Inspection on 02/11/05 for Beech Hurst Nursing Home

This inspection was carried out on 2nd November 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Beech Hurst Nursing Home 24/04/06

Beech Hurst Nursing Home 08/06/05

Beech Hurst Nursing Home 08/11/04

Beech Hurst Nursing Home 08/06/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

1 Marten Road

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Beech Hurst Nursing Home Butlers Green Road Haywards Heath West Sussex RH16 4DA Lead Inspector Mrs S Gawley Unannounced Inspection 2nd November 2005 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 Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 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 Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beech Hurst Nursing Home Address Butlers Green Road Haywards Heath West Sussex RH16 4DA 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) 01444 412208 01444 412091 Care UK Community Partnerships Limited Miss Wilhelmina Aletta Ackermann Care Home 60 Category(ies) of Dementia (24), Dementia - over 65 years of age registration, with number (24), Mental disorder, excluding learning of places disability or dementia (12), Mental Disorder, excluding learning disability or dementia - over 65 years of age (12), Old age, not falling within any other category (24) Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A Maximum of 60 Service Users male and female may be accomodated Accomodation is provided in three units each with its own categories of registration. One unit is for up to 24 service users male and female in the category (OP) One unit is for up to 24 service users male and female in the categorys dementia over the age of 45 years (DE) and dementia over the age of 65 Years (DE(E)). One unit is for up to 12 service users male and female in categories mental disorder over the age of 45 years (MD) and mental disorder over the age of 65 years (MD(E)). 8th June 2005 Date of last inspection Brief Description of the Service: Beech Hurst is a care home providing nursing care and accommodation for up to 60 residents in the categories listed above. The accommodation is laid out in three units to care for the categories of resdients separately. The home is located in Haywards Heath a short drive away from shops and other amenities. It consists of a two-storey building with kitchen and laundry facilities.The majority of the homes bedrooms are single and all of the rooms have en-suite facilities.The home has well-maintained and accessible gardens. Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 02/11/05. The manager, residents, staff and visitors were spoken to. Relatives were generally happy with the care offered at the home stating that residents were clean and well cared for. Two visitors did state that they felt there was a general lack of supervision for residents in the lounges and garden with staff not checking residents too often. This I observed in one unit where staff did not look in on two residents in one lounge for the time I was on the unit. The provision of activities was not displayed although the activities coordinator was spoken to and she stated that a second coordinator has been employed which will lead to an improvement in the provision and advertising of activities. # What the service does well: What has improved since the last inspection? What they could do better: It was not evident that fluid intake is monitored and encouraged. Fluid charts inspected showed considerably less than the recommended fluid intake in 24 Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 6 hours. Ways of improving the monitoring and recording of fluid intake were discussed with the unit manager and the registered manager and are a requirement of this inspection. 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 Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 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 Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 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): 1,3. Standard 6 is not applicable. Prospective residents have the information they need to make an informed choice about where to live. No resident moves into the home without having had his/her needs assessed and been assured that these will be met. EVIDENCE: A Statement of Purpose and a Service User Guide are in place and available to all residents and relatives. It contains information they need to make an informed choice about where to live. All residents have reassessment prior to admission and their needs are clearly set out in the care plans. Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 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 The resident’s health, personal and social care needs are set out in an individual plan of care. Resident health care needs are not met in full EVIDENCE: Care plans are in place and needs are recorded however not all needs are met and recorded. Fluid charts show minimal fluid intake and one resident who could not drink unaided had a full jug of water at 12:20pm. A suitable drinking cup/beaker was not supplied either. Fluid charts were inspected and these recorded minimal intake. This was discussed with the unit manager and with the registered manager. The unit manager suggested that the resident might have had more fluid, which had not been recorded. The need for staff to encourage fluid intake throughout the day and methods to facilitate accurate recording were discussed and its importance highlighted. Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 10 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): 12-15 The lifestyle experienced in the home matches expectations and preferences. Efforts are made to meet social need and recreational interests but these appeared minimal on this occasion. Contact is maintained with family and friends, but the ability to exercise choice was not apparent. There is a choice of meals on offer. EVIDENCE: Rooms are decorated according to choice and are personalised where possible. There were not any activities advertised. There was in particular a lack of stimulation observed in the mental disorder unit. The unit manager stated that he did not know what activities were on offer for the residents but that the category of resident makes stimulation difficult. It was suggested that care staff could engage more with the residents and not wait for the activities coordinator to be in attendance, this would lead to a more therapeutic environment. The activities coordinator stated that there is flexibility in the approach to activities on a daily basis and that these should now improve, as there is now another activities coordinator, who has just been appointed. The registered manager stated that it is intended to send the activities coordinators on some training to enhance their role. A varied diet was seen prepared and served which offered choice but menus are not on display in the dining rooms and staff spoken to stated that the residents would not understand them. Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 11 Efforts should be made to present these in a format to suit the capacities of residents. The kitchen was inspected and the regular chef was off. The chef covering and the kitchen assistant were spoken to. There was a cleaning schedule in place but it was not up to date. The floor under the cooker and other kitchen equipment/units were dirty. Temperature charts available were not complete and there was food stored in the fridge and freezer, which was not dated or labelled. These issues, which pose a risk to the health and safety of the residents, were discussed with the registered manager who will address this with the chef. Visitors were spoken to during the inspection and were generally happy with the care on offer and are free to visit at any time. One stated that communication could be more forthcoming from the staff rather than always having to ask for information and two stated that they felt residents sometimes did not have all the supervision needed when in the lounges or in the garden. All stated that they would know how to raise a concern and that it would be dealt with. The home handles small allowances for some residents, which are held securely and suitably recorded. On discussion with the registered manager she stated that training now in place on service user involvement, which is intended to help staff to relate in a more effective manner with residents. Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 12 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 and relatives are confident that complaints will be listened to and acted on. Residents are mostly protected from abuse. EVIDENCE: Residents and relatives were spoken to and stated that they are confident complaints will be listened to and acted on. There is a complaints book and procedure in place, which was available for inspection. Residents are protected from abuse by the provision of training and procedures on abuse. Manual handling procedures were not being adhered to as a resident was seen to be moved inappropriately from chair to wheelchair. This was discussed with the unit manager and the registered manager and will be addressed. Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 13 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): 19,22,26 Residents live in a safe, well-maintained environment. Residents have the specialist equipment they require to maximise their independence. The home is mostly clean, pleasant and hygienic. EVIDENCE: A programme of maintenance has been ongoing and improvements have been made. One bathroom in the mental disorder unit had a broken panel and the cupboarding around the cistern needed attention. The smokers’ lounge looked particularly shabby. Whilst this type of room will present certain difficulties the worn furniture and dirty ashtrays should be addressed. The unit manage stated that there are not any curtains in this room as the residents pull them down. One of the wheelchairs used by a resident in the smoking room was in disrepair and needs to be repaired or Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 14 replaced. Specialist equipment is in place for the moving and handling but was not used in moving a resident in the upstairs unit. The home today was mostly clean and free from offensive odours but there were issues of hygiene highlighted in the kitchen as described in standard 15. Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 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): 27-30 The numbers and skill mix of staff meets resident’s needs. Residents are in safe hands at all times. Residents are supported and protected by the home’s recruitment policy and practices. Staff are mostly trained and competent to do their jobs. EVIDENCE: Staff rota recruitment files and training records were available for inspection. The number of agency staff employed by the home has reached minimal levels ensuring continuity of care for residents. Training programmes were seen and staff confirm that they do receive training. Some areas were highlighted during the inspection as requiring update, encouraging and recording fluid intake, moving and handling and the upkeep of temperature charts and cleaning schedules in the kitchen to ensure the health and safety of residents Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 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): 35,36,38 Residents are safeguarded by the accounting and financial procedures of the home. Staff are appropriately supervised. The health, safety and welfare of service users and staff are mostly promoted and protected EVIDENCE: Bank accounts are not held by the home for residents. Small allowanced are held securely and records held. Staff supervision is not in place as yet as the manager has prioritised other areas such as recruitment. A deputy is to be appointed and will be involved in the implementation of supervision. Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 17 The health, safety and welfare of residents and staff are ensured by the provision of training in moving and handling, fire safety, first aid and food hygiene and infection control. Closer support supervision is needed in the monitoring of staff to ensure practices taught are those carried out in practice Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X 2 X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 2 X 2 Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP26 Regulation 16(2)(j) 13 (3) Requirement Timescale for action 31/12/05 2 OP22 3 OP12 4 OP36 5 OP15 The premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance. 13 (5) The registered person to make suitable arrangements to provide a safe system for moving and handling service users. 16(20(m)( The routines of daily living and n) activities made available are flexible and varied to suit service users’ expectations, preferences and capacities. 18(2) The registered person ensures that training and supervision arrangements are put into practice. 16(2)(i) The registered person ensures that service users receive a varied, appealing, wholesome and nutritious diet, (Fluids) which is suited to individual, assessed and recorded requirements, and that meals are taken in a congenial setting and at flexible times. DS0000024114.V261969.R01.S.doc 31/12/05 31/12/05 31/12/05 31/12/05 Beech Hurst Nursing Home Version 5.0 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Beech Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Hurst Nursing Home DS0000024114.V261969.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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