Inspection on 16/01/06 for Beech Close Care Home

This inspection was carried out on 16th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Beech Close Care Home 20/09/07

Beech Close Care Home 24/04/06

Beech Close Care Home 25/07/05

Beech Close Care Home 16/11/04

Similar services:

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

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

CARE HOMES FOR OLDER PEOPLE Beech Close Care Home Beech Close Desborough Northants NN14 2NP Lead Inspector Mrs Sheila Smith Unannounced Inspection 16th January 2006 10:00 X10015.doc Version 1.40 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 Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 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 Older People. 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 Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beech Close Care Home Address Beech Close Desborough Northants NN14 2NP 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) 01536 762762 01536 762313 www.shaw.co.uk Shaw Healthcare (de Montfort) Ltd Mrs Rose McClarnon Care Home 42 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (7), Old age, not falling within any other category (42), Physical disability over 65 years of age (6) Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. No one falling within the category of DE (E) may be admitted into the home where there are 12 service users who fall within the category of DE (E) already accommodated within the home No one falling within the category of PD (E) may be admitted into the home where there are 6 service users who fall within the category of PD (E already accommodated within the home No one admitted for intermediate care may be accommodated outside of the designated intermediate care unit No one falling within the category MD (E) may be admitted into the home where there are 7 service users who fall within the category of MD (E) already accommodated within the home. Service Users within the category MD (E) can only be accommodated in the area designated as flat 1 bedrooms 1 to 7 as detailed in the plan submitted to the commission on 04.01.05 No one falling within the category of MD (E) can be accommodated in any room outside of the area designated as Flat 1. 25/07/05 2. 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Beech Close is a home providing personal care to 42 residents in the old age, dementia and physical disability categories. The home is situated within the residential area of Desborough and is close to local facilities and amenities. The premises were purpose built some years ago and provide single rooms and a range of communal areas for the residents. These include small lounge areas within the 6 accommodation areas known in the home as ‘flats’ and ‘the Street’ area offering a variety of services including hairdressing, tea bar, library, shop and quiet room. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for Residents, and upon their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting 2 residents and tracking the care they receive through review of their records, discussions with them, and with the care staff, and observations of care practices. The inspection took place during a weekday over a period of 5 hours and was carried out on an unannounced basis. Communal areas, and some bedrooms were visited. A selection of care records, and essential records of the home were reviewed. A number of the residents, staff and a visitor to the home were spoken to as part of the inspection process. The Registered Manager Mrs Rose McClarnon, was available throughout the inspection. What the service does well: Beech Close has good admission procedures, which ensures that the home is able to meet the needs of residents. Residents confirmed that the home met with their expectations, expressed satisfaction with the facilities provided and were confident that their needs were being addressed. Residents are encouraged to maintain their independence for as long as possible and to maintain links with relatives, friends and the community. Residents spoken with, highly commended the Registered Manager and the staff, and feel that they are able to talk to them about anything, and that any concerns raised will be dealt with in a professional way. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 6 Members of staff appeared to have the knowledge and skills required to care for the current residents, and there was evidence that Shaw Healthcare Ltd., aim to provide a wide range of training, to meet the needs of the residents. What has improved since the last inspection? What they could do better: Care plans should be updated at the monthly reviews to ensure that the current needs of the residents are recorded, and agreed with the residents. The care plans and associated risk assessments would benefit from containing more information that give detailed instruction and guidance to the staff in the provision of care and support to the residents. The daily records should be a ‘pen picture ‘ of that resident’s life in the home Currently the records do not always contain sufficient information Residents would benefit from having a programme of group and individual activities. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 7 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 Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,5 The assessment of prospective residents prior to their admission to the home ensures that residents and their families can be confident that the home can meet their needs. EVIDENCE: The Registered Manager said that she visits all prospective residents to assess whether the home will be able to meet their needs. There was evidence in the case files seen that an assessment had been made prior to their admission, and that the prospective residents had been involved. Newly admitted residents could recall the visit being made, and of receiving written information about the home to enable them to make an informed choice of where to live. A contract is in place for each resident. This agreement clearly sets out the terms and conditions of occupancy, and had been signed by the resident. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 10 Prospective residents and their families are encouraged to visit the home, prior to admission to enable them to make a decision. Each admission is followed by a trial period to assess whether the home is able to meet the identified needs. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10,11 The current practice ensures that the health care needs of the residents are met. EVIDENCE: Care plans for residents did not always reflect the care that staff provided. The care plans seen through the case tracking did not provide sufficient information to care and meet the individual needs of residents. For example one resident required assistance with bathing but the plan did not specify in detail the care required. Assessments that had been undertaken and the information gained through these were not maintained and reviewed regularly. Risk assessments were not in place, for example a care plan indicated that a frail resident was able to make hot drinks, but there was no risk assessment relating to this task. Waterlow assessments were in place but either not completed, or reviewed. Activities were not recorded. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 12 The daily records did not always record outcomes, for example one record indicated that a resident was unwell two days before the inspection, but no record was made of his illness, or of his recovery during the following days. Care plans were not always reviewed on a monthly basis, although residents confirmed that they were aware of the care plan and said that they were invited to contribute to the review. All residents have access to the usual healthcare facilities, and residents confirmed that the Doctor was called if they were ill. A relative said that staff always informed her if her Mother was unwell, and expressed satisfaction in the care of her Mother whose health had deteriorated in recent months. The home has always had a local contracted pharmacist, however on the day of the inspection the pharmacist covering the home had been changed to Boots and to a monitored dosage system. Staff were working hard to install the new system, and therefore the medication was not checked in depth, and has been left to the next inspection. It was noted that each flat had a safe secure storage system, and the records that had been put into place were correct. Staff responsible for the administration of medication have received appropriate training. From discussion with the member staff, about how the residents needs are met, it was evident that the staff have a sensitive approach to the provision of personal care, and are aware of privacy, dignity and independence issues. Residents confirmed that staff always knock at their bedroom doors and at the front door of their flat before entering. The Home is committed to caring for residents who are dying for as long as possible, with the support of the primary health care teams. Good support is provided for pain relief and bed care. Relatives are kept informed of changes and welcomed to spend as much time as they wish to in the home. A member of staff commented that the Registered Manager encouraged staff to sit with residents who were ill, and that the Company had provided relevant training. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14,15 There are good opportunities for residents to make choices in their lives enabling them to live as independently as possible. EVIDENCE: Residents commented that there was little in the way of social activities provided at the home, as staff were generally too busy dealing with other matters, although thy did enjoy their bingo sessions. The care plans were not sufficiently developed to include social and recreational needs. For example one assessment examined indicated that prior to admission to the home a resident was a member of a local church group, and that she enjoyed knitting and reading. The care plan did not specify how these needs would be met within the home. There was no indication of individual activities recorded within the file. The Registered Manager said that she had recently employed an activity organiser, to develop this area of care, and also by relieving care staff of the responsibility of preparing the tea, would encourage more activities to take place. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 14 The staff enabled residents to maintain contact with whosoever they wish to, Relatives spoken to during this inspection confirmed that they could visit the home at any reasonable time, and were made welcome. Residents interviewed said that they were happy with the routine at the home and felt able to follow their own interests when they wished. Residents were observed to be making choices about how they filled their day; some were reading others were watching television, whilst others preferred to spend their time in the ‘street’ area of the home, having coffee and talking with their friends. Most of the residents were positive in their comments about the food provided, although some had been disappointed in the quality of the fish provided on the day of the inspection. The Registered Manager said that she would investigate the problem. The home provides a four-week menu, with two alternative choices of the main meal. Breakfast and tea are lighter meals and again choices are available. The menu for the main meal on the day of the inspection was Fish and Chips, Chicken nuggets, or Beef salad, followed by Bread and Butter Pudding. Fresh fruit is always available. The cook demonstrated that she had the knowledge and skills to provide food required by the residents, and could offer a range of special diets. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Complaints are handled objectively and residents are confident that their concerns will be listed to, taken seriously or acted upon EVIDENCE: A complaints procedure is available and residents were aware of whom they could complain to. The records held by the home and by the Commission of Social Care Inspection confirmed that no complaints had been received, since the last inspection. A relative said that she would complain in the first instance to the Registered Manager and was sure that she would investigate and deal with it in a professional way. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20,26 The environment provides safe comfortable surroundings and is maintained to an acceptable standard. EVIDENCE: The décor in the home and the furnishings are becoming worn, but the Company have submitted a redevelopment programme to the Commission for Social Care Inspection, due to commence in April 2006, therefore requirements have not been made at this inspection. The home is divided into six separate units each unit having a communal lounge and kitchen area. Facilities are available for those who are able to make drinks on the units, and staff were seen preparing mid morning drinks in the individual units. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 17 Smoking is not allowed on the individual units. For those Residents who smoke there is an area on the ground floor, which they can use, which doesn’t impact on other Residents. Residents said that they were satisfied with the standard of their rooms and that the staff who cleaned the rooms ‘were very particular’. Resident’s rooms seen during the inspection contained personal possessions. The ‘street’ area, provides a good-sized comfortable communal space where residents can meet each other for coffee, visit the hairdresser or purchase items from the shop. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29. The staff team are experienced, and knowledgeable about the resident group, and committed to improving the quality of life of the people they care for. EVIDENCE: Additional staff have now been employed to prepare the tea, thus relieving the care staff from this responsibility and allowing them to spend more time with the residents. Discussions with staff indicated that they had a good understanding of their own job descriptions and that of other staff deployed with them. Observations were made of staff engaging appropriately with residents who seemed comfortable and relaxed in their company. A newly appointed member of staffs file was examined, and seen to evidence a thorough recruitment process with appropriate references and Criminal Records Bureau clearances being obtained before appointment. In discussions with the Registered Manager, it was clear the home maintains a good supervision system, and that training is targeted and specific to individual staff need. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 The Registered Manager offers a clear sense of leadership, which reflects on the day-to day delivery of care practices of residents and the general running of the home. EVIDENCE: The Registered Manager has been employed to manage the home for a number of years, and it was evident through discussion and review of documentation that she is knowledgeable and competent to run the home. Over the past few years the home has undergone a long period of change and uncertainty, through a change of ownership, nevertheless staff interviewed stated they feel there is an open and inclusive atmosphere within the home, and that they feel supported and able to make suggestions openly. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 20 During the inspection the Registered Manager was observed communicating and interacting with residents and staff in a relaxed and professional way. There are a number of quality assurance systems in place in the home. These include Management checks, and audits, supervision for staff, staff meetings, and questionnaires. Staff have responsibility for cleaning certain areas of the home and sign when they have completed them. It is the Home’s policy only to look after small amounts of spending money. Where such assistance is requested all transactions seen appeared to be properly recorded and receipted. All areas of the home seen appeared to be safe. A maintenance person is employed, and records of testing the fire alarms and emergency lighting were seen and found to be up to date. During the inspection the water system was being tested for Legionnaires Disease, and the Registered Manager said that regular maintenance of the equipment was up to date. Staff and residents confirmed that equipment is replaced or repaired, and observations made during the inspection confirmed that the residents live in a safe environment. A member of staff demonstrated that she was aware of her responsibilities regarding health and safety, and of the reporting procedure for faulty equipment. Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X 3 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard 7 7 12 Good Practice Recommendations The care plans should be developed to include sufficient instruction and guidance for staff in the provision of care Residents risk assessments should be developed to include instruction and guidance to staff in how to manage and how to minimise any identified risk A programme of meaningful activity should be developed, in line with the likes and wishes of the residents, Beech Close Care Home DS0000060165.V276876.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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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