Inspection on 22/02/06 for Beech House

This inspection was carried out on 22nd February 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 House 21/01/07

Beech House 29/03/05

Beech House 24/01/05

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Beech House 11 Prowse Close Thornbury South Glos BS35 1EG Lead Inspector Melanie Edwards Unannounced Inspection 22nd February 2006 09:30 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 House DS0000020316.V276166.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 House DS0000020316.V276166.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beech House Address 11 Prowse Close Thornbury South Glos BS35 1EG 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) 01454 412266 01454 412000 Beechcare (Thornbury) Limited Mrs Judith Peachey Care Home 55 Category(ies) of Old age, not falling within any other category registration, with number (55) of places Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate up to 55 persons aged 50 years and over who are receiving nursing care Staffing Notice dated 15.2.02 applies Manager must be a RN on parts 1 or 12 of the NMC register Date of last inspection 15th September 2005 Brief Description of the Service: Beech House is a purpose built nursing home, situated at the head of a private housing development, close to the centre of Thornbury in South Gloucestershire. Thornbury is a market town with a wide range of shops. It is easily accessible to both the M5 and M4 Motorways. Beech House has been trading since January 2001 and is one of three homes run by the Groundmount Group. The other homes are in Almondsbury (Glebe House) and Horfield in Bristol (Field House). Beech House has been built to the highest standards and is tastefully decorated throughout. Furnishings offer a high level of comfort. Care is provided for 55 service users in 49 single rooms and 3 double rooms, all with en-suite facilities. There is a large conservatory on the ground floor, with two other lounges and dining rooms. The home has two lifts therefore the home is fully accessible. The gardens are to the rear and to one side of the property. There are two paved areas complete with garden furniture that provides an area to sit out in good weather. A gazebo has been completed that will provide additional outdoor space when the good weather returns. Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Twenty-one residents and several visitors were consulted to find out their views of the Home and the service provided and what daily life is like for residents. The registered manager, one registered nurse, three care assistants and the chef were also consulted about their roles and responsibilities, training needs, and how they assist and support residents. Residents were observed being assisted with their needs by staff. A selection of records relating to the day-to-day running and management of the Home were inspected. A range of resident’s care records and care plans were also reviewed. The majority of the environment was seen; the only areas not viewed were a small number of resident’s bedrooms. What the service does well: What has improved since the last inspection? What they could do better: Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 6 Residents’ best interests would be better protected if the fire safety risk assessment of the Home was reviewed more regularly to ensure it is up to date and best suits the Home. To better protect residents safety there should be written records of bedrails checks. This should help ensure the checks are kept up to date, and bed rails continue to be maintained in working order. To benefit one resident, the written medication administration protocols for assisting the resident in the administration of their medication, need to be expanded to better reflect their changing needs. 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 House DS0000020316.V276166.R01.S.doc Version 5.1 Page 7 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 House DS0000020316.V276166.R01.S.doc Version 5.1 Page 8 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): 3,4 Residents’ assessed needs are well met by the Home. EVIDENCE: Five residents assessment records were reviewed to ascertain how residents’ care needs are assessed. Generally assessment records were informative, and showed the residents had been consulted with to ascertain the range of physical, mental and social needs they have. A physiotherapy assessment is also carried out, that is funded by the Home for all new residents, demonstrating a commitment by the Home to ensuring residents’ range of needs are fully assessed. During the inspection the physiotherapist was observed working in the home carrying out assessments of residents needs. There were many comments of satisfaction expressed by residents about the care they receive. Examples of comments made included, ‘it’s very very good here all the time’, ‘the service is excellent and the staff are very kind and helpful’, and, ‘the Home is wonderful they are all helpful and polite’. These comments were Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 9 reflective of the majority of comments made by residents. Two residents commented on how busy staff often seem to be however, they also said staff were kind and caring. Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 10 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 Residents’ nursing and personal care needs are being well met. EVIDENCE: Five care plans were reviewed, to find out how residents are supported by staff to meet their care needs. The care plans were reasonably informative and detailed how to meet the health care needs of the person. The majority of care plans clearly stated what actions staff must follow to assist the resident to meet their needs. However one resident’s care plan demonstrated that their needs are changing significantly due to changes in their health. This was discussed with the registered manager as their changing health needs has affected the person’s ability to be able to take their medication. It was advised that the written medication administration protocol that is in place needs to be further expanded and include more detailed information to better assist the resident in administration of medication. Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 11 Care plans had been reviewed and updated regularly by registered nurses, demonstrating residents’ health needs are being monitored and kept under review. A significant number of residents said staff are very helpful, kind and caring, when they assisted them with their needs. A number of residents also said that, nothing would be too much trouble for any of the staff. During the inspection the visiting dietician came to the Home for a consultation with residents and they commented very positively about the Home and the standard of care residents receive. There was also supporting information in residents’ care plans that demonstrated residents are well supported with their physical health care needs by the GP, the dentist, and the chiropodist. One resident told the inspector they had had treatment from the dentist the day before, and they had come to the Home to carry this out. Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 12 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): 12,15 Residents are provided with a varied range of social and therapeutic activities, and also a varied well-balanced appealing diet. EVIDENCE: Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 13 As was applicable at the last inspection, residents benefit from the Home employing two activities coordinators who each work three days a week. This demonstrates a commitment by the Home to providing a range of activities for residents. Residents are provided with a copy of the weekly timetable of social activities, which is circulated throughout the Home, to ensure they are aware of current activities taking place in and out of the Home. Residents can take part in a range of social activities as well as exercise classes and regular trips out into the local community. On the day of the inspection resident’s daily ‘exercise and a glass of sherry group’ was taking place. The inspector was invited to join the group and it was evident how much benefit and enjoyment residents gain from this activity. Residents further benefit from a mobile shop, which is taken around the Home regularly. The activities organiser explained that she also spends time talking on a one to one basis with residents while she takes the shop around the Home. This helps ensure residents who spend more time in their rooms are offered regular social contact. The Home also has two cats, and a dog visits the Home regularly, these are all a source of obvious pleasure for residents. Three is also a hairdresser who attends to residents from the Homes own salon, and residents were observed having their hair attended during the inspection. The resident’s menu was inspected and, the choices seen were nutritionally well balanced. Residents were asked their views of the quality and variety of meals provided at the Home, and all residents said the food was satisfactory and very good. Tables were laid with linen tablecloths and flower arrangements. There are two and four seated tables provided, this helped to make the lunchtime meal a relaxed and social experience for residents. The inspector ate lunch with a group of residents. The meal choices were either turkey in cream and orange sauce, or spaghetti bolognaise with fresh cooked new potatoes and two fresh vegetables, followed by a dessert of home made sponge with custard, fresh fruits, or ice cream. The meal was tasty and well presented. There were also alternative meals options being served to residents who are on special diets. Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 14 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): 16,18 Residents are protected from abuse by the systems in place, and resident’s complaints about the service are responded to promptly. EVIDENCE: To ensure residents can easily access the complaints procedures a copy of the procedure is on display by the reception. This is a well-frequented area by residents and visitors, helping to make this information easily accessible. The complaints procedure includes the up to date contact information for the area office of the Commission for Social Care Inspection if a person wanted to complain directly to the Commission. All residents are also told the telephone extension number of Mrs Peachey’s office telephone, and can contact her at any time if they so wish. The complaints record book was reviewed, and there had been no complaints recorded since the last inspection. The complaints records showed that the Home had responded promptly and had investigated thoroughly one complaint that had been received before the last inspection. Residents are well protected in the Home by a range of relevant policies and procedures in place relating to the issue of protection of vulnerable adults from abuse, and staff attend training courses to ensure they are up to date in understanding the principle of the protection of vulnerable adults from abuse. Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 15 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): 19-26 Residents’ benefit from a Home that is safe, well maintained and very suitable to meet their needs. EVIDENCE: Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 16 Beech House is a purpose built care home, designed around meeting the needs of the older person. The Home is located close to private houses and a short distance from the local town and nearby bus stops. The building is wheelchair accessible; and there is a passenger lift servicing the upper floor. There are adaptations in place throughout the Home to assist residents as well as visitors who are disabled. The majority of the building was viewed both inside and out. The only areas that were not seen were a small number of bedrooms. Rooms are spacious and the standard of fixtures and fittings are of a high standard. The environment was clean, tidy and well maintained, and this helps to enhance the quality of life for residents who live at the Home. The environment is maintained to a high standard, and the standard of the fixtures and fittings is also very high. Residents were observed sitting in all of the communal areas, and in bedrooms, looking very relaxed and comfortable. Each bedroom includes a television and telephone line that is provided by the Home. A full time maintenance worker is employed to address general maintenance and they were observed carrying out their duties during the inspection. The service records were seen for the fire fighting equipment and for the lifts. The records showed that an external contractor had serviced equipment within the last twelve months. This helps to demonstrate that the Home is safe and well maintained. There is a CCTV security camera sited by the ground floor office to view the main entrance and this is for security purposes only. Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 17 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): 27,28,30 Residents benefit from sufficient numbers of staff who are skilled and competent and are working hard to meet individual’s needs. EVIDENCE: To observe staff carrying out their duties, the inspector spent time sitting in the communal areas while staff assisted residents. Staff were good humoured and courteous in manner, and residents evidently enjoy warm relationships with staff. Since the last inspection the number of staff on duty for each shift has been reviewed and adjusted to reflect the increasing dependency of residents, which has increased over the previous twelve months. Residents’ benefit from an increased number of staff on duty. This ensures staffing levels are sufficient to meet resident’s current needs. There is a minimum of two registered nurses recorded as on duty at all times and nine care assistants in the morning, with seven care assistants and two registered nurses in the afternoon. At night there are two registered nurses and three care assistants on duty. There is at least two additional staff employed on a daily basis to serve drinks and assist with meals for residents. The number of staff on duty is above the legally required minimum staffing levels that are conditions of the Home’s registration. The training records of two registered nurses and two care assistants were reviewed to see if registered nurses were keeping up to date with their clinical knowledge and practice. There was evidence that demonstrated registered Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 18 nurses had attended clinical training sessions, and updating over the last six months. The care assistants’ records also demonstrated staff had attended training sessions over the last six months. Beech House DS0000020316.V276166.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): 37,38 Residents’ rights and best interests are safeguarded by the Home’s record keeping polices and procedures. EVIDENCE: Residents’ rights are protected by records, which are well maintained, up to date, legible and in good order. Care records were satisfactorily maintained up to date and in order. Individual records and the Home’s records were kept secure in the Home, and available to staff when required. Other records are referenced elsewhere in the report. The environment looked satisfactorily maintained throughout, and there are health and safety policies and procedures in place for staff to follow to ensure the safety of residents is maintained. Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 20 Health and safety practices in the Home are also addressed at the new staff induction day. The inspector read a selection of recent residents’ accident forms which showed that registered nurses recorded in detail the nature of the occurrence, and recorded all follow up action over a period of days after the event. To further safeguard residents one of the registered nurses audits and monitors all residents’ accident records. The fire logbook was checked and showed weekly tests of fire alarms being carried out. The fire fighting equipment was also being checked regularly, thereby helping to maintain the safety of those inside the building. There was a record to show staff had attended fire safety update training in the last twelve months to ensure they are aware of fire safety procedures in the Home. To protect all residents there is a fire safety risk assessment of the environment. However it is recommended that this assessment needs to be reviewed on a more regular basis to ensure it remains current to the needs of the Home. Mrs Peachey and the administrative manager take responsibility for health and safety matters, and carry out regular health and safety audits of the environment to ensure it is safe throughout the Home. Mrs Peachey explained that there are checks carried out of bedside rails, however currently a record of these checks is not being maintained. It was recommended that an up to date record should be maintained of bedrails checks to further ensure residents health and safety is maintained. Staff are provided with regular support and supervision to help them in their work and understanding of residents’ needs. Several staff told the inspector about the system of supervision that is in place. They said they were provided with regular supervision sessions. Supervision records were reviewed and demonstrated staff are supported and encouraged to develop skills in their work and practice Beech House DS0000020316.V276166.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 X 4 4 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 3 3 4 3 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 X X X X X X 3 3 Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP38 OP9 OP38 Good Practice Recommendations There should be an up to date record of bedrails maintenance checks carried out in the Home. There should be a more detailed medication administration protocol in place for the resident identified at the inspection. The fire safety risk assessment of the environment should be reviewed more regularly to ensure it is still relevant to the needs of residents. Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Bristol North LO 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 Beech House DS0000020316.V276166.R01.S.doc Version 5.1 Page 24 - 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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