CARE HOMES FOR OLDER PEOPLE
Beechcroft House 75 North Road Midsomer Norton Bath & N E Somerset BA3 2QE Lead Inspector
Jon Clarke Unannounced 7th June 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Beechcroft House Address 75 North Road Midsomer Norton Bath & N E Somerset BA3 2QE 01761 419531 01761 419531 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 Sarah Louise Thomas Mrs Sarah Louise Thomas Care Home only 14 Category(ies) of OP Old age,14 registration, with number of places Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: May accommodate up to 14 persons aged 65 years and over requiring personal care only. Date of last inspection 11-Jan-2005 Brief Description of the Service: Beechcroft is a small family run care home for 14 older people established by the current owner 15 years ago and situated in the town of Midsomer Norton. The home is an extended and converted detached house. Accomodation is provided in single rooms over two floors with stair lift access to the first floor. All rooms other then 3 have en-suite facilities the remaining three have wash basins, there are bathrooms as well as shower facilities. There are two lounges one of which includes a dining area in addition there is a conservatory with level access to the garden. Beechcroft aims to provide its residents with a secure, relaxed and homely environment in which their care, well being and comfort are of prime importance.. we pride ourselves on offering a highly professional care service, with a personal touch. (from the homes Statement of Purpose) Beechcroft also offers day care by arrangement. The homes Mission Statement states Beechcroft Residential home strives to provide consistent high standard of care at all times. To do this we try hard to: Understand our clients needs, Promote the best care values and Train and motivate our staff. Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day, the staff were welcoming and helpful and the deputy manager Jane Towells assisted the inspector. During the inspection a number of residents were “ interviewed “ individually as well as in a group. A number of documents were looked at: care plans, daily records, assessment information, training records. Arrangements for the storage and management of medication including administering was also looked at as part of this inspection. What the service does well: What has improved since the last inspection? What they could do better:
Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 6 An Immediate Requirement was made following this inspection because a requirement from the previous inspection for night staff to undertake fire drills had not been met. A visit to the home on the 17th June confirmed that staff had completed these drills. The manager must ensure that all staff complete such training at the required intervals to ensure staff maintain their knowledge of action to take in the event of a fire. Whilst the new care plans are a positive step care needs should be reviewed on a regular basis to ensure that they accurately reflect the needs of residents. It would be good practice to extend the questionnaires to relatives and professionals who visit the home again this would give an opportunity for others to comment on the care provided at the home. At the last inspection the manager spoke of a particular member of staff organising activities and this has not happened as yet though still planned. This would be a positive step and provide greater opportunity for residents to take part in not only group but also individual activities. 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. Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The quality of assessments obtained by the home and undertaken by the home on admission were of a good standard providing a full and comprehensive picture of individual’s health and social care needs. This helps the home meet identified needs and provide good quality care. EVIDENCE: A number of assessments were looked at and illustrated a good level of assessment outlining potential resident social and health care needs. If individuals are admitted following an assessment by a local authority copies of the assessments are provided to the home. Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 Care Plans are comprehensive in outlining care needs providing the detail of tasks so that staff have the necessary information to provide the care required. The full range of health services including specialist services such as mental health is available to residents ensuring the health care needs of residents are met. The home has good arrangements in place for the safe administering and storage of medication so that resident’s diagnosed health conditions are treated correctly and in a professional way. EVIDENCE: Resident’s Care Plans gave full details of care tasks including personal care such as dressing and personal hygiene. Risk assessments are completed, as are Moving and Handling assessments. Care Plans were signed by residents and some residents who were asked about their care plans confirmed that they had been “ asked about what help I needed ’’ and “ I told them what I have problems with ’’. There was however no evidence of care plans being reviewed on a regular basis to make sure that they are up to date and accurately reflect the current needs of residents.
Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 10 There is good access to local health services such as optician, chiropody. A district nurse will visit if residents have health needs such as ulcerated legs, which need treatment. Residents said that they can always ask if they need to see a doctor and confirmed that where it is possible they have been able to keep their previous G.P. One resident had experienced a number of recent health problems and spoke positively of the support she had been given by staff. Medication administering record were seen and were accurate in their recording of medication given to residents. The storage of medication and the returning of unused medication is appropriate. Staff have completed accredited training in drug administering and medication so have a good understanding of its uses. Where able and safe residents can have responsibility for their medication and there is currently one resident who manages their medication. Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14,15 The homes makes good effort to cater for the social, recreational and religious needs of residents offering an environment which provides stimulation and meets social and religious interests. The home provides an environment, which helps and encourages residents to exercise choice and control over their lives. The meals in the home are of good quality offering choice and variety and catering for any special dietary needs. EVIDENCE: Residents had mixed response when asked about social activities from ‘ not enough to do ’, to ‘ there’s enough going on for me ”. This was also raised in response to resident survey where a number asked for “ more entertainment and quizzes ’’. Outside entertainers come into the home, as do representatives of the Church of England and Methodists who hold services in the home. Since the previous inspection weekly exercise sessions have started with the home paying for a physiotherapist to come to the home, residents spoke positively of these sessions. Residents commented positively on the lack of “ rules ’’ and how they could choose how “ I spend my day there’s no pressure on me to do certain things ’’. “ we are free to do what we like ’’. Residents felt that their
Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 12 privacy was respected and one resident said that she always felt “ staff treat me with respect ’’. “ Its our home “. Menus and record of meals provided at the home showed that there is a varied and balanced diet made available to residents with choices available and individual likes and dislikes catered for including special diets such as diabetic or vegetarian. All residents spoken to commented positively on the quality of the food and meals provided: “ cant fault the food “, “ food is excellent always well presented “, “ excellent choice of main meal “. On the day of this inspection the meal was well presented and appealing, there was an unhurried atmosphere and staff were clearly aware of the preferences of individual residents particularly in terms of the size of meal. Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home has a satisfactory complaints procedure and residents feel able to express their views, that they are listened to and can make a difference. EVIDENCE: There is a clear complaints procedure which meets requirements in terms of response time and advising residents of their rights. When asked residents were aware of the complaints procedure and how to make a complaint. They also stated that they felt able to speak to anyone if they had a complaint or “ worried about something ’’, “ we would say if unhappy about something ’’, “ I would tell them ( if I was unhappy or worried ) and they would put it right ’’. Residents were very positive about the home in that they all felt that the staff and manager were approachable and none felt unable to express how they felt. Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The standard of the décor and general environment is good providing residents with a homely and comfortable place to live. EVIDENCE: In looking around the home the decoration and furnishings were in good condition. Rooms are decorated regularly and records showed that equipment is maintained and serviced as required. Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 The recruitment practices of the home are good ensuring resident’s welfare is protected as far as possible. EVIDENCE: Records of new staff recruited since the last inspection were seen and were satisfactory with full details on application forms and two references being obtained. Criminal Record Bureau check had been obtained or were awaited for some staff. Staff had undertaken full induction and necessary training. Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 The home reviews the quality of care it provides through asking residents their views and promoting an environment which is open and honest. EVIDENCE: Since the last inspection a questionnaire has been circulated to all residents. There was a good response from residents with positive comments about the care provided at the home as well as suggestions. In particular comments were made about the staff “ the staff are carers in every sense of the word’’, “ all the staff are wonderful’’. Residents also stated during this inspection that they felt able to express their views “ I only have to say ’’, “ I just tell them what I think and its ok ’’. In talking to the residents during this inspection there was a real sense that residents felt confident and safe to say what they thought and more then one spoke of how they could always speak to staff about anything. Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 4 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 3 x x x x x Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 18 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 7 Regulation 15 (2) Requirement Ensure all elements of an individuals care plan are reviewed at regular intervals. Timescale for action From 7/6/05 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. 2. Refer to Standard 32 12 Good Practice Recommendations Extend questionaires to relatives and professional who visit the home to obtain views and suggestion on the service provided. Identify staff member to have specific responsibility for the organising of activities in the home. Beechcroft House D56_ S8148_BeechcroftHouse_V226011_070605Stage4.doc Version 1.30 Page 19 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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