Inspection on 07/02/07 for Beech View

This inspection was carried out on 7th February 2007.

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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Beech View 14 The Plies London Road Fairford Glos GL7 4AJ Lead Inspector Mr Nick Jones Key Unannounced Inspection 7th February 2007 10:00 Beech View DS0000067081.V291799.R01.S.doc Version 5.1 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 View DS0000067081.V291799.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 Adults 18-65. 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 View DS0000067081.V291799.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beech View Address 14 The Plies London Road Fairford Glos GL7 4AJ 01285 712437 01285 712437 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) The Brandon Trust Miss Cedria Ruth Clifton Care Home 6 Category(ies) of Learning disability over 65 years of age (6) registration, with number of places Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th January 2006 Brief Description of the Service: Beech View Plies is a registered care home and is able to accommodate six adults who have a learning disability. The home is situated close to the centre of Fairford and is about ten miles from Cirencester. It is an adapted house, which was originally a pair of semi-detached houses. The accommodation is on the ground and first floors, comprising of single bedrooms baths/toilets on each level and two lounges. There is a level accessible garden to the side and rear. The Brandon Trust runs the home, having taken over from the previous service provider in April 2006. A Statement of Purpose and Service Users Guide are available to prospective service users. Up to date information about fee levels was not obtained during this visit. Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service. The inspection took place during one day on the 7th February and a morning two weeks later. During the visits various documents were checked including examples of care plans, risk assessments, medication charts, health and safety records, daily records and staffing files. Some staff and service users were spoken with and time was also spent with the manager. Some general observation of life in the home took place and the premises were inspected. All staff were helpful and knowledgeable during both days of the inspection. Before the visit survey cards were sent out to staff and to relatives of clients, providing written feedback. What the service does well: What has improved since the last inspection? Some service users have had assessments completed by their funding authorities. The remaining people are due to be assessed in the coming months. Training provision for staff has improved including all staff being trained in the safe handling of medicines. Beech View DS0000067081.V291799.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 View DS0000067081.V291799.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Beech View DS0000067081.V291799.R01.S.doc Version 5.1 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 the following standard(s): 1&2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of an up to date Statement of Purpose and admissions policy may compromise a fundamentally sound approach to referrals and admissions. EVIDENCE: The Statement of Purpose and Service Users Guide were checked. They have not been recently reviewed or updated to include information about the new service provider. The admissions policy was also overdue for review as it was written in 2000 before the National Minimum Standards. There have been no new admissions in the previous year. There was evidence in service user files that funding authorities had undertaken needs assessments and produced care plans for three service users. The manager stated the remaining service users were due to be assessed in the next few months. Beech View DS0000067081.V291799.R01.S.doc Version 5.1 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 the following standard(s): 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The needs of the service users are on the whole clearly identified and wherever possible met. However records of care plans and risk assessments of service users must be reviewed and updated to ensure consistency in staff support. Service users are supported to make decisions and choices about their lives. EVIDENCE: The care plans and risk assessments of three service users were viewed in more detail. They contained a range of information about the support needs of each individual that included details about likes and dislikes, personal and healthcare, communication, mobility, routines at different times of day and use of vehicles. In general the plans provided clear, succinct guidance about people’s support needs and covered appropriate areas. One included details of an IPP review meeting held in July 2006. Some care plans and risk assessments had been written in July 2005 and reviewed most recently in November 2005. One file did not contain risk assessments, which the manager Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 10 stated where being re-written by a member of staff. Some care plans indicated reviews had taken place but were not signed or dated. The manager also stated person centred plan formats were to be introduced when reviewing and re-writing peoples’ care plans. One service user had a care plan and risk assessment for support they require when eating or drinking. It has been signed by some of the staff that work with the person. A number of the plans included health care issues and it was noted that other professionals were consulted. This included the community nurse, and other clinicians from the Community Learning Disability Team (CLDT). Discussions with staff and observations of staff interactions with service users over the two days demonstrated that staff have a detailed understanding of the support and communication needs of service users. Care plans included references to respecting people’s choices. Staff gave examples of how they did this in practice, such as about personal care routines and food/drink. Beech View DS0000067081.V291799.R01.S.doc Version 5.1 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 the following standard(s): 12,13, 14, 15, 16 &17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clients enjoy a variety of activities within the local community and friends and family are welcomed. People have individual interest and routines that are accommodated and respected. A varied and healthy diet supports clients to lead active lifestyles. EVIDENCE: