Inspection on 04/10/05 for Beech Care

This inspection was carried out on 4th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beech Care 08/06/07

Beech Care 30/05/06

Beech Care 28/06/05

Beech Care 12/10/04

Beech Care 14/04/04

Beech Care 18/11/03

Similar services:

Thorndene

Sutton Lodge Nursing Home

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Beech Care Ltd 99 Dunes Road Greatstone New Romney Kent TN28 8SW Lead Inspector Geoff Senior Announced Inspection 4th October 2005 02:00 Beech Care Ltd DS0000023334.V251132.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 Beech Care Ltd DS0000023334.V251132.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. Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beech Care Ltd Address 99 Dunes Road Greatstone New Romney Kent TN28 8SW 01797 362121 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) Beacon Care Holdings PLC Mr David Leslie Hussey Care Home 6 Category(ies) of Learning disability (5), Physical disability (1) registration, with number of places Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The resident with a physical disability should also have a learning disability 28th June 2005 Date of last inspection Brief Description of the Service: BeechCare, 99 Dunes Rd. Greatstone is registered as a Care Home for up to six adults with a learning disability. BeechCare Ltd. is the registered Provider.The Registered Manager.Mr David Hussey is in day to day control of the functioning of the Home. The home is a detached proprty set in a residential area of the seaside village of Greatstone. The accomodation comprises six single bedrooms for the service users. There is a large loung/dining room with access to the enclosed rear garden. Car parking is available to the front of the property. Local facilities (shop, pub, post office and GP) are all within walking distance. Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and was undertaken on 4/10/05 and commenced at 2pm. In the course of the visit the inspector met and spent time with the manager, and spoke generally with all staff on duty. The level of functioning of the service users precluded the opportunity for any meaningful verbal interaction. However the inspector observed, throughout the visit, the staff’s attention to the service users’ immediately expressed needs, their patient, friendly and respectful manner and their treatment of each service user as an individual. The Inspector viewed the premises and inspected a range of records; care plans, daily records, staff files and training records. What the service does well: 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. Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 6 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 Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 7 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): 4,5. The pre-admission information available provides general detail of the service the home aims to provide. The statement of terms and conditions of residence may benefit from additional information to reflect the service offered and the roles and responsibilities of both parties. EVIDENCE: Three of the service users have lived at Beech care for a number of years. Two transferred from nearby homes within the group and were familiar with the service and personnel. The most recent admission was offered the opportunity to visit and stay but it was felt by the sponsoring authority to be in the client’s best interest to expedite the move without delay. The standard format statement of terms and conditions generally complies with the standard. The registered person needs however to ensure that all the requirements of NMS 5.2 (I-viii) are adequately detailed to reflect the individual service provided. Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 8 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): 6,10. Good progress has been made to provide a clearer, more consistent care planning system. The inclusion of further detail and guidelines would assist in providing staff with the information they need to meet service users needs EVIDENCE: Care plans contain an improved level of information in a more accessible format. Staff are required to cross reference entries in the daily reports with the care plan. The manager agreed at the last inspection visit to ensure staff are clear on the ‘how to’ detail in meeting identified goal and targets. The manager reported at this visit that he has discussed with staff but has still to complete the written guidelines in the individual care plans. It was confirmed that issues of confidentiality are highlighted during the induction programme and reinforced through ongoing discussion. There was no public display of confidential or private information Records may be securely stored with access on a ‘need to know’ basis. Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 9 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): 14, 15,17 Staff have a good understanding of service users general support needs. They may benefit from additional guidance /support in providing stimulating pastimes. There is an open and relaxed feel to the home. EVIDENCE: Service users are provided with a varied and balanced diet. Specialist advice has been sought in respect of special dietary needs. It was previously noted that, whilst the Inspector appreciated that the majority of the service user group are near or beyond retirement age and prefer a quieter environment there was little information available to evidence the appraisal or application of meaningful activity or pastimes. There was no further development in this area.The home has a vehicle available for transporting service users to and from trips out and social venues.It was reported however that the space and facility for wheelchairs is, on occasion, insufficient for staff to appropriately supervise and attend to service user needs. Visits by friends and family are welcomed without restriction save the convenience and wishes of the service user. Those unable to visit may communicate via phone and e-mail for information. Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 10 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. Staff have a good understanding of individual support needs and have been reminded to ensure they are provided in such a way as to promote privacy and dignity at all times. The registered person needs to evidence that staff are appropriately trained and competency assessed in the safe handling and administration of medicines in the home. Storage arrangements need to be reviewed. EVIDENCE: Staff are generally aware of issues relating to privacy and dignity when offering personal support and care. The manager agreed at the previous inspection to review the training and competency assessment of staff involved in medication administration, recording and storage. This has yet to be completed. Current storage arrangements need to be reviewed. The home is not in possession of a dedicated cabinet, which may compromise security. Service users are all registered at a local surgery and are subject to regular health checks. Appropriate referrals are made as necessary. Staff complete daily records and shift handovers, which include reference to the general health and welfare of the individual during the shift. The home aims to provide a home for life and would continue to offer care and accommodation for as long as appropriate and possible. Support services would be sought as necessary. The Manager reported that he has approached service user representatives for information regarding arrangements in the event of terminal illness and death of a service user. Responses have been recorded. Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 11 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): 23 The home has a written complaints system. Staff have limited awareness of Adult protection issues, which would protect service users from possible risk of harm. EVIDENCE: It was previously reported that staff spoken to expressed a limited awareness and understanding of Adult protection issues and would benefit from specific training. The manager has obtained the most recent protocol from the local multi agency protection committee. Further training for staff has yet to be arranged. Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 12 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): 29, 30. Here is a good standard of décor and cleanliness within the home. It provides a homely and welcoming environment in which to live and work EVIDENCE: At the time of inspection the premises appeared to be clean, tidy and free from undue odours. Laundry facilities though domestic in scale are reportedly adequate for the needs of the home. Specific equipment has been provided to assist staff and service users where the need has been identified. Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 13 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): 32,34. Recruitment practices provide for the protection of service users. Staff are accessing training courses to enable them to work more effectively with the service users. The staff team is well supported and supervised by the management and is clear about its roles and responsibilities EVIDENCE: Staff were noted interacting with service users in a friendly and non patronising manner. Service users were seen responding to staff without inhibition. It was confirmed all staff have been offered NVQ level 2 training, subject to funding, following the completion of a ‘Foundation for care’ introductory course. Numbers have yet to be finalised. Staff files viewed showed appropriate checks had been undertaken prior to appointment or unsupervised access to service users. Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 14 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): 37,38,39,42 The home is being generally well managed thus, providing a caring and supportive service. EVIDENCE: The manager has yet to verify completion of an appropriate training course. He expressed clear plans and intentions to progress the service in attaining and maintaining the NMS. He recognises and acknowledges areas that would benefit from further development. Time and resources need to be set aside for the completion of administration tasks without detriment to the service users. The home employs a maintenance person to oversee the property. The manager will check the current validity of the electrical inspection report as it has no date identified for re-test. Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X 3 2 Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 2 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 X 3 X x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Beech Care Ltd Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 2 3 3 x X 2 x DS0000023334.V251132.R01.S.doc Version 5.0 Page 16 yes 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 YA42 Regulation 13 Requirement The registered manager ensures so far as is reasonably practicable the health, safety and welfare of service users and staff. Staff, in sufficient numbers,to complete the training requirements of the standard The registered person ensures that service users are safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self harm, or inhuman or degrading treatment, through deliberate intent, negligence or ignorance, in accordance with written policy. Staff should receive training appropriate to the requirements of the standard(this was a req1uirement at the last two inspections) The registered manager develops and agrees with each prospective service user a written and costed contract/statement of terms DS0000023334.V251132.R01.S.doc Timescale for action 30/11/05 2 3 YA32 YA23 18 13 31/12/05 31/12/05 4 YA20 18 31/12/05 5 YA5 5 31/12/05 Beech Care Ltd Version 5.0 Page 17 and conditions between the home and the service user. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA14 Good Practice Recommendations Home to evidence appropriate assessment and consultation regarding leisure and debvelopmental activities.(this was a recommendation at the last inspection) Care plans to include guidelines for staff in order to complete the identified tasks.(this was a recommendation at the last inspection) 2 YA6 Beech Care Ltd DS0000023334.V251132.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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. 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