Inspection on 10/05/07 for Beech House, South Molton

This inspection was carried out on 10th May 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, South Molton 13/07/06

Beech House, South Molton 16/01/06

Beech House, South Molton 20/06/05

Beech House, South Molton 18/11/04

Beech House, South Molton 22/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Beech House, South Molton North Road South Molton Devon EX36 3AZ Lead Inspector Jo Walsh Unannounced Inspection 10th May 2007 09:15 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, South Molton DS0000039190.V331164.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, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech House, South Molton Address North Road South Molton Devon EX36 3AZ 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) 01769 572124 01769 572996 Judy.flanagan@devon.gov.uk www.devon.gov.uk Devon County Council Judy Ann Flanagan Care Home 37 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (37) of places Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Beech House is a care home providing personal care and accommodation for up to 37 older people and have now also extended their categories of registration to include caring for those people with dementia. Most people live at the home on a long-term basis, but short stays are available. The home is owned by the Local Authority, Devon County Council and is centrally located in South Molton, North Devon. First opened in 1975 the home consist of a two-storey purpose built building which is close to shops and local amenities All service user accommodation is on the ground floor with private accommodation provided in single bedrooms. There are 3 lounges, 3 dining rooms, 2 conservatories and a quiet room for residents shared use. The home is divided into three wings, Verney, Loosemore and Carter. The home is surrounded by its own grounds, which are easily accessible. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on a weekday in May and lasted for approximately 7 hours. During this time 10 residents were spoken to length about their experiences living at Beech House and some time was spent observing residents and staff interactions in a lounge area. Four visiting relatives were also spoken to. All gave positive feedback about the care and support given at the home. The manager and staff on duty were spoken to about their roles, understanding of residents needs and training they have participated in. The home were also asked to complete a pre inspection questionnaire that gives details about staff training as well as how the registered provider maintain the home and ensures all aspects of health and safety are covered. This information helped to inform the inspection process. Prior to the inspection, residents were asked to complete a questionnaire, as well as a selection of relatives and staff. Their comments are included throughout this report. What the service does well: Beech House provides residents with a clean, safe and well-maintained environment. The home is purpose built and has a good range of equipment to ensure that individuals needs can be met safely. Residents said ‘’Staff are absolutely marvellous, so caring and helpful. Staff are all very nice and kind. The staff are wonderful, couldn’t fault it here at all’’ Systems are in place to ensure that residents’ needs are assessed prior to moving in so that staff can plan for their care and support. Each resident has a plan of care to ensure that all personal and health care needs are met by a consistent approach. Staff are able to demonstrate a good understanding of individuals needs and this is supported by training to enable staff to do their jobs effectively. Residents said ‘’ we are well looked after. The staff help with anything I need.’’ Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 6 Many of the staff have worked at the home for several years. This provides continuity of care. They are keen to ensure the well-being and comfort of the residents and were observed treating them with great respect and kindness. The home provides a good balanced diet and offer an excellent array of choices for residents to ensure that all likes and dislikes are catered for. Most residents expressed a high level of satisfaction with the meals proved. One said ‘‘the food is excellent, and we always get a good choice.’’ The home is well managed and run in the best interests of the residents. There are systems in place to ensure that residents are able to have their say and be involved in some of the decision-making. What has improved since the last inspection? What they could do better: The registered provider needs to make sure that all areas of the home are safe for residents. This includes the grounds. Some of the pathway around the house has been assessed as a risk to residents and a portion of it has been cordoned off. This needs to be well maintained to allow residents to enjoy the outside space, free from risks. The residents bedrooms currently only have one electrical socket. This means that if residents wish to use a number of electrical items, extension leads wound need to be used, which could present as a risk. The registered provider needs to consider how this can be addressed to maintain the health and safety of residents and staff. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 7 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, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 8 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, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 9 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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a good admission and assessment process, which ensures that the home can meet their needs. EVIDENCE: Assessment information was looked at for the two newest residents, one of whom had been an emergency admission. The home makes sure they get a copy of the individuals’ assessment and care management plan from Social Services and this helps them to plan for their care. For the person who was admitted as an emergency, details were obtained from family members and a care plan was being developed during the first 48 hours of their stay. This ensures that staff have a good understanding of peoples needs and deliver care in a consistent way. