Inspection on 16/01/06 for Beech House, South Molton

This inspection was carried out on 16th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 13/07/06

Beech House, South Molton 20/06/05

Beech House, South Molton 18/11/04

Beech House, South Molton 22/04/04

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Poldhu

Queensmount

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Belma

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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 Announced Inspection 16th January 2006 09:30 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.V263136.R01.S.doc Version 5.1 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.V263136.R01.S.doc Version 5.1 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 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.V263136.R01.S.doc Version 5.1 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. 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.V263136.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and took place during the hours of 9.15 to 3pm on a weekday in January. The main focus of the inspection was to seek the views of the residents and 10 were spoken to during the day. Time was also spent talking to staff members, the registered manager and reviewing some of the key documents, which included care plans, medication records, staff files, accident/ incident reports, the fire logbook and risk assessments. The home had completed a pre inspection questionnaire and asked to request that residents and their carers complete feedback cards. A small number of these were returned. During the inspection two visiting relatives were spoken to also. What the service does well: What has improved since the last inspection? As this was the first inspection I have completed in this home, it is difficult to comment on what has improved since the last inspection, particularly as the requirements made previously still need to be worked on. Beech House, South Molton DS0000039190.V263136.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Beech House, South Molton DS0000039190.V263136.R01.S.doc Version 5.1 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.V263136.R01.S.doc Version 5.1 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): 4,5 Residents can be confident that a trained and caring staff group can meet their needs. Opportunities are provided for prospective new residents and their relatives to visit the home prior to admission. EVIDENCE: Staff spoken to confirmed they have opportunities to receive training in all key areas, but would benefit form some dementia care training to further enhance their skills. Records back up the fact that staff have regular training support and supervision. One resident confirmed they were able to come and look round before moving in and another stated their family looked on their behalf. The home has detailed information to give to any prospective new service users, and the manager is keen to work in conjunction with CSCI to make this more user friendly. Beech House, South Molton DS0000039190.V263136.R01.S.doc Version 5.1 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): 7,8,10 The home are unable to demonstrate that they can fully meet residents individual needs to incomplete and inadequate care plans. Residents can be assured that health care needs will be met and that their right to privacy and dignity will be maintained. EVIDENCE: Seven care plans were viewed and discussed with a staff member. One individual had no care plan written, it was stated that this was because they were in the process of rewriting them all. Three of the plans were not completed in sufficient detail to demonstrate that the home had assessed and reviewed the individuals needs and considered their preferred routines, likes and dislikes. The last section of the plan asks for the individual’s preferred daily activities. This section was not completed or contained insufficient information on all plans viewed. The plans were not signed or dated and there was no evidence that they were reviewed on a monthly basis. Given that some residents have complex needs, it is vital that detailed plans be devised and reviewed to meet the individuals changing needs. Beech House, South Molton DS0000039190.V263136.R01.S.doc Version 5.1 Page 10 Files did contain evidence that health care needs were being met, and staff confirmed that they ensure their key work individuals attend health care appointments. It was also evident in the detailed handover meeting that health care was being fully considered and relevant actions taken. Residents confirmed they were well cared for and this included health care needs. As part of the inspection process the medication records were checked and medications were seen to be safely and securely stored. Records in respect of assessments for self medication were not reviewed on this occasion, although this is an area that was highlighted as needing further work to ensure residents who do self medicate, do so within a risk management framework. Staff were observed to be providing care and support in a respectful manner that took into consideration individuals dignity, respect and rights to privacy. Some residents confirmed that they preferred to spend most or all of their time in their rooms and staff respected this wish. Beech House, South Molton DS0000039190.V263136.R01.S.doc Version 5.1 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 The home offers a good range of activities to ensure residents are engaged and stimulated. Residents can be assured that the home will enable them to maintain family and friends contacts, that visitors are made welcome and that individuals are given choice and control over their lives. The home ensures that a good range and choice of meals are available in order to provide a balanced diet. EVIDENCE: In each lounge area there is a timetable of daily activities and during this inspection residents were observed to be engaged in board games, reading and one to one chats. Staff confirmed that the staffing levels do now allow them more dedicated time to engage with residents. One staff member did state that more outing could be arranged to enhance the resident’s quality of life and experiences. Several residents stated that they enjoyed taking part in organised activities, which did also include some outside entertainment. One resident stated that a great deal of effort had been made for their birthday, which made them feel special and wanted. One visiting relative confirmed that the family were always made welcome and kept fully informed of any changes