Inspection on 14/07/05 for Beech Lodge

This inspection was carried out on 14th July 2005.

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 Lodge 25/09/06

Beech Lodge 19/01/06

Beech Lodge 24/02/05

Beech Lodge 05/08/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Beech Lodge Guildford Road Broadbridge Heath Horsham, West Sussex RH12 3PW Lead Inspector Annette Turner Announced 14 July 2005 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Beech Lodge Address Guildford Road, Broadbridge Heath, Horsham, West Sussex, RH12 3PW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01403 791725 Dr Shafik Hussein Sachedina and Mr Shiraz Boghani Mrs Corrine Alison Nikolova CRH 30 Category(ies) of LD Learning disability - 30 registration, with number LD(E) Learning disabiity over 65 - 1. of places Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users accommodated in Beech Lodge One and Two may also have a physical disability. 2. Service users accommodated in Redwood House are in the category Learning Disability (LD) requiring personal care only. 3. One named service user in Redwood House is in the category Learning Disability over 65 LD(E). Date of last inspection 23 February 2005 Brief Description of the Service: Beech Lodge is situated in a rural area about five miles from the town of Horsham. There are two buildings on the site. There is a purpose built establishment that accommodates twenty people on the ground floor and a detached two storey house that accommodates ten people on the ground and first floor. There is one double room; eighteen people are accommodated in single rooms. Eighteen rooms have en-suite facilities. There are four communal areas in one building and one communal room in the other building. The communal areas are used for activities and there is a separate activities room adjacent to one of the buildings. A spa pool and sensory room are available on the site. The service is privately owned by Sussex Health Care; Dr S Sachedina and Mr S Boghani are the responsible individuals. Mrs Corinne Nikolova is the registered manager reponsible for the day-to-day running of the home. Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over two days. This was the first inspection since through a variation to the registration Beech Lodge and Redwood House became one establishment. Mrs Corrine Nikolova and the staff assisted with the inspection. A tour of both buildings took place. Care staff assisted with communication so that five service users could express their views to the inspector. Nine members of staff were spoken with including a group of seven staff. Comment cards were received from four health and social care professionals and seven relatives. Nine service users were assisted by staff to complete comment cards. The majority of comments received were positive about the service. All the service users communicated that they like living at Beech Lodge. What the service does well: What has improved since the last inspection? Person centred care planning is being introduced to make sure that each person can express their goals and aspirations. Progress is being made in providing a coordinated service. The new registration and management arrangements will provide people with opportunities to share facilities more easily. Staff records have been reviewed and updated recently to make it clear that the recruitment policy is being followed for the protection of service users. Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 6 The manager has developed an open approach; service users and staff said that they feel heard. 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 Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 4 and 5 The needs of service users are thoroughly assessed before they move to Beech Lodge to make sure that they will know that their needs will be understood and met. Service users have a transition plan so that they can visit the home and stay overnight to make sure that the home will suit them. Everyone has a written contract detailing the terms and conditions of their stay. Key points are available in symbol format. EVIDENCE: Sussex Health Care provides a thorough pre-assessment form to ensure that service users’ needs and aspirations are understood before a place at Beech Lodge is offered to them. Service users are at the centre of the assessment process and information is also gathered from health and social care professionals and relatives who know the service user. Senior staff carry out the assessment and the registered manager and other key staff meet the service user prior to a transition plan being made. Examples were given where people were not offered a place at Beech Lodge because their needs and aspirations would not be able to be met. Each person has a transition plan to make sure they have the opportunity to visit the home for overnight stays before they make a decision about a move. Copies of the terms and conditions of residency were seen on case files. Some key information is provided in symbol format so that it can be more easily understood by service users. Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 and 10 Service users have their needs assessed and reviewed so that the care plans reflect their views. Not all service users were clear about what was written in their care plan. Documents showed that service users are supported to make decisions about their lives where they are able to do this. People are encouraged with independence skills and potential risks identified. Service users are consulted in some aspects of their lives. Staff understand the need to protect the confidentiality of service users. EVIDENCE: All aspects of people’s physical and social care needs were identified in the case records that were seen. Person centred care planning is being introduced. This process will ensure that individual goals and aspirations are clearly identified. Risk assessments had been carried out to ensure that service users are protected. It was evident that reviews have been carried out and changes of need noted, however several service users were not clear about their care plans. The manager said that she would consider ways to make sure that people are more involved and aware of what is written about them. There was evidence to show that where people’s choice or freedom had been limited due to an identified risk they had been involved in this decision. Case records are kept in a lockable office. There are policies regarding Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 10 confidentiality and staff spoken with were clear about this issue. Service users could be reassured that information kept about them is handled appropriately. Weekly meetings are held to plan activities and the menu for the following week. Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15 and 17 Service users have opportunities for personal development through a programme of activities. People are supported to attend college and to take part in leisure activities of their choice. Contact with friends and relatives is encouraged. People are provided with a healthy diet and mealtimes are relaxed. EVIDENCE: It was clear from case records seen that service users have access to specialist support when they need this. People are encouraged to attend college courses of their choice. College outreach sessions are held in several Sussex Health Care Homes during term time. The manager said that during the holiday period there is an emphasis on activities and outings. Several people make use of facilities at the new Sussex Health Care Centre. Two people said that they had been supported to go shopping recently. Some people are able to use the local swimming pool because they do not need special equipment for swimming. Two mini buses are available to take four people in wheelchairs out at one time. There is a programme of activities in the home and on the day of the inspection a cooking activity and a music session were available. The Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 12 manager and activity coordinator said that the activity programmes are being reviewed to ensure that everyone has a programme that they enjoy. The use of the activity room in the older building is being reviewed. There is a sensory room and spa pool available in the new building. The manager said that 75 of service users have funding for aromatherapy and reflexology; some people were benefiting from this service during the inspection. People are supported in their contact with relatives and friends. Several people visit their family at weekends. A summer barbecue was planned for the weekend and a number of visitors were expected. The manager said that a ‘holiday from home’ programme has been planned because it has been difficult to find a suitable holiday facility. Those facilities identified were expensive and some service users did not have access to the funds to allow them to take up this opportunity. Service users should have the choice to go away for a holiday each year; the manager agreed to follow this up. There is a kitchen and a chef with a separate menu in each building. Special diets are catered for and special requirements are documented. Service users are provided with a nutritious diet and are involved in choosing the menu each week. Kitchen records that were seen were in order. Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 Service users are provided with the personal, physical and emotional care that they need. People have access to appropriate medical services. EVIDENCE: There are policies and procedures regarding the way that personal care should be provided. Staff spoken with said that they had been given guidance on these issues as part of their induction. The personal and health care needs of service users were clearly identified on the case records that were seen. People living in both buildings have access to a visiting GP once a week. It was clear from case records that people are supported to attend hospital and other medical appointments. The issue of oral hygiene was discussed with the manager who confirmed that appointments have been made for all service users to see a dentist. Some people are registered with a dentist near their parent’s home. An optician visits Beech Lodge twice a year; the manager said that this is beneficial as people are more relaxed at home. Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Service users indicated that they feel listened to. There is a complaints policy and procedure that is produced in symbol format to assist service users. Staff are provided with training to ensure that they understand how to protect people from abuse, harm and self-neglect. EVIDENCE: The complaints policy has been made available to everyone in the home. Complaints are recorded and the complaints books for both buildings were seen. Complaints had been appropriately recorded and investigated. A record is kept of all meetings and correspondence. Service users spoken with and those who returned comment cards indicated that they feel listened to. There are policies and training regarding adult abuse and protection. The staff spoken with indicated that they understand what to do in the event of a concern that abuse may have occurred. There are policies regarding protecting service users’ finances however the manager explained that it is sometimes difficult to ensure that service users have access to the monies that they are entitled to. This issue is being followed up with local authority placement officers. Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 and 30 The two buildings at Beech Lodge provide different environments for service users. The older building is more suitable for people who have some mobility. The newer building provides purpose built facilities for people who have a physical disability. People are provided with rooms and equipment that meets their needs. There are sufficient bathing and laundry facilities. Environmental risk assessments should be carried out in the older building to ensure that people have a safe environment. EVIDENCE: A range of facilities is provided in the two buildings including sufficient communal space. There is a programme of maintenance and redecoration. Emergency repairs are carried out as required. A number of safety issues in the older building were brought to the attention of the manager and some were addressed at the time. The manager agreed to seek the advice of the fire officer and the environmental health officer. A fire inspection was due to be carried out the following week. Service users spoken with were happy with their rooms. The purpose built facilities were designed to meet the needs of people who have physical Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 16 disabilities. In addition to the communal rooms there is a spa pool and a sensory room that are used by people in both buildings. A physiotherapist provides assessments and treatment programmes to ensure that people have the equipment they need. Several people have accessed funding for specialist equipment to help them sleep more comfortably. There is a lack of storage space for large items of equipment that are currently stored in a communal lounge. There are sufficient laundry and sluice facilities. The care staff who work in the older building currently undertake cleaning and laundry duties. Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 and 36 Service users are supported by staff who are suitably trained to understand their needs. There were sufficient staff on duty to provide for the needs of service users. The recruitment policy and procedure ensures the protection of service users. Staff are supervised and supported to ensure that service users receive the care that they need. EVIDENCE: The staffing rotas and some training records were seen. Staff are employed in sufficient numbers to meet the needs of service users. Care staff who work in the older building currently undertake cleaning and laundry duties in addition to their care responsibilities. An activity coordinator is based in the newer building. Sussex Health Care provides an induction and ongoing training programme. The records of staff who have undertaken mandatory training were seen to be up to date. Staff said they are supported to undertake NVQ and other relevant training. Staff records showed that all the necessary checks are carried out prior to employment in order to ensure the protection of service users. Staff said that they feel well supported and have practical supervision. The manager said that she would be developing a structured system to ensure that all staff receive supervision and appraisals. Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 41 and 42 Service users benefit from a well run home. The ethos and management approach is open and inclusive. The amalgamation of two units under one registration has presented some challenges and provides opportunities for service users. Efforts are being made to ensure the health and safety of service users. Environmental risk assessments should be carried out and issues addressed in the older building. EVIDENCE: Mrs Nikolova is suitably qualified and experienced in running a care home for people who have learning and physical disabilities. Mrs Nikolova has recently completed the NVQ level four award in management. Service users and staff said that they feel listened to. It is clear that Mrs Nokolova makes herself available to staff and service users. The tour of the older building showed that there are safety issues that need to be addressed. The fire officer’s inspection is due and the manager said that these issues would be raised and advice sought. The advice of the Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 19 environmental health officer is to be sought regarding the window restrictors that are in use. Building work being carried out in the grounds has presented some risks for people who are mobile; some building equipment was moved during the course of the inspection. Health and safety training records were seen to be up to date. The incident recording was checked and methods of monitoring the welfare of service users were discussed with the manager. Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Beech Lodge Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x 3 2 x H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 21 NO 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 24 and 42 Regulation Reg 13 (4) (c) Requirement The registered persons shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. Timescale for action 31/08/05 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 Good Practice Recommendations Beech Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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 Lodge H60-H11 S43443 Beech Lodge V229932 140705 Stage 4.doc Version 1.30 Page 23 - 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. 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