Inspection on 28/07/05 for Beech House

This inspection was carried out on 28th July 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Beech House 09/10/06

Beech House 24/01/06

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 Vicky Dutton Unannounced 28th July 2005 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 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 I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Beech House Address Brownlow Bend Basildon Essex SS14 1QD 01268 286863 01268 286863 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Christian Care Homes Miss Kaye Andrews Care Home 28 Category(ies) of DE(E) Dementia - over 65 (22) registration, with number OP Old Age (28) of places Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Total number of service users for whom personal care is to be provided shall not exceed 28. 2. Personal care can be provided for up to 28 older people over the age of 65 years of age. 3. Personal care can be provided for up to 22 older people who have dementia and are over 65 years of age. 4. Miss Andrews to undergo formal training in the Protection of Vulnerable Adults within three months of the date of registration. Date of last inspection 06/01/05 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 residetns. 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 I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of six hours. On the day of inspection twenty eight residents were being accommodated at Beech House. The registered manager was not available on the day of inspection, but spoke to the inspector over the telephone and offered to come in. The inspector was assisted throughout the inspection by senior carers and other staff. A tour of the premises was undertaken. Care, medication and other records were randomly selected and examined. A staff handover was observed. Many residents were spoken with. The inspector also spoke with staff and briefly with three visiting professionals. A notice was displayed beside the homes signing in book advising any visitors that an inspection was taking place, with an open invitation to speak with the inspector. What the service does well: What has improved since the last inspection? The home is working towards improving the environment for residents. So far two bedrooms have been decorated. Following comments in the previous inspection report the layout of the homes main lounge/dining area had been altered. This is to try and minimise the conflicts that can arise from the different care needs and expectations of residents with/without dementia. Storage has been improved by the building of small garden shed areas. Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 6 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 I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 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 standard(s) 3, 4, 6. Prospective residents have their needs assessed before moving into the home. EVIDENCE: A requirement from the previous inspection was for the homes Statement of Purpose to include a sample of the contract/statement of terms and conditions used by the home. Examination of a statement of purpose on display in the homes front lobby area indicated that this had not yet been actioned. The care records of a recently admitted resident showed that an assessment of their needs had been carried out by the home. A senior carer confirmed that the manager and generally another member of staff always went and assessed residents before they moved into the home. Residents spoken with felt that the home met their needs. Staffing records could not be examined on this occasion but from conversations with staff it is clear that generally the staff group are well trained with many having undertaken or undertaking NVQ based training. There did however seem to be Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 9 some gaps and not all staff spoken with were able to identify that they had undertaken training in dementia care. Intermediate care is not provided at Beech House. Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10, 11 Residents health and care needs were identified and planed for. Medication practices at the home were well managed and ensured that residents were kept safe. EVIDENCE: During the inspection several care plans were viewed. The format used seems to work well for the home. Care plans are now maintained by each resident’s key worker and reviewed monthly. The home also tries to have three monthly reviews involving the resident and relatives. During the inspection staff demonstrated a good understanding of residents individual needs. Care records showed that residents health care needs are monitored, and appropriate actions taken in response to any concerns. Residents have regular access to a chiropodist and optician. Pressure relieving equipment was available around the home, and in use for specific residents. A visiting district nurse felt that the care the home offered was excellent. Residents weight is monitored and a nutrition record maintained. Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 11 The home uses a monitored dosage system of medication administration. The system is well managed and no anomalies were noted on records sampled. Staff stated that they had completed a safe handling of medicines course and received in house training before undertaking medication tasks. During the inspection staff were noted to treat residents with respect and uphold their privacy and dignity. A pay phone is available and some residents have their own telephones in their rooms. Care records include information on residents/relatives wishes in relation death and dying. During the inspection two residents were being care for appropriately in bed. Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 15 Some activities are provided at the home, but these do not always provide sufficient stimulation and occupation for all residents. Visiting at the home is open. The food provided by the home is plentiful and residents are offered choice. EVIDENCE: The home employs an activities co-ordinator who works from 13.30 to 17.30 on four days each week. Outside of these times staff reported that, although they try, particularly at weekends, there is often not time to provide consistent stimulation and occupation for residents. The activities co-ordinator was not available during the inspection but it was reported that she does provide a service for all residents. Good practice was noticed in the care plan of one bedfast resident. Under the activities section it was recognised that appropriate things would be one to one tactile and sensory activities. On the day of inspection some residents enjoyed a visit to the hairdresser during the morning. During the afternoon they mostly sat in the lounge areas with the televisions on. Although staff were monitoring residents interactions were mainly task orientated. More able residents said that they were sometimes bored. Residents said that they were offered choices in their daily lives. Care plans encourage staff to promote independence and offer residents choices. Monthly church services are held at the home and some residents have their own arrangements in place to meet their spiritual needs. Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 13 Residents spoken with said that visiting at the home is very open and that their relatives can visit at any time. All residents spoken with said that the food at the home was very good and that they were offered choices at each meal. This was confirmed by the homes nutrition records. Lunchtime on the day of inspection was a social occasion with music on and residents being offered a sherry before their meal. Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 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 standard(s) 16 A complaints process is in place that is understood by residents. This enables people to raise any concerns. EVIDENCE: The home has a clear complaints process in place. This was on display in the homes lobby area. Residents spoken with said that they would feel confident about raising any concerns. The homes complaint record could not be found at the time of inspection, but it was not thought that any concerns had recently been raised. One issue had been raised directly with CSCI, this was not a formal complaint. Beech House acted speedily and appropriately to clear up a misunderstanding. Although this standard was not fully assessed some staff seemed unsure as to if they had undertaken training in adult protection issues. Other staff were clear that this had been included as part of their NVQ training. A senior member of staff on duty was aware of the ‘No Secrets’ procedures. Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 22, 24, 26. Residents at Beech House live in a comfortable and homely environment. The home is well maintained. Sufficient bathing facilities are provided and residents have access to relevant equipment to meet their needs. EVIDENCE: The home is situated in a residential area. The home is all on one level for residents and fully accessible. The home has a safe and enclosed courtyard garden for residents to enjoy. To improve the environment for residents some bedrooms are currently being decorated. The home provides sufficient communal space. There are two large lounge/dining areas at the home. This provides residents with a choice of seating areas. The home has four bathrooms and two shower rooms available for residents. One shared room has a large en suite area to provide additional facilities. Additional toilets are also available. Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 16 The home has hoists and other equipment available to meet the needs of residents. Corridors are fitted with grab rails to assist residents mobility. Although not currently used it was noted that the home has a low vision reader available for residents with sight difficulties. Residents bedrooms were personalised and showed that people had been able to bring in personal possessions and items of furniture to make them feel at home. Residents spoken with all said that they were happy with the accommodation provided. Screening is provided in shared rooms to provide residents with privacy. On the day of inspection the home was free from offensive odours. The home has a good laundry facility that is able to meet the needs of residents. Care needs to be taken to ensure that residents are always kept safe and the laundry kept secure when no staff are in attendance. Two senior staff could not recall having undertaken training in infection control. Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27. Staff are offered training opportunities to enhance their knowledge and enable them to care well for residents. Care must be taken to monitor the amount of hours staff work to ensure that residents receive care that is not compromised in any way. EVIDENCE: The homes rotas showed that staffing levels are being maintained at four care staff plus one person in charge during the day and two awake staff at night. Staff spoken with felt that these levels were sufficient for them to meet residents needs. Residents spoken with spoke well of the staff and said that they were kind and caring. Some said that although they sometimes have to wait for attention, they thought that this was within acceptable limits. Appropriate levels of ancillary staff are provided. However care staff do undertake laundry tasks. Agency staff are not used at the home so residents receive care from people that they know. The staffing rota highlighted a concern about the amount of hours some staff are working. One member of staff will have worked at least 109 (63 in one week) hours in a two week period with only one day off. This is not good practice and could compromise resident care and staff safety. Long hours are also being worked by senior staff. Other staff work across the groups three homes. The senior on duty said that the hours worked by these staff would be monitored by their timesheets. Staffing records could not be examined at this inspection as the registered manager had taken the relevant keys home with her in error. Although she Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 18 offered to return these it was agreed instead that staffing records will be assessed at the next inspection. An NVQ assessor was visiting the home during the inspection. Many staff spoke of having completed NVQ training, and of their wish to progress to the next level. Other staff are undertaking an NVQ at the moment. Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The home is generally run in a way that ensures that residents are cared for safely. EVIDENCE: Staff spoken with identified that they had received training in first aid. Some thought that they were due for moving and handling updates. Fire records were well maintained showing that regular checks and drills are carried out. Equipment such as wheelchairs and hoists are regularly serviced to ensure the safety of residents. An accident book is maintained for staff but for residents individual records are made and stored on their files. To enable to home to monitor falls/incidents and identify and eliminate any hazards it was advised that a log be developed. Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x 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 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x 3 Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 5 Requirement It is required that a standard form of contract is included in the statement of purpose. This requirement is carried forward from the previous inspection. All staff should receive training relevant to the tasks they are to undertake. This refers to the possible training shortfalls identified during the inspection including: Dementia, adult protection and infection control. The date when CRB checks are applied for to be recorded. This standard was not inspected at this inspection. The requirement is carried forward from the previous inspection when a requirement date of 01/03/05 was set. 4. Timescale for action 01/10/05 2. 4, 18, 26, 38 18 01/12/05 3. 29 19 01/10/05 Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 22 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. 4. Refer to Standard 12 26 27 38 Good Practice Recommendations All staff should be encouraged to provide social stimulation and occupation for residents. Staffing levels should reflect the social needs of residents. The laundry area of the home should be kept secure when no staff are in attendence. The hours that senior and care staff are working should be monitored to ensure their well being and the consistency of care for residents. A log should be kept of any accidents or incidents in order that monitoring can be undertaken. Beech House I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 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 I56-I06 S18103 Beech House V240763 280705 Stage 4.doc Version 1.40 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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