Inspection on 24/01/06 for Beech House

This inspection was carried out on 24th 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 House 09/10/06

Beech House 28/07/05

Beech House 06/01/05

Beech House 13/07/04

Beech House 30/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Beech House Brownlow Bend Basildon Essex SS14 1QD Lead Inspector Ron Reeves Unannounced Inspection 24th 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 House DS0000018103.V275182.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 DS0000018103.V275182.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beech House Address Brownlow Bend Basildon Essex SS14 1QD 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) 01268 286863 01267 286863 Christian Care Homes Miss Kaye Andrews Care Home 28 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (28) of places Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Total number of service users for whom personal care is to be provided shall not exceed 28. Personal care can be provided for up to 28 older people over the age of 65 years of age. Personal care can be provided for up to 22 older people who have dementia and are over 65 years of age. Miss Andrews to undergo formal training in the Protection of Vulnerable Adults within three months of the date of registration. 28th July 2005 Date of last inspection Brief Description of the Service: Beech House provides care and accommodation for up to twenty eight older people. Within this number the home is registered to provide dementia care for up to twenty two people. The home is in a residential area of Basildon. Local amenities and the town centre are accessible. The home has its own transport in the form of a minibus available. Accommodation for residents is all on the ground floor. The home has five shared rooms with the rest providing single accommodation. There are comfortable lounge areas for residents. A central, enclosed courtyard garden area is accessible to residents. There is a small garden area around the home and parking to one side, as well as on the street. The small first floor of the building provides an administration and staff area. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection which took place over a period of eight hours. The inspection was managed by the manager and the proprietor’s responsible individual. The inspection process consisted of a tour of the building, inspection of a sample of policies, procedures and records, discussions with six residents, two visiting relatives and four staff. 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 House DS0000018103.V275182.R01.S.doc Version 5.1 Page 6 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 DS0000018103.V275182.R01.S.doc Version 5.1 Page 7 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): 1-5 The admission process is well managed and ensures the home can meet individual residents needs. EVIDENCE: The home has a comprehensive Statement of Purpose. The homes’ Service Users Guide required further development to meet the standard. Residents care plans seen contained a comprehensive pre-admission assessment and evidence that Beech House ensures that they can meet prospective residents needs before moving in. The manager explained that residents and their families are invited to visit the home before making a decision. This was confirmed by visiting relatives. Each residents’ file contact a written contract detailing the terms and conditions of residence. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 8 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): 7-11 Residents’ personal and health care needs are consistently being met by the home. EVIDENCE: Care plans examined during the inspection evidenced that all residents’ assessed needs were being met. The care plan format was seen to be based at Person Centred Planning and detailed residents care needs over a full twenty four hour period. It provides information in such a way that care staff find it easy to follow. Positive discussions were held with the manager and the proprietor’s representative in further developing the care planning system into full person centred planning. Visiting relatives informed that they had seen their residents care plans and that they were very satisfied with the care provided by the home. Care plans evidenced that resident’s health care needs are monitored and appropriate action taken in response to any concerns. Records are maintained of health professionals visits. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 9 The home uses a monitored dosage system (MDS) for the majority of tablet medication. Medication that cannot be stored in the (MDS) system is administered direct from bottles and packets. The medication administration records (MAR) were found to be appropriately completed. Protocols for medication prescribed “as and when required” need to be produced and liquid medication should be marked with the date of opening. Staff responsible for administering medication had received training. During the inspection residents were seen to be treated in an unhurried and sensitive manner. Residents spoken with said they are looked after well and the staff are very nice and helpful. Care records include information on residents/relatives wishes in relation to death and dying. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 10 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 Activities provided for the home have improved but still require further development. Residents are encouraged to exercise control over their lives within their abilities. Dietary needs of the residents are well catered for offering a wide range of nourishing meals. EVIDENCE: The home continues to employ an activities organiser for four afternoons a week. She was available during the inspection and spoke enthusiastically about what activities she provides and what she hopes to develop in the future. She informed she holds various activities, with large groups and on an individual basis. She ensures she visits those residents who are either confined to their own room for medical reasons or decide to spend their time in their own rooms. Staff spoken with said they do sit and talk to residents when they have time, but this is not always possible due to their workload. Discussions were held with management regarding ways of enabling staff to spend more time with the residents. Residents spoken with said they could exercise controls over their daily lives. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 11 The home operates an open visitors policy, which encourages residents to maintain contact with their family and friends. Residents spoken with said they can have visitors at any time and visiting relatives felt they were always made welcome. The home operates a four week rotating menu based on resident’s likes and dislikes and reviewed on a regular basis. Menus seen were wide, varied, contained choices and appeared nourishing. All the residents spoken with said the food provided was very good, one described it as “gorgeous” and confirmed that they were offered a choice at each meal. Nutrition records evidenced this. The home kitchen was large, well equipped clean and tidy, however one of the kitchen wall units needs repairing or replacing. The home holds relatives meetings but these are not well attended. The manager is working on developing ways of encouraging relatives to be interested in being involved in the day to day activities of the home. