Inspection on 25/09/08 for Beech Court

This inspection was carried out on 25th September 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beech Court 05/06/07

Beech Court 16/06/06

Beech Court 22/09/05

Beech Court 18/04/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Beech Court 52 Church Lane Selston Nottinghamshire NG16 6EW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mary OLoughlin     Date: 2 5 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Beech Court 52 Church Lane Selston Nottinghamshire NG16 6EW 01773581450 01773581445 beechcourtcare@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Alan Peter Pearce Type of registration: Number of places registered: Mr Alan Peter Pearce,Mrs Lesley Pearce care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Beech Court Care Home is registered to provide personal care for male and female service users who fall within the following categories :- Old age not falling within any other category - OP (23) Dementia - over 65 years of age DE(E) (23) The maximum number of persons to be accommodated in Beech Court Care Home is 23 To accommodate the person named in variation application number V33681 who has dementia and is under the age of 65 years Date of last inspection Brief description of the care home Beech Court, 52 Church Lane Selston, Nottinghamshire is a 23 bedded, care home offering personal care for older people with dementia. The building is a converted rectory with a purpose built extension and is on two floors. There is a passenger lift to Care Homes for Older People Page 4 of 27 Over 65 23 23 0 0 Brief description of the care home the first floor. The home has an easy accessed garden and is located in a quiet corner of the village opposite the church. The fees range from £344.00 to £472.00. Extras payments are needed for hairdressing and Chiropody. The registered Provider provides a fully funded day trip out on an annual basis. Information about the home including the last inspection report is available from the manager. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. A review of all the information we have received about the home was considered in planning this visit including the Annual Quality Assurance Assessment (AQAA), and this helped decide what areas were looked at. The main method of inspection used was called case tracking which involved selecting Care Homes for Older People Page 6 of 27 the care plans of 3 people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. Members of staff, people who use the service and their relatives were spoken with as part of this visit. A partial tour was undertaken, which included looking at people’s bedrooms and communal areas of the home. The last key inspection was done on 05/06/07. What the care home does well: What has improved since the last inspection? What they could do better: The management of controlled medicines must improve to ensure that all medicines have a suitable audit trail in a bound book with numbered pages and that the storage complies with the revised safe custody laws. Improvements are needed to the safety precautions when hand writing medicines by signing the medicine record sheet and having someone else check and sign the entry. To make sure liquid medicines can be audited they need to be dated when they are opened. Medicines that are used on an as required basis should have clear instructions to staff about when they should be given and for what reason. This is particularly important when medicines can cause drowsiness. Care Homes for Older People Page 8 of 27 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a high value on obtaining information before people are admitted to ensure that their needs can be met safely and according to their wishes and needs. Evidence: The way people are admitted to the home takes into consideration the life changing decision that people are making. The home has consistently ensured that people receive a thorough assessment before they agree admission. Relatives tell us that significant time and effort is spent supporting the person and their relatives through the process of the admission and ensuring that any equipment or aids that are needed are in place before people come to stay ensuring that their needs are met at the point of their admission. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to be as independent as possible and their health and personal care is safely monitored and supported by suitable care plans and a skilled staff team. The management of medicines does not fully protect people from harm. Evidence: We saw how staff support people to maintain their independence through person centered thinking and records such as care plans were written to ensure staff supported people to be as independent as possible, taking their wishes into consideration. Where people were identified as at risk of falling they had provided equipment such as variable height beds and alarm mats that reduce the risk to people when they try to get up unaided. People have their health monitored regularly through risk assessments and reviews by the Doctor and District nurses. We saw how people have their nutrition monitored and how staff identify weight loss and access support from external professionals as required. Care Homes for Older People Page 12 of 27 Evidence: People told us they were happy with the way staff care for them. Relatives told us that they are kept fully informed of any changes and are involved in drawing up the care plans which ensures they are in agreement with the services provided. The management of medicines is generally safe but some improvements are needed in ensuring that risks are reduced as far as possible. We found that hand written medicines were not always signed and witnessed which would reduce errors. When people are prescribed medicines on an as required basis or when medicines may cause drowsiness there was insufficient information in the care plan to ensure staff knew the reasons for the medicine being used, its potential effects and possible adverse outcomes. Staff are suitably trained to administer medicines safely and the manager ensures that the medication practices are audited regularly. However we saw that liquid medicines were not always signed when opened and controlled medicines were not recorded within an appropriate record book. Controlled medicines were stored in a safe within a locked cupboard but following discussion with the commissions pharmacist inspector it was confirmed that this does not comply with the revised safe custody requirements to ensure that the medicines are held in tamper proof storage cabinets. The staff we spoke to showed that they were knowledgeable about people in the home and knew how to communicate through verbal and non verbal ways, recognising each individuals needs. Staff training records identified that they receive regular training in the specific needs of people in the home to enable them to undertake their work safely. We saw that staff approached people with respect and showed great sensitivity to maintaining the persons dignity. People told us that they felt safe and cared for. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in meaningful daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. They have been fully involved in the planning of their lifestyle and quality of life. Evidence: We have seen that the service has continually met these standards and the information we received within the AQAA shows us that they recognise the importance of offering people opportunities to participate in activities of their choice. People told us on this visit that they are able to do a variety of things both inside and outside of the home. We saw people receiving visitors, enjoying a drink together and sharing their time either in the privacy of their own room or within one of the two communal day areas. People told us that they go on trips to the sea, visit national attractions and local community events. Care Homes for Older People Page 14 of 27 Evidence: Relatives told us that they are very much encouraged to take part in events, the manager covers the expenses and they always enjoy the opportunities available. Relatives say they are made to feel very welcome in the home, are able to take meals at no charge and can make drinks as they wish. We saw how staff record the nutritional needs of each person and keep records of their dietary intake if necessary. Staff are trained in safe food hygiene practices and also in the control of diabetes and associated diets. A large separate dining room is available which has a hearing aid loop system fitted for people with hearing difficulties. People said they were happy with the meals provided and that they are offered a choice of main meal. We saw how staff go to great lengths to help people celebrate important events such as birthdays. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected from harm and have their concerns taken seriously. Evidence: We have found no slippage in how the service manages complaints or allegations. People continue to tell us that they feel safe and are listened to and taken seriously by staff at the home, they are regularly consulted about the service provided through care plan reviews and in house meetings. The homes records of investigations into 3 complaints since the last inspection, show that they respond to people in a timely way and ensure that people are properly protected through strict adherence to policies and procedures for safeguarding adults. Staff recruitment files show that they always make sure that new staff are confirmed into post only when they have received all appropriate checks such as references and police records to ensure that people are always in safe hands. Staff training records tell us that staff have received regular updated training in how to protect people from abuse and some staff have learned how to manage difficult behaviour without restraint. Care Homes for Older People Page 16 of 27 Evidence: The commission have not received any complaints or safeguarding referrals in the last year. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and safe environment that has aids and equipment to support their individual needs. Evidence: The home was clean and warm throughout with suitable equipment in place to control infection. The environment is made safe for people by the provision of safe hot water temperature to reduce any risk of scalding. People told us about how the manager purchased equipment to manage a persons risk of falling out of bed and ensured that there were sufficient safeguards in place to maintain the persons safety. The external doors are fitted with alarms to help staff be alerted to anyone that may leave the building who may be unsafe to do so. The bathrooms have recently been upgraded and include a specialist adapted bathing system to help people who are unable to bath independently. Care Homes for Older People Page 18 of 27 Evidence: People told us that they can go out into the gardens easily through a level access onto the covered patio area leading into a safe enclosed garden. Staff training records identify that they receive regular training in how to control infection within the home to prevent people from any spread and protect those that are vulnerable to infection. People said they liked their private rooms and we saw how they had been able to bring in their own things from home to personalise them. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are in safe hands at all times from a skilled staff team. Evidence: We found that the manager follows safe practices when staff are recruited to the home, ensuring all pre-employment checks have been completed before they commence working at the home which recognises the importance of the delivery of good quality services and for the protection of individuals. We looked at how people were trained to do their jobs and found that each person receives a six week induction into the home using a recognised national framework for induction. Once people have undertaken induction they then commence on a training course to National Vocational Level 2 in care. We identified how staff continue to update their knowledge and skills in the needs of older people including how to care for people with Dementia showing that they place a high level of importance to meeting peoples individual needs in a person centered way. Care Homes for Older People Page 20 of 27 Evidence: We observed how people were receiving their support and saw that staff follow safe practices when moving people to prevent injury. People using the service said they liked the staff and found them friendly. People told us they have confidence in the staff who care for them. Relatives told us that the staff team are brilliant and that they care for people very well. The AQAA tells us that the manager continues to ensure staff have access to training and development and allows consultation through regular meetings and supervision of the team. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well managed home and have their health and safety protected by safe working practices. Evidence: The manager is also the registered owner of the home and looking at the responses we received through the homes AQAA document we see that he leads and supports a strong staff team who have been recruited and trained to a high standard. It also shows us that he is aware of current developments both nationally and by CSCI and plans the service accordingly. The home have received the Quality award from Nottingham City and County Councils for providing good services in 2008. They offer value for money through the provision of equipment for people in the home to support their needs, exceed the minimum training standards for staff and provide Care Homes for Older People Page 22 of 27 Evidence: private rooms above the National Minimum Standards for space. The people who use the service and their relatives told us that they are always consulted on the care provided and they have opportunities to influence improvements in the home through regular meetings and an approachable and available manager. The manager reviews and updates care practices in the home through regular audits to ensure staff work towards meeting the aims and objectives of the service. We saw how people have their finances protected through safe accounting procedures and secure storage. The home has a consistent record of ensuring the health and safety of the people accommodated. There are low levels of accidents reported. The manager has considered innovative ways to reduce injuries from self closing doors, investing in new mechanisms that do not swing shut and endanger older people who are unsteady on their feet. We examined the prevention of fire within the building and identified that staff follow safe procedures to test the fire alarm system regularly and review fire risk assessments as required. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 You must ensure that the record book for controlled medicines is a bound book with numbered pages and ensure that all liquid medicines are signed with the date of opening. To ensure that there is a suitable audit trail that cannot be altered. 30/11/2008 2 9 13 Controlled medicines must 30/01/2009 be stored in compliance with the revised safe custody law. To make sure that the storage is tamper proof and meets the legal requirement for potent medicines. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Research more person centered care planning models. Care Homes for Older People Page 25 of 27 2 8 Complete a care plan for the use of medicines that are on an as required basis and medicines that may cause drowsiness to ensure that staff are fully aware of the reasons for use, the effects and the need to regularly review the usage. Make sure all hand written medicines are signed and witnessed to reduce any error. 3 9 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!