Inspection on 12/09/05 for Beech House Care Home

This inspection was carried out on 12th September 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 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 Care Home 20/10/08

Beech House Care Home 18/10/07

Beech House Care Home 03/01/07

Beech House Care Home 17/01/06

Beech House Care Home 13/09/04

Beech House Care Home 12/08/04

Beech House Care Home 16/03/04

Similar services:

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

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

CARE HOMES FOR OLDER PEOPLE Beech House 294 Carlton Road Worksop Nottingham S81 7LL Lead Inspector Elaine Cray Unannounced 12th September 2005 10:00 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 C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Beech House Address 294 Carlton Road Worksop Nottingham S81 7LL 0190 947 2149 0190 947 2149 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) Mr Moussa Durgahee. Mrs Sabitree Durgahee. Mrs Sabitree Durgahee Care Home - Private 18 Category(ies) of DE Dementia 18. registration, with number MD(E) Mental Disorder - Over 65 18. of places OP Old Age 18. Beech House C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 13th September 2005 Brief Description of the Service: Beech House is a large 3 storey adapted older house on the outskirts of Worksop, offering care to 18 older people. The home has well maintained grounds and there is car parking at the rear of the property. The 18 single bedrooms are located on the ground and first floor, with 9 rooms having en suite facilities. There is a passenger lift to give access to both floors. The home has 2 communal lounges, a dining room and conservatory. There are sufficient bathroom and toilet facilities to meet requirements. Beech House C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 8th September 2005 over a period of 5 hours. The manager and staff provided information throughout the visit. Five residents and one relative were spoken with and all expressed a high level of satisfaction with the care provided in the home. Two doctors visited the home during the visit and passed positive comments on the care provided in the home. Four care plans and a variety of records were inspected and a partial tour of the building was made. What the service does well: Beech House offers a well maintained environment. The manager and staff encourage residents to be as independent as possible and provide a relaxed, comfortable and homely environment for the residents. Residents are treated with a high level of dignity and respect and staff have an excellent understanding of the individual needs, preferences and personalities of each resident. There is a warm rapport between staff and residents. Residents presented as well groomed and they said they liked living at the home, commenting that the staff were very kind and one resident said that the home was “perfect” and had lived there for over seven years. Care plans are detailed and form a good basis for an assessment of need and to provide the day to day support to enable residents to maintain their independence and be provided with appropriate care and support. Health care needs are well met and the staff at the home liaise well with health care and medical agencies. Residents, a relative and two doctors spoke highly of the manager’s and staff’s commitment to promoting and maintaining the health needs of the residents. The manager and staff form a cohesive team, with good communication between themselves, with the residents and with other professionals. Staff have undertaken NVQ and dementia training and the manager is keen to develop her own skills and knowledge. Beech House C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 6 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 C53 C03n S8630 Beech House V247099 080905 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 C53 C03n S8630 Beech House V247099 080905 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 and 5 Arrangements for providing information about the home, enabling prospective service users and their representatives to visit and providing opportunities to discuss the prospective service user’s needs are well managed. EVIDENCE: The manager stated, and service users verified, that prospective service users and their relatives are encouraged to visit the home before deciding to live there. A relative was very complimentary about the information offered about the home, the manager and staff’s helpful manner and how she was involved in planning for her mother’s care. Other residents said that they had visited for lunch and were able to have a look around and meet other residents and the staff. Beech House C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 9 The manager stated that she will also visit prospective residents in hospital or other placements in order to tell them about the home and ask about their needs. There is an assessment process and records were available on and had informed each care plan. Service users, a relative, staff and records confirmed that the needs of each service user are discussed before moving into the home. A relative was so pleased with a pre-visit to the home and the manager and staff’s response to meeting her mother’s needs that she joined the waiting list that exists for admissions to the home. Beech House C53 C03n S8630 Beech House V247099 080905 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 and 11 The health care and medical needs were identified, well met and promoted, but some attention to medication procedures are required. There is a warm and interactive rapport in the home and residents are treated with respect and dignity. EVIDENCE: Three care plans were viewed on this inspection. Medical histories, health assessments and how and who were involved in meeting these needs were comprehensively recorded in each plan. The manager and staff on duty at the time of this inspection provided a clear and detailed insight into the medical and health needs of the residents. Residents, relatives and visiting professionals were very pleased with the health care and support provided by the home. A relative commented that the home communicates well about the health needs of her relative and involve her at all levels of care. Beech House C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 11 Two doctors visited on the day of this inspection and both commented that the health care needs of the residents are very well organised by the staff. One GP commented that the manager and staff are “spot on” with preventative care and approaching medical services when needed. The regular visits and details of consultations made by doctors, district nurses, the optician, chiropodist and other medical professionals are recorded. Records provided evidence that the home liaises with relevant medical agencies to seek advice and further consultation when necessary. The manager is very persistent in approaching agencies and consultants in order to obtain specialist consultations. The manager has taken steps to improve the storage of medication and the organisation was generally good. However, some medication had been placed in a pot, but had not been given to resident, despite the record sheet having been signed by a member of staff. Arrangements for the storage and return of refused and excess medication were poor as there was a large amount of varied medication in one large container and returned