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 12 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 Arrangements for protecting vulnerable residents and responding to their concerns are satisfactory. EVIDENCE: The home has appropriate policies procedures and practices for dealing with residents and their relatives concerns. The manager said their complaints process is monitored by the Essex County Council through their contract arrangements. No complaints have been received by the home, but there was evidence of many compliments. The manager explained that those residents who qualify are included in the local voters’ register. The home has appropriate procedures in place to ensure residents are protected from abuse. Some staff have received training for the Protection of Vulnerable Adults and the remaining staff are booked on courses. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 13 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 Beech House provides a homely and comfortable environment for the residents, which is well maintained. EVIDENCE: The home is located in a residential area. All rooms used by residents are on the ground floor. Offices and sleeping-in accommodation is located on the first floor. There is a safe and enclosed courtyard garden for residents to enjoy. There is adequate communal space that offers residents a choice of seating areas. Sufficient adapted bathrooms and toilets are provided for residents use. The home provides adequate hoists and other equipment to meet the needs of the residents. Resident’s bedrooms seen were nicely decorated, furnished and personalised to each individual residents tastes. Residents spoken with said they were happy with their bedrooms. Screening is provided in shared rooms for privacy. The home has an adequate laundry facility able to meet the needs of the residents. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 14 Due to the resident’s frailty, the laundry room is now kept locked. The laundry contains a large butler sink, which requires a thorough clean. The floor of the laundry is covered with lino tiles many of which are broken and require replacing. On the day of the inspection, the home was found to be clean and tidy throughout and odour free. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 15 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): 27-30 The home benefits from an enthusiastic staff group. A wide range of training is available to staff and NVQ training promoted. EVIDENCE: Since the previous inspection the home has increased its care staff to five on duty on the early shift and for part of the evening and for the remainder of the day four staff are on duty. Night staff remain as two at nights and one member of staff on call. In addition the home employs a cook and a kitchen assistant for seven days a week and two domestic assistants for six days a week. However, care staff undertake laundry duties. Staff spoken with said they felt that the present staffing levels were generally satisfactory. Discussions took place with the proprietor’s representative regarding the employment of a laundry assistant on a part-time basis, to enable staff to spend more time with the residents. The home does not employ agency staff and staff cover holidays and sickness. Staff rotas showed that the excessive hours previously worked by staff have been reduced. The manager was reminded that it was her responsibility to ensure that staff are always competent in performing their tasks. Staff records seen evidenced that robust recruitment procedures are in place. A wide range of appropriate training is provided by the proprietors including dementia and abuse training. A high proportion of staff (66 ) have achieved NVQ level 2 and one member of staff achieved NVQ level 3 and a further three staff are undertaking training at NVQ level 3. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 16 Residents spoken with said the staff were “very nice” “staff very good”, “staff in the home are lovely”. It was observed that the residents enjoyed a good rapport with the staff and demonstrated they had confidence in the staff. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 17 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): 31-37 The home benefits from an experienced competent manager who provides stable leadership to staff to ensure a consistent high quality of care. EVIDENCE: The manager has over 17 years experience in the care of older people and has achieved NVQ level 4. Staff spoke highly of the manager saying she was easy to approach and very supportive to her staff. The home has issued quality questionnaires to residents and their families. Discussion took place with the proprietors’ representative regarding fully developing an effective quality assurance programme. The proprietors are a registered charity. There was no evidence to support that they were not financially viable. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 18 The home looks after small amounts of residents’ money for day to day expenses. A sample of money and records evidenced that the money was appropriately spent and recorded. Staff records showed that staff receive regular supervision. Records seen throughout the inspection were seen to be well maintained and stored securely. Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 19 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 3 3 X Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 20 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. 1 Standard OP33 Regulation 24 Requirement The house must establish a system for reviewing and improving the quality of care provided by the home. The home must develop its service users guide. The home must ensure the floor in the laundry room is repaired and the sink is clean and hygienic and a kitchen wall unit is repaired or replaced. Timescale for action 28/02/06 2 3. OP1 OP3 5 23 28/02/06 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP12 OP38 Good Practice Recommendations All staff should be encouraged to provide social stimulation and occupation for residents. Staffing levels should reflect this. A log should be kept for any accidents or incidents in order that monitoring can be undertaken (not inspected on this occasion. Carried forward to next inspection). Beech House DS0000018103.V275182.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 DS0000018103.V275182.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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