records were held securely relating to the care of the individuals living in the home. The home has a confidentiality policy. Staff were observed discussing information of a confidential nature in an appropriate place. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 13 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): 11,12,13,14,15,16,17, Residents are encouraged to lead active lifestyles both in the home and the local community. Residents have built positive relationships both in the home and with friends and families. Residents have available to them a balanced and nutritious diet. EVIDENCE: There was information in care records demonstrating how the home was meeting the social, emotional and psychological needs of the individuals. There was information about interests and hobbies. Evidence in daily records was that the activities were structured to the individual. Residents had an opportunity to have an annual holiday. This year seven of nine individuals went to Dawlish or Minehead. A senior carer stated that two of the residents are going on day trips due to changes in staff and health issues. These were being planned and discussed at the staff meeting and being arranged. It was evident that the residents were the focus of the planning and were involved in the decision process. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 14 Staff were observed communicating in a positive and inclusive manner to the individuals living in the home. Residents were observed moving freely around their home. Where restrictions were imposed, for example the stair gate, this was clearly documented with the reasons and kept under review. Residents had a combination of day centres and college courses made available to them. All residents had access to a five-day activity plan. The home has available to them a number of vehicles to enable residents access to the community, which are shared with the other two homes on the Manor House site. Care records demonstrated that residents had access to and choose from a range of leisure activities supported by the staff team. This included trips to the cinema, theatre, trips to places of interest, shopping trips or just a walk around the common adjacent to the home. It was evident from talking with staff that the home was ensuring the balance of an ordinary home life where residents could relax in their own home and participate in organised activities. Residents were observed relaxing in the kitchen area of the home and interactions were positive. Residents appeared relaxed and at home with their surroundings. A resident stated that they liked living at Beck House with their friends. Residents were observed going to their bedrooms and relaxing in other areas of the home. Residents were observed seeking out staff to assist them with activities. A relative raised a concern that their sibling spent significant time in their bedroom and when they first arrived there was no music or television to occupy them. Staff stated that the individual spends time, both in their bedroom and in the lounge and when in their bedroom staff spend time and check at 15-minute intervals. On the whole however the relative was happy with the care being delivered by Beck House. Staff support residents to maintain contact with relatives and friends. This includes telephone conversations and arranging visits and organising transport. A record was in place confirming this. This formed part of the home’s quality audit. This is good practice. It was clear from talking with the staff that this was seen as a fundamental role of the carer to support individuals in making and maintaining relationships with friends and relatives. Staff stated that all main meals are prepared at the Manor House and residents have a choice available. Where residents prefer a snack this can be made at Beck House. Staff stated that residents did not get involved in the catering and preparation of the meals so this does not hinder residents independence but releases care staff to spend more care time with individuals. This should be Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 15 kept under review to ensure that this does not hinder the independence of the individuals or that an opportunity is taken away that reflects ordinary living. The home has demonstrated that they have met the standards relating to lifestyle. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 16 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): 18,19,20,21 Resident’s personal and health care needs were being met including addressing the ageing process and the care needs of the individuals in the events leading up to their death. EVIDENCE: Care plans clearly documented the personal and health care needs of the residents. Systems for monitoring an individual’s wellbeing were in place and concerns about health were quickly addressed. Residents had access to other health professionals including a GP, opticians, chiropody, dentist and the community learning disability team. The home records all health checks in a collective diary and this information is transferred to the individual’s care records by the key worker/co-coordinator. This practice should be reviewed to ensure that confidentiality is maintained. Staff have attended training in first aid and manual handling. The home has developed a comprehensive planner for training to ensure that periodic updates are undertaken. Plans of care included individual assessments for manual handling. Whilst these were being kept under review. Residents had two manual handling guidelines. One contained additional comments and amendments. Where Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 17 information is not current this should be archived and where amendments have been made rewritten to reduce confusion for staff. Training for staff was in place relating to manual handling. It was evident that the physiotherapist and the occupational therapist had been consulted on the care needs of the individuals and aids and adaptations put in place where recommended. The home has robust procedures and practices on the administration of medication, including a comprehensive induction and training package for staff. Policies and procedures were in place to guide staff and information was sought as part of the assessment process on how individuals would like to be supported in the event of a death including contacts. Residents and relatives had been involved in the process. This is good practice. Training is being planned for all the staff team in bereavement and loss and dementia awareness to assist with the support to the individuals that are getting older. This is in response to a recommendation from the last inspection. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 18 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 The home has robust procedures for the protection of residents and responding to complaints. EVIDENCE: The home has a robust complaints procedure in place. The home’s record of complaints provided further evidence that residents are protected in that the home has complained about the conduct of two agency nurses. This is good practice. Residents meetings also covered concerns or complaints. These included the actions to alleviate the concerns raised. The home has procedures for the protection of individuals living in the home including an abuse, bullying, anti-racism, financial, gifts and a whistle blowing policy. Staff were aware of the procedures to safeguard residents. There was a requirement for the home to ensure that staff undertake training in prevention of abuse. Training was being arranged by the Organisation and a senior manager has attended a ‘training the trainer’ course on abuse. The plan is for this to be cascaded to all staff over the next six months. Training records provided evidence that staff attend yearly updates on ‘Nonviolent Crisis Intervention’ and this was compulsory training for all staff. Finances were checked. These were found to be satisfactory and safeguards were in place to protect the individual’s monies including regular checks, receipts and two staff signatures. The home has responded to a requirement to ensure that the travel tokens are treated in the same way as individual personal allowances with a record of expenditure and kept individually. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 19 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 Residents benefit from a homely, comfortable and clean environment, which meets their individual, and collective care needs. EVIDENCE: Beck House is a detached property in the grounds of the Manor House. The home was clean, well decorated and well maintained. Accommodation is on three floors and there were two staircases accessing the second and third floors. The home has three double rooms. All bedrooms have adequate furniture as per the standard and a sink. It was noted that some of the sink plugs were missing. These must be installed unless a risk assessment demonstrates otherwise. All bedrooms seen were personalised and reflected the individual’s taste. It was noted that many of the bedrooms are not fitted with a lock to enable the individual privacy. Risk assessments were in place detailing the decision process. Staff stated that none of the residents have a key to their bedroom door. There was no evidence that residents had been consulted in the process. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 20 One of the residents has recently moved from a double bedroom to a single room, which is further from the sleep in room. It was noted that the individual’s care plan from social services, which forms part of the contract with the home, stated that the individual must be close to the staff and should not have a sink in their room for fear of flooding and there was a risk with plug sockets. There were no risk assessments identifying these risks and the strategies in place to ensure the individual’s safety. Staff stated that this was low risk. However, it was noted that in the individual’s previous bedroom, the plug sockets had been covered. The change of bedroom and the risks must be discussed with the placing authority and, if relevant, the contract should be amended to reflect the changes in the individual’s plan of care. The home is registered for individuals with a physical disability. There are two ground floor bedrooms. However it must be noted that the only access to the other two floors is by a staircase and would not be suitable for individuals with a physical disability. All communal areas were on the ground floor including a lounge, conservatory and spacious kitchen. The kitchen is looking tired and worn on drawer fascias. The home must replace this within the next twelve months. Residents have access to a secure garden to the rear of the property. Bathrooms have been fitted with locks since the last inspection in response to a requirement. It was noted that two of the bathrooms did not contain toilet paper, hand towels and soap. The domestic addressed this in the afternoon although it was discussed with the carers in the morning. A toilet seat was missing from a bathroom on the first floor. There is manual handling equipment including a bath chair and toilet raisers. Some residents have specific seating to improve posture and assist with mobility. Evidence was available that the equipment in the home was checked at periodic intervals. Evidence was provided that repairs were responded to in a prompt manner, and that routine audits were completed relating to the fitness of the premises and appropriate action was taken where required. The home has had planning agreed to extend Beck House to provide additional accommodation for six individuals. As part of the extension the home is planning to install a lift. The Commission for Social Care Inspection has yet to receive an application for the changes to the premises and the home’s registration. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 21 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): 31,32,34,35,36, Sufficient and competent staff meet the care needs of the residents. Residents are protected by thorough recruitment processes. However, communication systems could be enhanced if clear guidelines were developed. EVIDENCE: There were three members of staff working in the home on the morning of the inspection, in addition to a domestic. During the afternoon there were six staff working in the home with no residents for a period of two hours. It would be advisable to review staffing. Staff stated that residents are at their day centres five days a week. The home was adequately staffed to meet the care needs of the residents according to the statement of purpose. In addition there were additional staff employed on a regular basis to provide residents with opportunities to go out socially. There was a senior carer on duty at all times and they provided the sleep in cover and support to the waking member of staff. Senior carers were responsible to manage the shifts on a daily basis and administer the medication. From conversations with staff it was evident that they were aware of their roles and the expectations of the service. Job descriptions were in place to guide staff. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 22 Staff spoken with during this inspection described a good level of job satisfaction. It was evident from reading the staff communication record that there was some conflict between some staff and this was being used as a vessel. Staff were aware of the comments but stated that this did not affect the day-to-day care of the residents. However, it was evident that staff were criticising each other for standards of cleanliness in the home for example washing up, cleaning toilets and laundry. There were also pages removed from the communication book. The home must review methods of communication within the home to ensure that there is an avenue to discuss their grievances, which is more appropriate. There were messages left for staff that should have been confidential to a resident and should not have been documented in the communication book but in the resident’s daily care records with a reference for staff to read the individual’s records. Staff described good support networks in the team including supervisions, team meetings and ongoing training. These were audited by the home and were part of the Home’s business plan and quality targets. This is good practice and demonstrated a proactive service that regularly reviews the quality of the service. There was a training plan for each member of staff. From training records there was a commitment to ensuring that staff attend regular training relevant to their role based on the care needs of the individuals. All staff were planning to attend protection of vulnerable adults training if they had not already attended, dementia and bereavement and loss was planned for all staff over the next six months. Health and safety training was in place including periodic updates. These included manual handling, first aid, food hygiene and fire and all staff attend non-violent crisis intervention which is updated annually. This level of training is commended. Other training noted was person centred planning, equality and anti-discrimination practice to name a few. On the second day of the inspection the manager was available and recruitment records were seen for three members of staff. These demonstrated that thorough recruitment practice was undertaken prior to staff taking up employment in the home. This included a completed application, two references, evidence of proof of identity and a POVA first and a criminal record bureau check being completed. The home has demonstrated compliance with an outstanding requirement. Once a member of staff is employed in the home. They complete a comprehensive induction after which they will proceed onto completing an NVQ 2 or 3 in care. There is an expectation for senior care staff to have an NVQ 3 in care. Two staff out of the four senior carers have completed this. However, one member of staff has a nurse qualification and the other is an occupational therapist. It was not clear how the organisation came to the conclusion that the occupational therapist qualification is equivalent to an NVQ 3 in care as the roles are very different. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 23 The manager stated that three care staff have an NVQ 2 and one person is in the process of registering. The home is demonstrating a commitment to ensuring that 50 of the workforce have an NVQ 2 or equivalent. Staff were knowledgeable about their roles as carer and the care needs of the individuals living in the home. There was a strong commitment to providing individuals with a quality service in a homely atmosphere and enabling individuals to make full use of the local community. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 24 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): 37,38,39,41,42,43 Residents benefit from a well managed and safe home with a strong commitment to providing a quality service. EVIDENCE: Mrs Newell has managed the home for the last five years. There was evidence that she has completed the registered manager’s award and a variety of training relevant to the care setting. Staff spoke positively about her support and guidance. There were good systems of communication between staff including daily handovers, records and meetings both for staff and residents. This demonstrated there was an open culture and support mechanisms both for staff and the residents. However, as previously mentioned staff need clear guidelines on the information that should be included in the staff communication book to ensure the privacy of the resident and to protect staff. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 25 The home is commended on the quality assurance systems in place ensuring that Beck House provides a quality service. Audits were completed on aspects of the home including seeking the views of the residents and their relatives. Comments from residents and their relatives were positive. In addition the provider completes a monthly audit on the home in respect of the Care Homes Regulations. The Commission for Social Care Inspection is receiving copies of these. Health and safety in the home was monitored both by the manager and an organisational health and safety committee. Where shortfalls are identified these were responded to promptly and appropriately. Health and safety training for staff was in place to ensure that residents are protected and supported by competent staff. Fire records including the fire risk assessment were found to be all in order including the checks on the equipment, fire drills and training. The home has an extensive policy file to guide staff and support the residents. Staff stated that these had been discussed as part of the induction process. A significant number of the policies have been reviewed in the last twelve months. It was evident that the residents were the focus of the policies and procedures. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 26 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 2 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 2 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Beck House Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 X DS0000003349.V256845.R01.S.doc Version 5.0 Page 27 No 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 YA3 Regulation Care Standards Act 13 ((4) (a-c) Requirement For the home to apply for a variation to the conditions of registration to include one named person with dementia. The home must ensure that all risks identified in the Social Services plan of care are documented on the home’s risk assessment format detailing strategies for minimising the risk whilst ensuring the skills and independence of the individual. To replace the kitchen. Timescale for action 26/11/05 2 YA6YA9 02/11/05 3 YA28 23 (2) (b) 26/04/06 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 2 3 Refer to Standard YA28 YA26YA6 YA20 Good Practice Recommendations Consideration for the home to install a dishwasher To contact Social Services re: the change of bedroom for one individual as reference is made in the plan of care to the bedroom next to the sleep in room. To ensure manual handling assessments are clear where DS0000003349.V256845.R01.S.doc Version 5.0 Page 28 Beck House 4 5 YA10 YA20 there are amendments for the home to rewrite. For the staff to have guidelines on lines of communication relating to the communication book ensuring confidentiality of both the residents and the staff. Seek guidance/authorisation on the use of homely remedies for the individuals living in the home. Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 29 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 Beck House DS0000003349.V256845.R01.S.doc Version 5.0 Page 30 - 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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