medication had not been recorded or signed for. There was a warm and respectful rapport between the staff and residents. Staff were observed to provide a sensitive level of care in terms of ensuring the privacy and dignity of residents is respected. Residents said that staff were very polite and kind. Comments from the manager and a relative presented a sensitive and respectful approach to managing death and bereavement, including respect for residents’ spiritual and religious beliefs and needs. Beech House C53 C03n S8630 Beech House V247099 080905 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, 14 and 15 This home provides a warm and enabling environment, promoting the wishes, views, independence and choices of residents. Catering arrangements were well managed and provide residents with regular and a well balanced choice of meals in a pleasant and social environment. EVIDENCE: All residents spoken with on this visit said that they enjoy living at the home and felt that they could do as they please and choose how their daily routines happen. One resident enjoys helping in the garden, some were doing exercises, one man enjoys sitting in the hall watching the comings and goings of the home and there is a selection of activities organised by the home’s activities co-ordinator. Residents’ likes, interests and hobbies are recorded in care plans and there is an awareness of each person’s religious, social, cultural and recreational needs. The activities co-ordinator provides a variety of individual and group activities, which range from reading with a resident, providing bingo and art sessions to visits to the local supermarket and pub. Beech House C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 13 Visitors are welcomed to the home and the residents, a relative and doctor commented on the warm and friendly approach of the manager and staff. All residents said that the food was very good. The meal time was a relaxed and social time, staff served residents with respect and helped some residents to eat their meal in a sensitive and discreet way. The menus are varied, balanced and nutritional. Most meals are cooked from fresh produce and the cook provides home baking on a daily basis. The kitchen was well organised, clean and all safety checks were carried out regularly. Beech House C53 C03n S8630 Beech House V247099 080905 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 and 18 The manager and staff have a clear awareness of the need to provide a safe environment for residents. The procedures for the protection of residents from abuse are addressed in the home. Residents are confident that they are able to express any concerns to the manager and staff and that these matters will be addressed. EVIDENCE: The manager and staff presented a good understanding of the vulnerability of older people living at the home, the need for consistent observation, individual assessment of risk and providing a safe environment. Risk assessments were well documented within the care planning format. Staff have received adult protection training. The complaints procedure is displayed in the home. All residents spoken with on this inspection presented a clear confidence that they could discuss any concern with the manager and staff in the home. Beech House C53 C03n S8630 Beech House V247099 080905 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 and 26 The home presents as well maintained, homely, well decorated, comfortable and exceptionally clean. EVIDENCE: All lounges and the dining room were viewed and presented as clean, well decorated and very homely, with comfortable furnishings, lots of pictures, ornaments, plants and flowers. Residents said they liked the home’s facilities and they were particularly complimentary about the well kept gardens. The home presented as well maintained, in a good state of repair and safe for service users. The standards of cleanliness were very high. . Beech House C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 16 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 and 30 The staffing arrangements in the home presented as well managed and staff have received a variety of training. EVIDENCE: Discussions with the manager, staff, a relative, two doctors and residents presented a clear view that the staffing arrangements in the home are well managed. Copies of the GSCC Codes of Practice have been obtained by the manager and she reported that these are due to be distributed to the staff. On the day of this inspection, the home was adequately staffed. The manager and many of the staff have good levels of experience. Regular training, including NVQ, is provided and staff were particularly enthusiastic about a recent course on dementia. All the residents spoken with on this visit gave positive comments about the staff and felt safe and well looked after, with staff encouraging them to be independent and providing support when needed and requested. Beech House C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 17 Discussion with the manager and staff demonstrated that staff were knowledgeable about the needs of the residents, were aware of the policies and procedures of the home and the inspector observed appropriate care practices throughout the inspection. Care plans were well documented and staff were observed to be carrying out tasks according to information given in the care plan. The doctor also spoke highly about the knowledge and caring commitment of the staff working at the home. Beech House C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 18 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) 31, 32 and 37 The management of the home was well organised, with staff feeling supported by the manager and records well maintained, accurate and up to date. EVIDENCE: The manager was present throughout this inspection and provided a thorough knowledge of the management and administration systems and the running of the home. The manager is a qualified nurse and is due to complete her Registered Manager’s award in October 2005. The staff reported a positive working relationship with the manager, based on good communication and support. Record keeping in the home was detailed, accurate and up to date. Policies and procedures had been updated, care plans were very comprehensive and practical for the day to day care for each resident and other required records were available in the home. Beech House C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 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 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 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x x x 4 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x x 3 x Beech House C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 20 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. 2. Standard 9 9 Regulation 13.2 13.2 Timescale for action Ensure all medication records are 31st signed after the administration of October medication. 2005 Ensure that all refused and 31st unused medication is October appropriately stored, returned 2005 and documented Requirement 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. Refer to Standard Good Practice Recommendations Beech House C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 C53 C03n S8630 Beech House V247099 080905 Stage 4.doc Version 1.40 Page 22 - 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. 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