All of the service users have individual programmes of interests and activities and they include attending various day centres, college courses, and the local sports centre. Sessions provided at home include aromatherapy massage and music. Activity records were checked from daily notes. These provided evidence that people accessed a range of activities including leisure and more vocational Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 12 activities. People had been supported to go shopping, to go to cafes and to go for walks. Various holidays have been provided that included a visit to a specialist Calvert Trust activities holiday in Devon, staying at a holiday chalet in Dorset and staying at a Steam museum convention. Some service users choose to go on day trips rather than stay away from home. Service users relatives are encouraged to visit and the home is able to take service users to visit friends/relatives who are not able to come to the home. Staff described flexible routines operating in the home; such as the times people went to bed and when people had a drink or snack. This corresponded to care plans and to observations over the two days. People living in the home were seen to move around freely and to treat Beech View very much as their home. Survey cards from relatives provided further evidence to back up this impression. Staff were seen to be respectful and sensitive to people’s individual needs and wishes. Clients were also seen to be involved in some household routines where possible. Menus and records of food consumed provided evidence that people living in the home were offered a varied, balanced diet including fresh ingredients. Staff described how service users were offered choice around food and drink. A meal was observed. People ate together in the kitchen/dining room in a relaxed atmosphere and appeared to be enjoying their food. Beech View DS0000067081.V291799.R01.S.doc Version 5.1 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 the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ personal healthcare needs are met, enhancing their dignity and wellbeing. Healthcare needs are also addressed, though there is scope for improving aspects of practice in this area to further safeguard people’s health. The procedures for the prescribing, storage and administration of medicines ensures the health and welfare of service users is maintained. EVIDENCE: Care plans provided good detail about how people like to be supported with personal care. Some of them were overdue for review. Records are kept of health related appointments and recommendations from health professionals such as a community nurse and a consultant psychiatrist are implemented. A returned comment card from a Community Learning Disability Team (CLDT) clinician stated the staff at the home communicate well with the CLDT. Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 14 There was evidence that service users are provided with regular health checks and that medical interventions with conditions such as epilepsy are implemented appropriately by staff. The prescribing of medicines was also seen to be have been reviewed appropriately with the involvement of GPs or a consultant psychiatrist The records of service users’ weights showed that some service users had not been weighed on a regular basis. Discussions with staff indicated that one service user should have their hearing re-assessed. Staff administer medicines and there was a record of the receipt, administration and disposal of prescribed medicines. Medicines were being stored appropriately. Well written guidelines were viewed as to how staff should administer medicines to service users. They were not signed or dated. Appropriate facilities are provided for the safe storage of medication. All staff have been trained in the safe handling of medicines. A CLDT community nurse has provided training to staff in procedures they may have to administer to service users with epilepsy. Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place for managing complaints that ensure the views of clients and their relatives are listened to and acted on. Systems are in place that help to protect clients from harm and abuse. EVIDENCE: Discussions with staff and viewing service user’s files showed that the staff team have good information about how best to ascertain the needs and wishes of service users as much as is possible. Speech and Language therapy clinicians from the local CLDT (Community Learning Disability Team) provide support to the home. Team meeting minutes showed the staff team discuss how to meet the needs of service users on an on-going basis. All staff have completed or are booked on Adult Protection and ‘Whistle blowing’ procedures training courses. Staff spoken with demonstrated an understanding of abuse and the indicators that it may be taking place, along with their responsibilities if they were concerned about something. They expressed confidence in the arrangements for reporting and investigating concerns. Samples of financial records for two services were checked and appeared to be in order. The manager said that there were balance checks after each transaction, which was observed being carried out by staff on two separate occasions. All service users’ cash balances are checked by two staff at staff Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 16 handovers. The Brandon Trust is in the process of setting up new savings accounts for service users. Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 17 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 the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clean, homely and comfortable environment, in the main, is provided, promoting service users’ quality of life. EVIDENCE: All communal areas and all of the occupied bedrooms were checked during the inspection. Beech View was seen to be homely and comfortable throughout, with service users’ rooms being attractively decorated and personalised. The home was found to be clean and hygienic. Staff have access to disposable gloves, aprons and laundry bags. Three fire doors were found to be propped open with wedges. They were the laundry and laundry lobby doors, and the ground floor lounge door. The manager stated requests had already been made to the housing provider to install electro-magnetic door holders to these doors. Some service users would Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 18 not be able to access these areas of the home independently without the doors being kept open. Some parts of the first floor of the building were found to be considerably below a comfortable ambient temperature. The manager stated the housing provider had sent a heating engineer to assess the central heating boiler and heating system. Discussions took place about the design of the building and facilities available within it. The manager stated that the home is included in the Brandon Trust’s Estates and Services Strategy. The Trust intends to review in more detail the service in 2007/ 2008. Some service users are not able to access a bath, though the manager stated these service users do not express dissatisfaction with having a shower. Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 19 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Support is provided by a skilled, well-trained staff team, helping to ensure that service users’ needs are met. The manager has a sound understanding of recruitment and selection ensuring service users are protected. EVIDENCE: Staff demonstrated over the course of the inspection that they are committed to meeting the needs of service users and are approachable and accessible to them. There was good evidence that the home is well supported by other professionals such as clinicians from the Community Learning Disability Team. The home has half of the staff team with an NVQ 2 in care or above. One member of staff was undertaking their NVQ 3 in Care, with one staff member undertaking their Learning Disability Award Framework (LDAF) induction. Staff were positive about how the staff team worked together and that, in the main, there were sufficient staff working at the home to meet the needs of Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 20 clients. Duty rotas showed there were usually a minimum of two staff on shift with a waking night staff member working at night. The duty rotas showed in recent months that an additional third member of staff was possible less frequently than some planned activities required. This has been due to longterm sickness of two staff. Team meeting minutes viewed showed they take place regularly and discussed a wide range of issues. Three staff files were viewed and found to contain all the details as required under Schedule 2 including details of PoVA First and CRB checks. The manager described the steps that she takes when recruiting staff, demonstrating a sound awareness of the relevant National Minimum Standards and Care Homes Regulations. A training matrix was being maintained identifying what training has been undertaken and when planned training is due. Staff said that they were attending a range of mandatory training and refresher courses. This included manual handling, safe handling of medicines, adult protection, first aid and food hygiene training. Training specific to the needs of people living at the home is provided if needed. There was evidence that staff are well supervised and there are good communication systems between staff, which enable them to offer flexible support to the service users. Staff surveys indicated that team members felt that they worked well together and provided high quality care to clients. Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 21 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run, promoting positive outcomes for clients. Systems are in place that help to monitor and improve the quality of the service provided. Health and safety in the home is promoted which safeguard people’s wellbeing. EVIDENCE: The Registered Manager has considerable experience in the field of care and management, and has an NVQ Registered Managers Award at Level 4. Staff spoken with added that the manager was approachable and that the home was well run. She has promoted an inclusive style of management that Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 22 has enabled the staff team to develop in their roles and develop a clientfocused approach. The Brandon Trust has devised some quality standards and home managers were asked to complete a self-audit that would in turn be checked by their line manager. The manager said that this was being completed the week following the inspection with her line manager. It is understood that the quality standards are to be reviewed following this initial exercise. Regulation 26 reports are being forwarded following monthly visits by representatives in the Trust. Minutes from staff meetings provided evidence of wide ranging discussions taking place regularly. Health and safety aspects of service provision were being maintained and monitored. Records viewed included fire safety checks, water temperatures, various health and safety checks/assessments and servicing of equipment. The manager has produced a new Fire Safety risk assessment in January 2007 that was detailed and contained relevant details. Records of fire drills did not contain details of service users and staff involved with the drill. Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 23 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 Standard No Score 1 2 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 2 X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 3 X X 3 X Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 24 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 2 3 4 5 Standard YA1 YA6 YA9 YA24 YA24 Regulation 6 15 13(4) 23 24(4)(c) Requirement Review and update the Statement of Purpose and Service Users Guide. Care plans for all service users must be reviewed. These must be signed and dated. Risk assessments for all service users must be reviewed. These must be signed and dated. A solution must be found to provide sufficient heat to areas of the first floor of the building Self closing fire doors must be installed to the three doors highlighted in the report Timescale for action 31/05/07 31/05/07 31/05/07 30/09/07 31/05/07 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 YA2 YA6 Good Practice Recommendations The Trust should fully review and update the admissions policy dating from 2000 The eating and drinking care plan guidelines for one service user should be signed by all staff DS0000067081.V291799.R01.S.doc Version 5.1 Page 25 Beech View 2 3 4 5 YA19 YA19 YA24 YA42 Service users should be regularly weighed One service user should be offered a hearing test Review the bathing facilities to enable all service user to be able to access a bath Records of fire drills should include details of the staff and service users who have taken part in an evacuation Beech View DS0000067081.V291799.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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. 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