Inspection on 23/05/05 for Beech Trees

This inspection was carried out on 23rd May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Trees 10/04/06

Beech Trees 03/10/05

Beech Trees 21/10/04

Beech Trees 23/06/04

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.

DOMICILIARY CARE AGENCY Beech Home Care Services Unit 21 - Image House 326 Molesey Road Hersham Surrey KT12 3PD Lead Inspector Denise Debieux Announced 11 July 2005 @ 09:45am th 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 agency are those for Domiciliary Care. 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 Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Beech Home Care Services Address Unit 21 Image House 326 Molesey Road Hersham Surrey KT21 3PD 01932 223050 01932 221951 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) Mrs Henrietta Sumner Mrs Henrietta Sumner DCA - Domiciliary Care Agencies N/A Category(ies) of DCA - Dominiliary Care Abencies registration, with number of places Beech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 25 August 2005 Brief Description of the Service: Beech Home Care Services is a Domiciliary Care Agency supplying domiciliary care workers to service users in their own homes, on an hourly or ‘live in’ basis, in the Woking, Walton and Egham areas. The office is based in a business complex and includes, meeting, training and interview facilities. The accommodation is split-level with the Domiciliary Care Agency operating from the ground floor. The company also runs a Nurses Agency, which operates from the first floor of the premises. The agency is situated in Hersham, Surrey close to the main line railway station with public parking available nearby. Beech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 6.75 hours and was the first inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. This inspection was carried out by Denise Débieux, Lead Inspector for the service. Mrs Henrietta Sumner, Registered Manager, Mrs Jo Sumner and Mr Michael Sumner were present as representatives for the service. Prior to the inspection, survey forms were sent to a sample of ten service users with seven being returned and to ten of the care workers with eight being returned. Survey forms were also sent to a sample of health professionals, with three being returned. The results of these surveys and comments made are used in this report. Three care plans were inspected in depth and staff files, staff training records and policies and procedures were all sampled. The inspector would like to thank the staff for their time, assistance and hospitality during this inspection and the service users, care workers and health professionals who participated in the surveys. What the service does well: What has improved since the last inspection? Since the last inspection the agency has revised their statement of purpose, service users’ guide, individual contracts and updated the procedure for the protection of vulnerable adults. A new medication policy has been introduced to clarify the agency’s procedure for the administration of medication and staff training adjusted accordingly. Documentation of service user plans has been further developed, with carers writing more about the specific care that has been provided during a visit and formal risk assessments have been developed to identify any risks and protect the safety of service users and carers providing their care. Beech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 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 Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS User Focused Services (Standards 1–6) Personal Care (Standards 7-10) Protection (Standards 11-16) Managers and Staff (Standards 17-21) Organisation and Running of the business (Standards 22-27) Scoring of Standards Statutory Requirements Identified During the Inspection NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 8 User Focused Services The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. Current and potential service users and their relatives have access to comprehensive information, so that they can make informed decisions on whether the agency is able to meet their specific care needs. The care needs requirements of service users and their personal or family carers when appropriate, are individually assessed before they are offered a personal domiciliary care service. Service users, their relatives and representatives know that the agency providing their care service has the skills and competence required to meet their care needs. Each service user has a written individual service contract or equivalent for the provision of care, with the agency, except employment agencies solely introducing workers. Service users and their relatives or representatives know that their personal information is handled appropriately and that their personal confidences are respected. In the case of standards 5.2 and 5.3, these do not apply to employment agencies solely introducing workers. Service users receive a flexible, consistent and reliable personal care service. In the case of standards 6.3 and 6.4 these do not apply to employment agencies solely introducing workers. 6. The Commission considers Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 4 and 6 The agency provides a consistent and reliable service that meets service user’s individual needs. Information about the agency is clear and concise and is used by prospective service users to help them choose a service that is right for them. Contracts are supplied to service users who are self-funding. EVIDENCE: Following the previous inspection, the agency has revised their statement of purpose, service users’ guide and service users contracts. Together these documents now provide comprehensive information assisting prospective service users and their representatives to decide whether the agency can meet their needs. NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 9 The three care plans sampled during this inspection were seen to be based on thorough needs assessments. They were clear and well laid out and provided detailed information of the care required of the care workers. Where available, the preferences of the service users and the views and experience of relatives have been included. All of the service users surveyed stated that their carers had never missed a visit, understood their needs and would do things differently if they were asked. All of the health professionals surveyed stated that they felt the manager and staff show a clear understanding of the service users’ care needs. NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 10 Personal Care The intended outcomes for Standard 7 – 10 are: 7. 