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 10 Staff spoken to confirmed that they usually had information about an individual before they moved in and that when they first arrived this was discussed in some detail as part of staff handover. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 11 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. Residents’ care is well planned, providing staff with information they need to meet residents’ needs. Residents’ health needs are met and supported by the appropriate involvement of other health professionals. There are good systems for managing medications. Staff and the management team promote residents’ privacy and dignity. EVIDENCE: Most residents spoken to said they were happy with the care. Comments included ‘’Staff are absolutely marvellous, so caring and helpful. Staff are all very nice and kind. The staff are wonderful, couldn’t fault it here at all’’ Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 12 One resident did comment that their call bell was not always answered quickly enough. This was fed back to the manager who agreed to discuss this further with the individual and resolve any concerns they may have about delivery of care. Plans of care are in place for all residents. These include a section on preferred routines and gives staff a good understanding of individuals needs. The manager is planning to further enhance this information by including what actions are specifically needed to ensure that all needs are met by staff. Staff spoken to say that the care plans helped to clarify individuals’ needs. Plans include details of how health care is provided and residents spoken to said that they see their GP, have access to a visiting chiropodist and are assisted to get to other health care appointments. Daily notes show that good monitoring of individuals health care is taking place, and any issues are discussed as part of each shift handover. Staff spoken to were aware of the need to treat residents with respect and knew of ways of protecting their privacy. They were seen to knock on residents’ bedroom doors and speak to residents respectfully. Residents and staff confirmed that when general practitioners or nurses visited they were able to receive their treatment in a private place. The medication system for storage, recording and administering was checked during this inspection. This appears well managed, with only one senior member of staff per shift having responsibility for medications. All staff that take on this role only do so following training. This ensures that residents are protected. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 13 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. Routines are flexible and social activities meet most residents’ expectations and preferences. Residents benefit from contact with their family and friends, which is encouraged and supported by the home. Residents enjoy a balanced diet which takes into account the likes and dislikes of individuals. EVIDENCE: Residents spoken to said that they could choose when to get up. Several residents said they prefer to spend most of their time in their room and that staff respected this and enabled them to have their meals where they wanted. On the day of the inspection it was clear that individuals daily routines were being honoured, in that some residents were having a late breakfast, others said they had been up early and one or two were enjoying a lay in. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 14 Four visiting relative confirmed that they are made welcome, can visit at any time and are kept informed of their relatives well being. One said ‘’ we are very happy with the care, staff are very helpful and when needed the GP is called promptly. If there is ever a slight problem they will ring me.’’ One resident said that they are able to receive calls and can use the phone in private and confirmed they get their mail unopened. The home has a weekly programme of activities and staff try to ensure that they involve residents in these. Two staff were observed playing a game with residents. The atmosphere was relaxed and residents were encouraged to join in and appeared to be enjoying the activity. One survey from a resident said that they would welcome some trips out, to enjoy a change of scenery on occasion. Most residents spoken to and those who returned surveys said they enjoyed the meals and that there was a good choice on offer. The main meal of the day is served at lunchtime and this is usually at least two choices and several options available for pudding. The manager said that they try to ensure that all tastes are catered for and that some individuals have a limited choice they will accept. They try to ensure that where individuals have poor appetites that snacks are offered at regular intervals and that diet and fluid intake is monitored if there are concerns. The menu plans show that the home offers a balanced diet and tries to cater to all tastes. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 15 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 a satisfactory complaints process with evidence that complaints are listened to and acted upon. Residents are safeguarded from abuse. EVIDENCE: All residents spoken with and those responding with surveys felt that staff listen and act on what they say. All knew who to speak with should they have any concerns or complaints. Relatives spoken to said they could speak to staff about any concerns and would be confident that issues would be sorted out. No complaints have been received by CSCI since the last inspection. One complaint received by Social Services is being dealt with by their complaint department, and they have sought advice from the manager and from CSCI in respect of this complaint. Residents say they feel safe at the home. Staff spoken with demonstrated a good understanding of abuse and would report any concerns to the manager. The manager has a good understanding of the procedures to be followed and is aware of her responsibilities. Staff has received training in the prevention of abuse. The homes records for handling residents’ finances were checked and these were accurate with a well-maintained audit trail. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 16 Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 17 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. Resident’s benefit from living in a clean, well-maintained, comfortable home. Some improvements are needed to ensure that all areas of the home are safe EVIDENCE: During the last inspection it was noted that not all residents bedrooms are clean and fresh smelling. The manager explained that this had now been addressed to some extent, that one resident who is reluctant to allow staff to clean their room has agreed to allow them to do a deep clean on a regular basis. The home was found to be overall clean and fresh smelling. The registered provider ensures that the home is reasonably well maintained, although two areas need to be addressed. The pathway around the house has some parts that are uneven and have been assessed as a risk to residents. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 18 This needs to be looked at, as although the area assessed as being unsafe has been cordoned off, resident could, if they chose still access this area. The other issue that should be addressed is that currently residents only have one socket in their bedrooms. If they have a number of electrical items they wish to use, extensions would have to be used, which can present as a trip hazard. The registered provider should ensure that each room has at least two plug sockets for residents to use safely. The manager said they are currently looking at how they can improve their bathrooms and toilet facilities, so that there is more space available for those residents who need to use a wheel chair. This would improve the safety of both residents and staff. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a staff group that are well trained and have a good understanding of their needs. A robust recruitment process protects residents. EVIDENCE: Staff spoken to and those who returned surveys said that they have good opportunities for training, although two said they would like the opportunity to do more, such as first aid and further NVQ training. This was passed to the manager who confirmed training needs were identified via supervision and appraisals and where possible training was always provided. More staff have now completed training in dementia care. The numbers and skill mix as indicated on the staff rota appear sufficient for the number and needs of the current resident group. Management need to ensure that staffing levels are kept under review to ensure that all care needs can be met in a timely fashion. The staff files were not available for inspection, but the pre inspection questionnaire evidenced that new staff do have CRB checks and references are followed up. This ensures that residents are protected. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 20 One staff member commented that they are not always given praise and support by management, but several others said that the staff team work well together and that their efforts were acknowledged as part of supervision and team meetings. Minutes of team meetings confirmed that the manager had thanked staff for their efforts. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 21 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. The home is well managed and run in the best interests of the residents. EVIDENCE: The manager currently in post is seconded from another home belonging to Social Services. She has previously worked At Beech House and has a good understanding of the home, residents and staff team. The home has developed their quality assurance programme to include surveying residents on a regular basis on specific issues such as the meals or activities. The manager said that where ideas were made these have been looked at. She gave the example of someone suggesting a video afternoon, Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 22 and some residents wanted to get involved in gardening so they were looking at getting some raised borders to enable this. Policies and procedures are well documented and financial transactions are robust. The accounting system for residents’ monies was checked during this inspection. The pre inspection questionnaire details that policies are in place as well as good maintenance of the building and equipment. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 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 3 X X 3 Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 24 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 OP29 Regulation 17 (2) Requirement The registered person must maintain in the care home the records specified in Schedule 4. (Previous requirement timescale of 20/09/05, 30/03/06 and 30/09/06 not met) n.b. this requirement could not be checked during this inspection as staff records were not available. Timescale for action 30/09/07 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 OP30 Good Practice Recommendations All Staff should be provided with training that helps them to fully meet the needs of service users who have dementia. The registered provider should ensure that all parts of the DS0000039190.V331164.R01.S.doc Version 5.2 Page 25 2. OP19 Beech House, South Molton 2. OP27 home are safe and free from risk. This refers to the pathway needing to be well maintained and the residents’ bedrooms only having one electrical socket. The home should keep the care staff levels under review to ensure they can meet all residents’ needs. Beech House, South Molton DS0000039190.V331164.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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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