Inspection on 13/07/06 for Beech House, South Molton

This inspection was carried out on 13th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Beech House, South Molton 10/05/07

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 13th July 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Beech House, South Molton DS0000039190.V296090.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.V296090.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 http/www.devon.gov.uk/adoption.htm Devon County Council Judy Ann Flanagan Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th January 2006 Brief Description of the Service: Beech House is a care home providing personal care and accommodation for up to 37 older people. Most people live at the home on a long-term basis, but short stays are available. Many of the people living at the home need care as they have been diagnosed as having Dementia. An application to vary the registration of the home to register it as a specialist home for people with dementia, as well as for older people with problems that relate to old age, is currently being considered by CSCI. 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.V296090.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a weekday and lasted approximately 7 hours. The inspection was unannounced meaning the home were not made aware of the inspection date. During this inspection time was spent talking to residents and most of the staff group on duty that day. The inspection process also involved a tour of the premises and reviewing some of the homes key documents, which included care plans, medication records, the fire logbook and records relating to individuals finances. Questionnaires were sent to all of the residents and to a third of the staff group. 6 responses were received from residents and 9 from staff. The home also completed a pre inspection questionnaire prior to the inspection and this helped to inform the inspection process. Six relatives of individuals living at Beech House were contacted following the inspection. All stated that they were overall satisfied with the care and support provided. One family member said that things have improved since being involved in the reviewing of the care plan of their relative. What the service does well: The home ensures they can meet the needs of prospective new residents by a pre admission assessment process. The home’s medication storage and recording system appears to be robust to protect residents. The home offers a good choice and variety of meals that provides residents with a balanced diet and can cater for special dietary requirements. The home has a weekly plan of activities offered to residents and one member of staff is tasked with ensuring that activities are offered and suit individuals’ needs and preferences. Visitors are made welcome and are able to visit at any time. Six relatives contacted by phone and two spoken to on the day of the inspection confirmed this. Policies, procedures and training are in place to protect residents from abuse. The home is well maintained and safe. The staff group are knowledgeable and experienced to provide good quality care to the residents. Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 Page 6 The home operates a robust recruitment process that ensures the protection of its residents. 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, South Molton DS0000039190.V296090.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, South Molton DS0000039190.V296090.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 at least once during a 12 month period. 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.” Prospective new residents can be assured that their needs will be assessed prior to moving into the home EVIDENCE: The information for the two newest residents were viewed and discussed with the assistant manager. The home always obtains a copy of the care management assessment and care plan, and where possible complete their own assessment of the individuals needs to ensure they fully understand the needs and that Beech House can meet these needs. Beech House, South Molton DS0000039190.V296090.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 at least once during a 12 month period. 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.” Individuals’ personal and health care needs are well met. Residents are protected by the homes policies and procedures for dealing with medications. Residents are mostly treated with respect and dignity and their privacy is ensured. EVIDENCE: Four care plans were looked at in some detail during this inspection. The home have worked hard to ensure that plans include details of the individuals personal and health care needs as well as some social history and what they enjoy doing. The home are now also involving the individual and/or their relatives where possible to review and develop plans. This is a very positive step forward in ensuring that all needs are met in a consistent way. Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 Page 10 The home are now also evidencing that plans are reviewed on a monthly basis. Plans of care include risk assessments, moving and handling plans and where needed weight monitoring. Health care needs are recorded on a separate sheet. Details of appointments and emotional well being are also recorded as part of the daily records that get written up after each shift. Some residents spoken to confirmed that they are able to see their GP when they needed and that there was a visiting chiropodist and optician. Residents also confirmed that district nurses are called when dressings are needed. The home’s medication storage and recording system were viewed and this appears to be robust to protect residents. The room where medications are kept was very warm, although the weather was exceptionally hot on the inspection day. It is recommended that the home keep a check on the temperature of the medication storage room to ensure medications are not compromised in the heat. Residents spoken to stated that overall they were treated kindly and with respect by the staff, but one or two did mention that it depended on the staff on duty. One person stated that one member of staff did not treat them with respect, and this had been raised with the manager. The observations of the way staff interacted with residents during the inspection were generally very positive. Two staff was observed hoisting residents in a very gentle and relaxed manner that clearly helped put the residents at ease. The lunchtime appeared a little chaotic and one member of staff was observed not to listen to what a resident was saying. Six relatives were contacted by phone and all said that they were generally happy with the care provided and that staff were mostly kind and respectful to their relatives. One did mention that occasionally the odd staff member did not appear as approachable as the rest, but that they did not feel this was cause for concern or feel they needed to raise this with a senior member of staff. Beech House, South Molton DS0000039190.V296090.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 at least once during a 12 month period. 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 tries to meet individuals’ social and recreational interests. Residents are assisted to maintain contact with their family and friends and are enabled to exercise choice and control over their lives. The home provides a good range and choice of meals that suits individuals’ preferences and special diets. EVIDENCE: Plans of care now detail individuals’ preferences in relation to social activities. The home has a weekly plan of activities offered to residents and one member of staff is tasked with ensuring that activities are offered. One member of staff stated that although there is a plan of activities these do not always happen, due to staff shortages and being too busy attending to individuals care needs. During this inspection day one resident was taken out on the home’s electrical scooter for a drink at the local pub, as it was their birthday. Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 Page 12 One staff member stated that they have a resident whose first language is not English and they have been trying to look up words and sentences to converse with this individual in their own language. Some residents were able to confirm they enjoyed playing games and singalong that staff organised. Others confirmed that they are able to choose where to spend their days, a few preferring to spend most of their time in their room. One resident stated that they enjoyed reading and that the home organised for daily papers to be delivered and books in large print was available. Relatives spoken to confirmed they are able to visit when they wished and are made welcome by staff. The assistant manager stated that individuals are enabled to stay in touch with their families and friends via visits and phone calls that can be taken in private. She also confirmed that staff does not open post, but for some residents relatives sort out their mail. Two staff surveys returned voiced concern about the fact they are asked to get residents to bed by 9 pm. The assistant manager stated that this is not the case, but that some individuals are encouraged to get ready for bed prior to 9 pm when there is a reduced staff, especially if they require two carers to assist them. Residents spoken to who were able said they were able to decide what time they got up and went to bed. The home offers a good choice and range of meals. On the day of the inspection the cook had called in sick and the assistant manager had had to step in and prepare the lunchtime meal. Residents spoken to appeared to enjoy the meals and choices provided and one survey returned stated that the kitchen staff made every effort to ensure pureed food was still appetising. One resident felt the meals were very bland as no salt was added to the cooking, but this was the only negative comment. Beech House, South Molton DS0000039190.V296090.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 inspected at least once during a 12 month period. 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.” Complaints and concerns are taken seriously and acted upon, but the home needs to make clear to the complainant what actions have been taken. Residents are protected from abuse EVIDENCE: The record of complaints was not made available for inspection as this was locked in the manager’s office and she was not available that day. The CSCI have received one complaint since the last inspection and are satisfied that the home resolved this in a satisfactory manner. One resident did say they had made a complaint to the manager and had not had any feedback. The inspector was unable to check this; the complaints records were not available. The home must ensure that all complaints are recorded including what actions have been taken to resolve issues and what feedback was given and whether the complainant was happy with the response. Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 Page 14 Staff have received training in POVA and those spoken to were aware of what they should do if they suspect abuse. The home has policies and procedures in place to ensure that residents are protected. The homes records for handling residents’ finances were checked and these were accurate with a well-maintained audit trail. Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 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 the following standard(s): 19,26 “Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service.” The home is suitable for its stated purpose and residents can be assured that the environment will be homely and well maintained. Some improvements are needed to ensure that the environment is kept clean and odour free. EVIDENCE: During this inspection a tour was made of most of the building. There are one or two areas that are in need of some refurbishment. One of the sun lounges was out of use due to the flooring being a risk to residents. Clear signage had been put to ensure people did not use this room. A couple of the residents’ bedrooms were found to be a quite a dirty state and smelled quite strongly. This was discussed with the assistant manager who explained that the individuals involved were very reluctant to allow staff to clean their rooms. Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 Page 16 Staff surveys returned and staff spoken to on the day all indicated that the home was not as clean as it used to be, that hygiene standards had declined and that on some days the home did not always smell pleasant. On the day of the inspection the home was odour free apart from the residents’ bedrooms already mentioned. The assistant manager explained that they have been short on domestic staff and they are currently looking to recruit, but that standards in her opinion had not declined. This is an area the home needs to look at given the high volume of concern expressed by the staff group. Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” The staff group are knowledgeable and experienced to provide good quality care to the residents. A robust recruitment process protects residents. EVIDENCE: The pre inspection questionnaire completed by the home evidences that staff have training in all core skills and that some staff have now received training in the care of people with dementia. The assistant manager also stated that further dementia training was planned for staff. Staff spoken to confirmed that they have opportunities for training and receive support and supervision from senior staff. The numbers and skill mix as indicated on the staff rota appear sufficient for the number and needs of the current resident group, although three staff members indicated that the afternoon shifts can be chaotic. Management need to ensure that staffing levels are kept under review to ensure that all care needs can be met in a timely fashion. Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 Page 18 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.V296090.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 “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 was not available on the day of the inspection, but from previous inspections she has been able to evidence that she is qualified and experienced to run the home, and ensure that she has ongoing training. The home’s quality assurance programme was not fully inspected, as information regarding this was not available. The assistant manager was aware that questionnaires are sent to those individuals who use the service for Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 Page 20 respite, but was not clear about whether the home uses surveys for permanent residents. They do hold quarterly residents’ meetings but minutes were only available for 9/6/05. The home needs to ensure that the quality assurance programme seeks the views of all residents and that any results of surveys are made available to residents and a copy to CSCI. 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.V296090.R01.S.doc Version 5.2 Page 21 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 2 17 X 18 3 3 X X X X X X 2 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 2 X 3 X X 3 Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 Page 22 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 and 30/03/06 not met) n.b. this requirement could not be checked during this inspection as staff records were not available. The Home must ensure that it seeks the views of all residents in relation to the quality of care and that results of any surveys are made available to residents and a copy sent to CSCI. Timescale for action 30/09/06 3. OP33 26 30/12/06 Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 Page 23 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 5. Refer to Standard OP9 OP16 OP26 OP27 OP30 Good Practice Recommendations The home should ensure that regular temperature checks are kept on the room where medications are being stored. The home should ensure that complainants are made aware of what actions have been taken to resolve issues. The home should ensure there is sufficient domestic staff to keep all parts of the home clean and smelling fresh. The home should keep the care staff levels under review to ensure they can meet all residents’ needs. All Staff should be provided with training that helps them to fully meet the needs of service users who have dementia. Beech House, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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, South Molton DS0000039190.V296090.R01.S.doc Version 5.2 Page 25 - 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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