8. 9. 10. The care needs, wishes, preferences and personal goals for each individual service user are recorded in their personal service user plan, except for employment agencies solely introducing workers. Service users feel that they are treated with respect and valued as a person, and their right to privacy is upheld. Service users are assisted to make their own decisions and control their own lives and are supported in maintaining their independence. The agency’s policy and procedures on medication and health related activities protect service users and assists them to maintain responsibility for their own medication and to remain in their own home, even if they are unable to administer their medication themselves. In the case of standards 10.8 and 10.9, these do not apply to employment agencies solely introducing workers. The Commission considers Standards 8 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 The service users’ individual plans are clear and comprehensive including details of needs and goals. They also incorporate service users known or indicated preferences. The carers treat each service user as an individual and work hard to ensure their right to privacy is upheld. Medication policies and procedures have been reviewed and now offer clear guidance to the carers on the safe management of medication. EVIDENCE: Service users surveyed were complimentary regarding the care they receive from the carers. One service user commented that they were delighted with the service and another that the carers were always friendly and chatty. Care plans inspected were comprehensive and set out actions which need to be taken by carers to ensure that all aspects of the health and personal care needs of the service users are met. Care carried out during a visit is recorded in daily notes and each carer writes a weekly summary. Incidents when a change had occurred were seen to be written in the notes together with the action taken, such as contacting the GP or district nurse. NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 11 It has been recommended that service users or their representatives are asked to sign the care plans to show their participation in and agreement with the plan. The inspector was advised that the carers only prompt or assist service users to take their medication and do not take responsibility for administration. The agency has reviewed their medication policies and procedures to make sure that the carers handle medications safely. A recommendation has been made that the agency clarify and define prompting, assisting and administering medications to make sure that service users and carers are clear on the difference. NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 12 Protection The intended outcomes for Standards 11 - 16 are: 11. 12. 13. 14. 15. 16. The health, safety and welfare of service users and care and support staff is promoted and protected, except for employment agencies solely introducing workers. The risk of accidents and harm happening to Service Users and staff in the provision of the personal care, is minimised, except for employment agencies solely introducing workers. The money and property of service users is protected at all times whilst providing the care service, except for employment agencies solely introducing workers. Service users are protected from abuse, neglect and self-harm, except for employment agencies solely introducing workers. Service users are protected and are safe in their home, except for employment agencies solely introducing workers. The health, rights and best interests of service users are safeguarded by maintaining a record of key events and activities undertaken in the home in relation to the provision of personal care, except for employment agencies solely introducing workers. The Commission considers Standards 11, 12 and 14 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12 and 14 Arrangements are in place to minimise risk so that the safety and welfare of service users are promoted. The policies and practices of the agency ensure that service users are safeguarded, as far as reasonably possible, from abuse or harm. EVIDENCE: Clear policies and procedures are in place covering health and safety topics. Care workers are made aware of these through the induction process and when any changes are made. The care plans sampled show that full risk assessments are carried out for all aspects of the care the service users are to receive, including any risks to the carers in providing the service. NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 13 All carers surveyed confirmed that they were never asked to care for service users outside their area of expertise. The agency now has a copy of the latest Surrey Multi-agency Protection of Vulnerable Adults procedure and have amended their own policy in accordance with the Surrey procedures. NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 14 Managers and Staff The intended outcomes for Standards 17 - 21 are: 17. 18. 19. 20. 21. The well-being, health and security of services users is protected by the agency’s policies and procedures on recruitment and selection of staff. Service users benefit from clarity of staff roles and responsibilities, except for employment agencies solely introducing workers. Service users know that staff are appropriately trained to meet their personal care needs, except for employment agencies solely introducing workers. The personal care of service users is provided by qualified and competent staff, except for employment agencies solely introducing workers. Service users know and benefit from having staff who are supervised and whose performance is appraised regularly, except for employment agencies solely introducing workers. The Commission considers Standards 17, 19 and 21 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 17, 18, 19, 20 and 21 The agency has a staff recruitment and training procedure which is designed to ensure, as far as reasonably possible, that service users are supported and protected but must make sure that any