in respect of their relative. Beech House, South Molton DS0000039190.V263136.R01.S.doc Version 5.1 Page 12 Residents spoken to stated that they were able to make choices about their lives, when to get up where to spend their time and that they were free to join in within the communal areas or spend time in their rooms. Menu plans evidence that the home provide a good range and choice of meals. The midday meal was sampled with residents and it was served in a relaxed and unhurried manner. Residents needing some support were given help in a respectful manner. Each smaller unit has its own dinning area so residents eat on small-shared tables. Comments form residents included ‘very good, there is as much as you want, plenty of choice’ Beech House, South Molton DS0000039190.V263136.R01.S.doc Version 5.1 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 Residents can be confident that their concerns and complaints will be taken seriously and acted upon. The home has procedures and policies in place that staff are aware of to ensure residents are protected from abuse. EVIDENCE: The home has a stated complaints procedure and copies are in evidence around the home. All of the residents spoken to were confident that if they had any concerns they could speak to staff and any issues would be dealt with. One visiting relative also believed that concerns would be listened to by staff. Staff spoken to were aware of key policies in place to ensure residents were protected form abuse and who they should speak to if they suspected any form of abuse. Staff also receive training in this area. The procedures and accounting system for handling residents monies were viewed and discussed with a senior member of staff. Records were seen to be accurate and there was a clear account of where monies were being spent. Beech House, South Molton DS0000039190.V263136.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The home provides a clean safe and well maintained environment for residents EVIDENCE: During this inspection all of the communal areas including the laundry area and some of the residents bedrooms were viewed. All areas were found to be clean and homely. It was acknowledged by the manager that some of the areas are in need of redecoration and it is hoped that with future plans for the home to develop as a specialist home for people with dementia as well as caring for the frail elderly, that some building work will be needed and following this most areas will be refurbished. Residents spoken to confirmed that the home was kept clean and tidy and most stated they liked their rooms. The laundry area is well maintained with appropriate facilities in place. Beech House, South Molton DS0000039190.V263136.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The home has sufficient staff per shift to ensure the needs of the current residents are met. Residents cannot be assured that they are properly protected by the homes recruitment procedures. Though skilled and competent to meet many needs of residents, staff do not have the knowledge required to meet all the specialist needs of people with Dementia. EVIDENCE: As part of the pre inspection questionnaire a sample of staff rotas were submitted, which evidences that there are sufficient staff on duty per shift. Staff spoken to were able to demonstrate a good knowledge base and experience of working with current residents, however it remains that they still require some ongoing training in care of dementia. Staff records do not conform with what is required in the regulations, i.e. records to be kept in the home for staff. This information is stored centrally and the home only has a check list of what is kept. On one persons staff file, there was no record that proof of ID had been seen. Beech House, South Molton DS0000039190.V263136.R01.S.doc Version 5.1 Page 16 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 The home is well managed by a registered manager who is qualified and experienced to ensure residents are well cared for in a safe environment. EVIDENCE: The registered manager is experienced and qualified to run the home. Staff spoken to confirmed that the management approach is open and inclusive and that they are well supported to do their job effectively. Policies and procedures are well documented and financial transactions are robust. The accounting system for resident’s 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. Staff records demonstrate that all key areas are covered in training. One staff member did raise that more regular fire drill would be useful and this is something the management are implementing. Beech House, South Molton DS0000039190.V263136.R01.S.doc Version 5.1 Page 17 Since the last inspection the home are now doing monthly checks on the fire extinguishers. The monthly visits by the responsible individual or their representative have not been happening. The last visit record was July 2005. Beech House, South Molton DS0000039190.V263136.R01.S.doc Version 5.1 Page 18 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 X 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 X 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 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.V263136.R01.S.doc Version 5.1 Page 19 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 not met) The home must ensure all residents have a care plan that details all personal, health care and social and emotional needs, and that these are reviewed at least monthly. The responsible individual must ensure that monthly visits to the home are made and quality monitoring is recorded and a copy sent to CSCI Timescale for action 30/03/06 2. OP7 15 30/03/06 3 OP33 26 30/03/06 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 OP7 Good Practice Recommendations The service user plans should set out in detail the action which needs to be taken by care staff to ensure that all DS0000039190.V263136.R01.S.doc Version 5.1 Page 20 Beech House, South Molton 2. OP9 3. OP30 aspects of the health, personal and social care needs of the resident are met. Risk assessments should be recorded and action taken to manage risks as indicated by these assessments where service users take responsibility for administering medication themselves. 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.V263136.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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.V263136.R01.S.doc Version 5.1 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. 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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