Inspection on 03/01/07 for Beech House Care Home

This inspection was carried out on 3rd January 2007.

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 17/01/06

Beech House Care Home 12/09/05

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 Care Home 294 Carlton Road Worksop Nottingham S81 7LL Lead Inspector Dawn Podmore Key Unannounced Inspection 09:00 3rd January 2007 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 Care Home DS0000008630.V324304.R01.S.doc Version 5.2 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 Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech House Care Home Address 294 Carlton Road Worksop Nottingham S81 7LL 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) 01909 472149 01909 472149 Mr Moussa Durgahee Mrs Sabitree Durgahee Mrs Sabitree Durgahee Care Home 18 Category(ies) of Dementia (18), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (18), Old age, not falling within any other category (18) Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2006 Brief Description of the Service: Beech House is a large 3 storey adapted older house on the outskirts of Worksop, offering personal 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. The owners intend to extend the home shortly. This will include 10 additional bedrooms, an activities room and a new office. At the time of the inspection the manager confirmed that the weekly fees ranged from £283 - £326 depending on the residents assessed needs. Additional charges are made for services such as chiropody, toiletries and hairdressing. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report, is available at the home. Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took any previous information held by the Commission about the home into account. The inspection included a site visit, which took place over six hours. The main method of inspection used was called case tracking. This involved selecting two residents and tracking the care they received through the checking of records, discussion with them, the care staff, and observation of care practices. A partial tour of the premises was also conducted which included looking at their bedrooms as well as communal facilities. Interviews with residents, visitors and staff took place; this included the proprietor and the Registered Manager. On the day of the visit 17 people were living at the home but 2 were in hospital. What the service does well: What has improved since the last inspection? What they could do better: Although no requirements were made following this inspection there were several areas that needed some attention. The documentation of initial assessments, which take place before residents are admitted to the home, could be improved. Care plans would benefit from having more comprehensive detail, so that staff have access to better information, guidance and instructions. This includes the plans to meet people’s social needs. Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 6 Although the system for recording resident’s personal monies has improved a running balance should be maintained so that they can be easily checked for accuracy, and regular audits undertaken. 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. The summary of this inspection report can be made available in other formats on request. Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 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 Care Home DS0000008630.V324304.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provides residents with detailed information about the terms and conditions of their residency. The home has an adequate assessment process in place, which helps to make sure that potential residents needs can be met. EVIDENCE: Since the last inspection the proprietors have amended the terms and conditions document so that it provided people with better information about their residency. The home has an admission policy, which includes assessing residents before admission, but this process had not been comprehensively documented in all cases. It was recommended that verbal information provided before people are admitted be documented in more detail to show that all areas of need have been considered. Staff and relatives confirmed that people had been assessed and invited to look round the home before coming to live there. Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans contain satisfactory information about peoples needs but documentation could be improved. The health care of residents is well managed. Medications are stored, administrated and disposed of safely. Staff respect the wishes and preferences of people living at the home while maintaining their privacy and dignity. EVIDENCE: Each resident has an individual plan, which contains information about his or her care needs. The manager said that the care planning documentation had changed since the last inspection and she was in the process of introducing new forms. Plans seen outlined the care needs of the resident concerned but did not always give clear guidance to staff about personal preferences, such as how they preferred their care to be delivered. It was recommended that further information be added to the plans to make them more comprehensive. Manual handling risk assessment had been completed to tell staff what assistance people needed and how to safely handle them. Other risks were identified within people’s files but the detail could be improved so that new Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 10 staff can easily see what actions needs to be taken to minimise any potential risks. Staff spoken with demonstrated a very good understanding of people’s individual needs and preferences. Care plans had been reviewed monthly with the input of the residents and/or their relatives; these gave a clear evaluation of any improvements or deterioration in the resident’s condition. People said that they were happy with the standard of care provided and felt that people were respected and their dignity was maintained at all times. Comments included: ‘the family are always involved in the care’ and ‘it’s a lovely home, the staff are wonderful and the care can’t be faulted’. Records showed that outside agencies such as, doctors, opticians and chiropodists had visited the home regularly to meet people’s health care needs. The manager provided a clear and detailed insight into the medical and health needs of the residents. Residents and relatives said that they were very pleased with the health care and support provided by the home. One relative said ‘we are very happy with his treatments, they always contact the GP when needed and keep us informed about his health’. The home has satisfactory policies, procedures and documentation concerning the receipt, storage, administration and disposal of medications. Discussions with staff and examination of the recording system showed that they had a good understanding of the correct process to follow. Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a warm and enabling environment, promoting the wishes, views, independence and choices of residents living there. Residents maintain good contact with their families, friends and the local community. Catering arrangements are well managed and provide residents with a well-balanced choice of meals in a pleasant and social environment. EVIDENCE: The home currently does not employ an activities coordinator, but the manager said that she hoped to fill this post as soon as possible. At the moment the care staff or families are providing any social stimulation. Although there is no set programme of daily activities records and peoples comments showed that regular activities, such as skittles, memory games and movement to music, took place. Residents had also been on outings from the home either with staff or their family. Comments included: ‘my family visited over Christmas but I choose not to go out’, ‘I am happy doing what I want, like chatting to people’ and ‘he likes to go out in the garden in summer and went to the coast with us, but he’s not really a mixer and the staff respect that’. Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 12 Care plans contained some details about what people liked to do but would benefit from more specific information and guidance so that staff know exactly what peoples interests are and can cater for individual preferences. Residents said that they were offered choice in their daily lives such as menu options, times for getting up and going to bed as well as how they preferred to spend their day. Bedrooms had been personalised and residents and relatives confirmed that they had been encouraged to bring small items of furniture, photographs and mementoes into the home. People said that anyone visiting the home was made welcome by the staff. One relative said ‘we come and go as we wish, they always make us feel welcome and offer us drinks’. Menus, the meal served on the day and peoples comments showed that the home offered residents a varied and nutritious diet that suited their needs. Comments included: ‘you get plenty of food and the standard is good too’, ‘they are very flexible, if dad goes out they will sort his food out for later’ and ‘he doesn’t like fish and chips so he has something different’. Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has satisfactory procedures for handling complaints and people feel confident that any concerns will be addressed appropriately. Residents are protected by the home’s procedures for handling allegations of adult abuse. EVIDENCE: The home has a complaints procedure, which tells residents and relatives how to make a complaint and how it will be handled. This forms part of the Service Users Guide, which is available in every bedroom, and on display in the home. Records showed that the home had received no complaints in the last year, but a system was in place to address any that may arise. Residents and relatives said that they knew how to make a complaint and felt that any concerns would be dealt with promptly. There are satisfactory procedures in place relating to adult protection. Staff comments and records showed that most staff had received adult protection training and more sessions were planned for new staff. Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home live in a clean, comfortable and homely environment. EVIDENCE: A partial tour of the building, which included some bedrooms, communal areas and toilets, showed that the home was clean, tidy and well maintained. People said that they felt it had a welcoming, homely atmosphere. It had comfortable furnishings, pictures, ornaments, plants and flowers. Residents and relatives said that they were happy with the accommodation provided and the home’s general facilities. The home was clean and odour free throughout. The proprietors said that they are planning to extend the home in the near future. This will include 10 extra bedrooms, an activities room and a new office. Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffing arrangements at the home ensure that residents are cared for in a safe, caring and competent manner. Residents are safeguarded by the homes robust recruitment procedure. Staff receive training to meet the needs of people living at the home. EVIDENCE: Staff duty rotas, as well as comments from residents, relatives and staff on duty, demonstrated that the home was providing adequate staffing levels for the number of people currently living at the home. The home has a robust recruitment procedure. Two staff files contained application forms, satisfactory written references, proofs of identity and a C.R.B. (Criminal Records Bureau) certificate. Files contained records to show that new staff had received an induction to the home when they started. This included completion of the Skills for Care folder, which helps to make sure that they have all the essential information they need to carry out their work. Records and staff comments confirmed that essential training had been provided, this included, adult protection, manual handling, health and safety and a dementia awareness course. Preinspection material completed by the manager showed that 33 of care staff had completed an N.V.Q. (National Vocational Qualification) course and she confirmed that another 4 were to be enrolled shortly. This course helps to make sure that carers have the Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 16 knowledge and skills to provide a good standard of care. The manager said that nurses from overseas, who were working at the home as senior carers, would be undertaking this course to enhance their personal care skills. Residents and relatives commented positively about the staff and their capabilities. Staff said that they felt that they were well trained and supported. Comments included: ‘I can’t fault them with the training programme, but I wish we had a bit more notice of the training courses’ and ‘best training I’ve had anywhere’. Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good leadership, guidance and direction are provided to staff to ensure that residents receive a good standard of care. The home consults people about the care they received. Residents’ finances are handled appropriately, but documentation could be improved. The home has health and safety policies and procedures, which help to safeguard staff and residents. EVIDENCE: Mrs Durgahee is the manager of the home as well as one of the proprietors. She is a qualified nurse and has completed her NVQ Level 4 in Management. During the visit Mrs Durgahee showed that she was keen to develop her own skills as well as those of the staff. Relatives and residents said that they felt that the home was well managed and staff said that the owners were approachable and supportive. Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 18 The home has developed a quality assurance system to gain the views of the people who live and visit the home. Questionnaires were currently being given to people and the manager said that once collated any comments would be used to improve the service provided. The owners are currently working towards the Investors in People award. The manager stores and manages the personal allowances of some residents and individual records and receipts were being maintained. It was recommended that individual accounts had a running balance so that they could be audited more efficiently for accuracy. A recommendation made at the last visit regarding providing two signatures for each transaction had been addressed. There are a range of policies and procedures regarding health and safety available to guide and instruct staff. There is also a programme in place to service and maintain the equipment in the home on a regular basis. Information provided to the Commission, and sampling on the day of the visit, demonstrated that checks on equipment such as lifts, portable electrical appliances and the fire system had taken place. Records and staff comments showed that fire safety checks including fire drills had regularly taken place. Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 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 X 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 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. 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 OP3 OP7 OP12 Good Practice Recommendations Verbal information provided before people are admitted should be documented comprehensively to show that all areas of care have been considered. Additional detail should be added to the care plans to provide more comprehensive information and guidance for staff. Care plans would benefit from more specific information and guidance regarding resident’s social interests so that staff know exactly what peoples interests are and can cater for individual preferences. It is recommended that individual accounts have a running balance so that they can be audited more efficiently for accuracy. 4. OP35 Beech House Care Home DS0000008630.V324304.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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