potential gaps in staff employment histories are fully explored. Staff providing formal supervision need to undergo appropriate training. EVIDENCE: The agency recruits staff from overseas, most recently from countries newly joining the European Union. Staff files were seen to contain two satisfactory references, police checks from their country of origin, letters from the Home Office confirming their registration on the Workers Registration Scheme and proof of identity. However, gaps in employment were not always fully explored and a requirement has been made. NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 15 The agency have revised their staff handbook and a copy is given to all new recruits. Staff induction is provided during two days of theory in the agency’s training room and includes interactive computer modules, videos and hands on training as appropriate. This training includes all topics specified in the TOPSS (Training Organisation for Personal Social Services, now Skills for Care) induction standards. Following the initial induction new carers then shadow an experienced member of staff for two days and are then supervised for a further two days. 87.5 of carers surveyed felt they had been provided with induction training to help them understand the way the agency works and how to work safely and respectfully with service users. However 50 indicated that they would like more detailed information when going to a service user for the first time. This was discussed with the management at this inspection who are now going to look for ways to work with the staff in developing the care plans to include more detailed information. The manager commenced studying for her Registered Managers Award in April of this year and carers are enrolled on NVQ (National Vocational Qualification) level 2 in care as places become available. Staff meetings are held at least 3 monthly and the care workers receive formal supervision at least once every 3 months. Supervision notes were seen in carers’ files. A requirement has been made that staff providing formal supervision attend an appropriate course. All service users surveyed stated that the staff are always polite and that they do a good job. Positive feedback was also received from the health professionals surveyed. NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 16 Organisation and Running of the Business The intended outcomes for Standards 22 – 27 are: 22. 23. 24. 25. 26. 27. Service users receive a consistent, well managed and planned service. The continuity of the service provided to service users is safeguarded by the accounting and financial procedures of the agency. The rights and best interests of service users are safeguarded by the agency keeping accurate and up-to-date records. The service user’s rights, health, and best interests are safeguarded by robust policies and procedures which are consistently implemented and constantly monitored by the agency. Service users and their relatives or representatives are confident that their complaints will be listened to, taken seriously and acted upon. The service is run in the best interests of its service users. The Commission considers Standards 22 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 26 Service users benefit from a well-organised, consistent and reliable service. The agency has a simple, clear and accessible complaints procedure which includes timescales for the process. EVIDENCE: Beech Home Care Services is run from office accommodation which is situated next to Hersham railway station. The office has been appropriately equipped and is accessible to all staff. The complaints policy is clearly set out and a copy is given to each service user. The service users surveyed all stated that they knew who to contact if they wanted to complain. Two service users indicated that they had made a complaint and that they were happy with what the agency did to correct the problem. All of the health professionals surveyed stated that they were satisfied with the overall service provided by the agency. One relative commented ‘Now we have the support of good quality carers ...’ NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Domiciliary Care have been met and uses the following scale. 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 User Focused Services Standard Number 1 2 3 4 5 6 Score 3 3 x 3 x 3 Managers and Staff Standard Number 17 18 19 20 21 Score 2 3 3 3 2 Personal Care Standard Number 7 8 9 10 Score 2 3 x 3 Protection Standard Number 11 12 13 14 15 16 Score 3 3 x 3 x x Organisation and running of the business Standard Score Number 22 3 23 x 24 x 25 x 26 3 27 x NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 18 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Domiciliary Care Regulations 2003 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 17.3 Regulation 12(1)(d) Sched 3 Requirement The registered person must ensure that no domiciliary care worker is supplied by the agency unless full and satisfactory information is available in respect of each of the matters specified in Schedule 3 of the Domiciliary Care Agencies Regulations 2002, as amended by The Care Standards Act 2000 (Domiciliary Care Agencies and Nurses Agencies) (Amendment)(England) Regulations 2003. The registered person must obtain the following information: - full employment history - explanation of any gaps in employment - verification of reason for leaving employment retrospectively for each of the care workers. The registered person must ensure that staff providing formal supervision receive appropriate training. Timescale for action 11.07.05 2. 17 12(1)(d) Sched 3 22.08.05 3. 21.6 10(3) 15(2) 11.10.05 NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 19 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. Refer to Standard 7.7 10 Good Practice Recommendations It is recommended that the agency ask the service users or their representatives to sign the care plans to signify their agreement to the content. It is recommended that the agency clearly define the difference between prompting, assisting and administration of medications. NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 NBeech Home Care Services H58 H09 S49087 Beech Home Care V225232 110705 Stage 4.doc Version 1.30 Page 21 - 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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