This inspection was carried out on 25th February 2010.
CQC found this care home to be providing an Poor service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Beechcliffe Residential Home 16 Park Drive Heaton Bradford West Yorkshire BD9 4DR zero star poor service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Stephen Marsh Date: 2 5 0 2 2 0 1 0 Information about the care home
Name of care home: Address: Beechcliffe Residential Home 16 Park Drive Heaton Bradford West Yorkshire BD9 4DR 01274487207 01274497352 satnam@pcslimited.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Jarnail Singh Bassan Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 25 Number of places (if applicable): Under 65 Over 65 0 25 dementia old age, not falling within any other category Conditions of registration: 25 0 The maximum number of service users who can be accommodated is: 25 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 25 Dementia Code DE, aged 55 years and above on admission, maximum number of places 25 Date of last inspection Care Homes for Older People Page 2 of 9 Brief description of the care home Beechcliffe Residential Home is a large detached Victorian building standing in its own grounds in the Heaton area of Bradford. The home provides accommodate for twentyfive people in a mixture of single and double rooms. The home does not provide nursing care. There is good disabled access into the premises and a large garden available for people to enjoy during the summer months. Car parking is available to the front of the building. The home is fairly close to a number of amenities within the local area including shops, public houses and a large park. The weekly fees range from GBP380.00 to GBP420.00 and do not include costs for hairdressing, chiropody, toiletries and personal transport. Care Homes for Older People Page 3 of 9 What we found:
We carried out a key inspection of this service on 4 December 2009. At that time we found that some of the requirements made at the previous inspection had not been dealt with. New timescales were set for these requirements and some new requirements were made. The purpose of this visit was to check if the home had taken action to make the required improvements. The visit was carried out over two days, the first day, 22 February 2010, was unannounced. We could not get access to all the records on 22 February 2010 therefore we went back to the home on 25 February 2010 to complete the inspection. During the visits we looked at various records including care records and staff files, we talked to staff and management and observed staff as they carried out their duties. At the end of the visits feedback was given to the management team and the owner. Two of the requirements related to pre-admission assessments and care planning. At previous inspections we identified concerns about peoples needs not being fully assessed before admission and about care plans not providing clear information for staff. During this visit we looked at four peoples care records. The format used for the care records it not very clear and there is a lot of duplication, this increases the risk of important information about peoples needs being overlooked. One person had recently been admitted to the home. There was very little information available about the pre-admission assessment. Staff told us the pre admission assessment had been done by the acting manager on the day the person was admitted and they were not sure whether it was an emergency or planned admission. The acting manager was not available on the first day we visited. There was very little information about the persons needs and there were no care plans in place to tell staff how to provide care for this person. The daily notes made by staff clearly showed that they were having some difficulty meeting this persons needs. In the three other peoples care records we found that the care plans were not always up to date and did not reflect peoples needs accurately. For example, one persons records said they were having a soft diet when in fact they were having their nutrition through a nasal tube and were not having anything by mouth. We identified concerns about how peoples nutritional needs are met in three of the care records we looked at. For example, one person who was identified as losing weight had not been weighed since December 2009 despite the fact that the review of the care plans stated that the person should be weighed every month. In another persons records we saw that there have been concerns about weight loss and loss of appetite for some time. The person was prescribed a diet supplement but is not having it. Staff said this was because she didnt like it but this was not recorded and there was no evidence that any attempt had been made to find an alternative. Nutritional risk assessments are not routinely done to identify if people are nutritionally at risk. There are no individual food/fluid charts in place to monitor what people are eating when
Care Homes for Older People Page 4 of 9 they are losing weight or have a low weight. The kitchen staff keep a record of peoples meals but this only records the main meals of the day and does not have any information about snacks and drinks between meals. These requirements have not been met and we will be following them up in line with our enforcement procedures. Two of the requirements related to the safe management of medicines. One was that the home must provide the correct storage facilities for controlled drugs, this has been dealt with. The other was that staff who are helping people with their medicines must receive appropriate accredited training. This is also being dealt with and will help to make sure that people are given their medicines by staff who are trained and competent. When we visited in December 2009 we identified a number of concerns about staffing and we made three requirements. The first was that the domestic hours must be increased to make sure the home is kept clean. At that time the home only had one domestic assistant and there was no domestic cover when this person was off duty. The general manager told us that a second domestic assistant was starting work on 1st March 2010 and this would provide an additional 16 hours domestic cover for the home. The second requirement related to the number of staff on night duty. The home is required to have two waking staff and one staff sleeping on the premises to make sure people are safe and their needs are met. The home told us that this has been dealt with. Improvements have also been made to the duty rota so that the senior staff on duty are clearly identified. The new rota was due to come into use on 1st March 2010. The third requirement related to the recruitment of new staff. In December we found that all the required checks were not being completed before new staff started work and this was potentially putting people at risk. During this visit we looked at two staff files. They showed that two written references and a PoVA (Protection of Vulnerable Adults) First check are done before new staff start work. There are arrangements in place to make sure that when staff start work having received a PoVA First but pending the return of a full CRB (Criminal Records Bureau) check they are supervised at all times. This helps to make sure people are protected. During the inspection in December 2009 we found there was no hot water in the wash basins in 3 bedrooms which were occupied. The home told us work had been done to make sure all bedrooms have an adequate supply of hot water. During this visit we checked the hot water in a number of en-suite bedrooms. The water pressure around the home varies, in some rooms there is very poor pressure giving only a trickle of water. We found that in some rooms it was necessary to pump the taps to get any water. The temperature of the water also varied, is some rooms it was barely warm and in others it was too hot. The general manager told us a new system for checking the supply and temperature of hot water was being implemented on 1st of March and where necessary taps would be replaced. During the visit in December 2009 we identified a number of issues with the environment. We asked the home to provide us with a refurbishment plan with details of the work they will do to make sure people are living in a safe and comfortable environment. This has been provided. At previous inspections we talked to the home about the importance of having effective quality assurance systems so that they can identify any shortfalls in the service and take
Care Homes for Older People Page 5 of 9 action to deal with it promptly. The general manager carries out monthly visit to the home and has developed a new format for these visits to make sure that all aspects of the service are looked at. We are being provided with copies of these visits so that we can be confident that the home is continuing to make improvements to the service. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 3 14 A thorough pre-admission assessment must be carried out before people are admitted to the home. This will make sure that staff have the skills, experience and training to meet their needs. 31/01/2010 2 7 15 Care plans and supporting 31/01/2010 documentation must give clear guidance to staff on how to meet peoples needs. This will make sure that people receive the care and support they require and enable staff to use the care plans as working documents. 3 7 15 Care plans must give clear guidance to staff on how peoples needs are to be met. 31/01/2009 So that they receive the level of care and support they require. Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 3 14 A thorough pre-admission assessment must be carried out before people are admitted to the home. This will help to make sure that staff have the skills, experience and training to meet their needs. 31/03/2010 2 7 15 Care plans and supporting 31/03/2010 documentation must give clear guidance to staff on how to meet peoples needs. This will help to make sure that people receive the care and support they require and enable staff to use the care plans as working documents. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 9 of 9 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
