CARE HOMES FOR OLDER PEOPLE
Beechcroft Nursing Home 62-64 Bidston Road Oxton Birkenhead Wirral CH43 6UW Lead Inspector
Jeanette Fielding Unannounced Inspection 19th December 2005 11:30 X10015.doc Version 1.40 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 Beechcroft Nursing Home DS0000020935.V275206.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 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 Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Beechcroft Nursing Home Address 62-64 Bidston Road Oxton Birkenhead Wirral CH43 6UW 0151 652 6715 0151 652 6715 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) Flightcare Limited Mrs Gaye Hayes Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 43 beds nursing care / 20 beds personal care in an overall total of 43 Date of last inspection 9th May 2005 Brief Description of the Service: Beechcroft Nursing Home is one of a number of care homes owned by Flightcare Limited. The home is managed by Mrs Gaye Hayes who is a first level nurse with many years experience in caring for the client group. This care home is a four storey mature building, situated in the Oxton area of Birkenhead close to local amenities. It is registered to provide nursing care for 43 older persons and 20 of the beds may accommodate clients who require personal care only. Various sitting areas are available throughout the home; these include the main lounge and a small lounge on the ground floor, a quiet lounge and a further sitting area on the lower ground floor. The main dining room is on the ground floor and dining facilities are also provided in the lower ground lounge at the request of residents. Televisions, music centres, piano, tropical fish tanks and in-house library are provided in communal rooms and a selection of celebrations cards can be purchased. Televisions are available for use in bedrooms and telephone sockets are provided in all bedrooms. Accommodation is provided in single rooms, however shared rooms are available on request. Most of the bedrooms have en suite facilities and many are large enough to provide a bed sitting room. A selection of bathrooms and toilets are provided on each floor and assisted bathing facilities are available. Ramp access is available at the side of the building and a lift serves all floors. The front garden is mainly car park. The secluded well maintained rear gardens have walkways and various sitting areas. Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted in one day and took place over a period of five hours. Service users, relatives and staff were spoken to, to gather information regarding the service provided, the choices offered and the quality of the care given. The manager was not on duty on the day of the inspection but this did not affect the efficient running of the home. Effective systems are in place to ensure that the home continues to run well when the manager and deputy are off duty. The home is well maintained and is decorated and furnished to a high standard. No requirements or recommendations were made following this inspection. What the service does well: What has improved since the last inspection? What they could do better:
The home should continue to undertake regular reviews to evaluate and improve the service and thereby maintain the high quality service provided. Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 6 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 Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 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 the following standard(s): 3 The home undertakes comprehensive assessments of prospective service users from all persons involved in their care to ensure that all needs and preferences are identified. EVIDENCE: Detailed pre admission assessments are undertaken on all prospective service users. The care files of the most recent admissions to the home were inspected. These contained completed pre-admission assessment forms which have been specially designed to identify the care needs of the service users. The forms also include information regarding equipment which may be necessary for use by the service user, or the staff, to provide the care and gives the opportunity to ensure that the equipment is in place in advance of the service users admission to the home. Special diets are identified and this information is given to the chef who may need to order particular foods to ensure that the appropriate diet is served.
Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 9 The assessments also include information gathered from relatives, hospital staff and any other person involved in the care of the service user to ensure that all care needs are identified. A basic plan of care is prepared prior to the service user being admitted to the home which is then reviewed and amended following the admission. Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 7, 8, 9, 10 The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service users medication needs are met. EVIDENCE: The care plans of four service users were inspected. These were found to be comprehensive and informative and provide staff with all the information necessary to meet their care needs. The care plans are reviewed each month or more frequently as necessary. The plans are agreed with the service user, or their next of kin, as appropriate, who signs them to indicate their agreement. The records held in the home provide evidence that service users health care needs are identified and that specialist advice and intervention is sought where necessary. All accidents are recorded and audited, and appropriate action is taken to prevent further accidents. Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 11 All records relating to the ordering, storing, administering, recording and disposal of medications were inspected. These were found to be well maintained, accurate and up to date. Service users and relatives spoken to confirmed that their privacy and dignity were respected. Service users confirmed that staff always knocked on their bedroom doors prior to entering and that personal care was always given discreetly and with respect for their dignity. Screens were in place in shared bedrooms and service users confirmed that they were used appropriately to protect their privacy. A pay telephone, with a privacy hood has been provided although some service users have chosen to have their own telephone installed in their room at their own cost. Mail is delivered unopened to service user. Locks are provided on all bathroom and toilet doors to provide privacy, although these can be opened from the outside in the event of an emergency. The care plans also give details of the name by which they wish to be referred to by and service users spoken to said that this is comforting and homely. Service users confirmed that they meet with their visitors in the privacy of their own bedroom or in one of the communal areas as they prefer. Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 12, 13, 14, 15 A comprehensive programme of activities is provided to enrich service users social opportunities. EVIDENCE: The home employs an activities co-ordinator to provide stimulation for the service users. A high level of activities are provided and a record maintained. These activities include movies, trips out, shopping, games, quizzes and massage. Both one to one and group activities take place within the home and service users spoken to said that they did not feel pressured into taking part but chose to do so. All service users spoken to during the inspection commented on the number and range of activities that take place both during the week and at weekends. The hairdresser visits the home each week and provides a reasonably priced service. Service users are free to choose whether they take their meals in their own bedroom or in one of the dining areas. All dining facilities are attractive and contribute the homeliness of the home. Service users choose from a selection of meals and the menus provide evidence that a balanced diet is offered.
Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 13 Special diets can be provided on the recommendation of the dietician, GP or at the service users request. Service users spoken to said that they were free to choose the time that they went to bed at night and got up in the morning. Discussion with both staff and service users confirmed that where possible, service users could request a particular member of staff to attend to their personal care needs in line with the home’s key worker system. Visitors to the home confirmed that they were made very welcome at any time and that staff made every effort to ensure that the service users were given the best care possible. Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 16, 18 Staff have a good knowledge of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a comprehensive complaints procedure which is detailed in the Statement of Purpose and Service Users Guide and is also displayed in the foyer of the home. No complaints have been received by the home since the last inspection. Visitors to the home said that they were completely happy with the care given to their relatives. The records held on the staff files show that training on abuse has been given. Discussion with staff demonstrated that they were aware of the different types of abuse and of the action that would be taken if it were suspected. All staff have had appropriate checks made on them to ensure that service users are protected within the home. Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 19, 26 A programme of improvements continues within the home to ensure a safe, comfortable and homely environment for the service users. The home is extremely well maintained, is clean and hygienic and provides a pleasant atmosphere. EVIDENCE: A number of bedrooms have been redecorated since the last inspection in line with the redecoration programme. All bedrooms are bright and welcoming and are personalised with photographs, pictures and items of memorabilia. Maintenance issues are addressed as soon as they are identified and the home is extremely well maintained. Health and safety is the responsibility of all staff, with the manager and maintenance person taking the primary role in ensuring that these are addressed. Staff have been given health and safety training and the records held in the home show that all procedures are followed as required.
Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 16 Laundry is attended to by designated staff. Care had obviously been given with the laundering of linens and personal clothing, and the laundry staff undertake labelling of clothes and minor repairs where necessary. Infection control policies and procedures are in place and staff records show that training in this is given during the induction programme. The home smells fresh throughout and no unpleasant odours were noted. Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 17 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The home has a robust recruitment policy and procedure to ensure that service users are protected. Staff morale continues to be high resulting in an enthusiastic and motivated workforce. EVIDENCE: The files of both new staff and those who had been employed by the home for some time were inspected. All were found to be comprehensive with all the necessary security checks having been made. A record is held of all training undertaken by staff including induction and professional training. The home employs qualified nurses at all times supported by sufficient care assistants to meet the needs of the service users. The home also employs chefs, kitchen assistants, domestic, laundry, catering, and maintenance staff. All staff have been given health and safety training to ensure the protection of the service users. Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 18 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Effective quality assurance monitoring systems are in place to measure the success in meeting the home’s statement of purpose in the best interests of the service users. Service users personal finances are safeguarded. EVIDENCE: The manager of the home is a qualified nurse who has considerable experience in the management of a care home for elderly people. She holds an NVQ in management at level 4 and records are held in the home of further training and qualifications to enable her to manage the home to a high standard. The home is accredited with the quality assurance system ISO 9002 and also undertakes their own internal audits every six months. Customer satisfaction questionnaires are sent to service users, relatives and other care professionals and these are evaluated and actioned where necessary to ensure that the service provided is regularly reviewed and improved. Service users confirmed
Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 19 that they were regularly asked their views and felt that their suggestions on improvements were taken into consideration. The Responsible Individual visit the home on a regular basis and completes a report every two weeks. Service users or their representatives are encouraged to deal with financial matters and the home only holds small amounts of cash for service users on request. Detailed records are held for all purchases made on service users behalf which includes receipts and accounts records. Secure facilities are provided for the storage of valuables and personal allowances. The manager and maintenance personnel are responsible for ensuring the health and safety of all service users and staff. All staff have been given training in health and safety to ensure their own and service users protection. Evidence of this training is held on the staff files. Safety certificates were inspected and found to be well maintained and up to date. Checks on fire detection equipment are made as required and are duly recorded. All accidents were recorded and the records show that action has been taken to reduce risks and provide protection for the service users. Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 20 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 3 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Beechcroft Nursing Home DS0000020935.V275206.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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