Inspection on 10/04/07 for Beeches Care Home (Arnold)

This inspection was carried out on 10th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Beeches Care Home (Arnold) 11/04/06

Beeches Care Home (Arnold) 05/01/06

Beeches Care Home (Arnold) 26/07/05

Beeches Care Home (Arnold) 03/11/04

Beeches Care Home (Arnold) 09/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Beeches Care Home (Arnold) 55 Furlong Street Arnold Nottingham NG5 7AT Lead Inspector Rob Cooper Key Unannounced Inspection 10th April 2007 10:00 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 Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 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. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beeches Care Home (Arnold) Address 55 Furlong Street Arnold Nottingham NG5 7AT 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) 0115 926 2838 0115 912 04397 www.schealthcare.co.uk Southern Cross Healthcare Services Limited ** Post Vacant *** Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (45), Physical disability (4), Terminally ill (5) of places Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the total number of beds a maximum of 4 bed maybe used for the category PD, where service users will be aged between 50 and 65 years. Within the total number of beds a maximum of 5 bed maybe used for the category TI 16th November 2006 Date of last inspection Brief Description of the Service: The Beeches was opened in 1995 and is situated close to the centre of Arnold in Nottingham. It is a two-storey building, with one large lounge, incorporating a designated dining area. A small lounge facility predominantly used, as a hairdressing room is available on the first floor as well as a separate smoking room. There are four bathrooms, of which two are fitted with an assisted, bathing hoist and one with a Parker bath and two separate shower rooms. All of the homes bedrooms are single with the exception of one, and twenty-eight of the bedrooms have an en-suite facility. Four adjoining rooms are available. There is a passenger lift. The home has a compact garden that is well maintained and easily accessible. Fees for The Beeches range from £334 - 370 per week. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection – so that no one at The Beeches knew that the inspection was going to take place. The inspection took approximately four hours through the middle of the day, with one inspector present. The method used to carry out the inspection was to send out a pre-inspection questionnaire, which asked questions about the service, to gather statistics, such as how many service users there are, the numbers of staff etc. We also sent out a number of surveys to residents and relatives, however none had been returned by the date of this inspection. This was followed with a visit to The Beeches, where a method called case tracking was used; this involved identifying four residents and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was done by a partial tour of The Beeches, looking at the activities on offer, and talking to staff and three residents about the quality of the service, and their experiences of living and working at The Beeches. The acting manager is currently on long-term sick leave, and therefore Southern Cross had moved a manager from another care home to The Beeches to oversee it’s day-to-day management. On the day of this key inspection there were forty-one residents living at The Beeches. Since the last key inspection in April 2006, there have been two random inspections of The Beeches. The first was in November 2006 and was to check on the progress made with requirements set at the key inspection in April 2006. The second was a month later in response to an anonymous complaint, which was found to be groundless. What the service does well: The Beeches is a comfortable and well-maintained home. Resident’s meals are monitored through the ‘nutmeg scheme’, which is a computerised system for assessing the nutritional value of food. This means that residents can be assured of receiving a balanced diet. Residents who were asked about the food, spoke positively, and said that there was a good choice. The management at The Beeches hold weekly surgeries where relatives are able to meet with the manager and discuss any issues or concerns that they might have. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 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 Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 13&6 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Prospective residents at The Beeches have sufficient information before they moved in to make an informed choice about where to live, and current residents are well informed about the services that The Beeches offers. The Beeches does not offer intermediate care. EVIDENCE: Both the Statement of purpose and the Service User Guide were seen, and both contained all of the information that Care Homes Regulations say that they should. Evidence was seen that residents at the Beeches had been given a copy of the Service User Guide, and two residents when asked said that they had received a copy. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 9 As part of the case tracking process four resident’s files were seen. Each file contained a formal assessment of need for the individual, with two having Shared Nottinghamshire Assessment Process (A SNAP) – which is Nottinghamshire’s assessment tool for older people. There were also two inhouse assessments for residents who did not have a Social worker actively involved in their placement. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 & 11 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. The residents have their health and personal care well managed, supported and recorded by the staff at The Beeches. EVIDENCE: Each of the four resident’s files seen as part of the case tracking process contained a clear plan of care, with care plans to meet the resident’s needs. The care plans were hand written, and in some files it was difficult to understand what had been written, this related to both the care plan and entries into it, this potentially leaves residents at risk due to care plans not being clear. In addition the evaluations of some care plans were not dated, and it was not clear which care plan the evaluation related to. Evaluations of care plans are important, as they are a method of ensuring that the current care an individual is receiving is based on the latest assessment of their needs. The resident’s files contained information, care plans and records relating to resident’s health, and all four residents who’s files were seen, had their health Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 11 well managed by the staff on their behalf, as evidenced by the records and care plans in place. Boots the chemists supplies the resident’s medication at The Beeches. They use a monitored dosage system (each resident having their medication dispensed into a blister pack on a series of cards), which makes dispensing the medication easier. The documentation relating to medication administration was seen, and there were no obvious errors or omissions. Boots will be carrying out ‘refresher’ staff training in medication procedures on 20th April 2007. Storage was secure, and there were clear records for medication coming in and out of the building. Three residents were spoken with, and each one said that they felt the staff treated them very well, and treated them with respect. During the inspection a number of staff interactions with residents were observed, and these were seen to be polite and caring. Staff were observed knocking on resident’s doors before entering, and the issue of residents having keys to their bedroom doors was addressed in individual files. Each of the files that was seen had identified the resident’s wishes at the time of their death. One resident had a specific care plan in place, and there was also information relating to who to contact within the family at that time. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 & 15 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at The Beeches have a lifestyle that reflects their cultural, social and religious interests, and needs. EVIDENCE: Three residents who were spoken with said they thought there were a number of activities arranged, and there was usually something for them to get involved with. A programme of resident’s activities was on display in the foyer, and there was some photographic evidence of residence taking part in activities. Interviews will be held shortly for an activity co-ordinator, which will help ensure that the programme of activities is implemented effectively. The Beeches do have visits from various representatives of different religious faiths, and residents are encouraged to attend churches if they so wish. All three residents when asked said that their families were able to visit at times that were convenient to them, and were always made welcome by the staff. Two relatives were spoken with who were visiting, and both said that they were quite happy with the arrangements for visiting The Beeches, and Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 13 that the staff kept them informed of what was going on, in relation to their relative’s care. Both residents who were spoken with said that they thought there was a good deal of choice at The Beeches. This ranged through choices at meal times, activities on offer, and whether to join in or not, and choices about where to be within the building. Observations of staff talking to residents showed that choices were offered in a number of different ways, which supported the resident’s view that they were able to make choices at The Beeches. Three residents were asked about the food at The Beeches and each one said that the food was good, and that they got enough to eat, and that there was always a choice. An inspection of the kitchen found it to be well organised, and all of the documentation relating to cooking and food storage was found to be complete and correct. Lunch on offer was a choice between home-made chicken & mushroom pie, and corned beef hash, or there was a vegetarian option as well. The Beeches have recently introduced the ‘nutmeg scheme’, which is a computerised system for assessing the nutritional value of food offered to residents, and helps in the production of a menu that offers a balanced diet. Two residents were asked about the quality of the food on offer at The Beeches, and both said that it was very good, and that there was always plenty of choice. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is excellent; this judgement has been made using available evidence including a visit to this service. Residents at The Beeches are safe, and their complaints are taken seriously and dealt with. EVIDENCE: The Beeches have received ten formal complaints since the last key inspection, and a review of the documentation relating to those complaints showed that they were dealt with in line with The Beeches complaints procedure. The manager at the Beeches holds regular weekly surgeries, where relatives know that they can come and meet the manager and raise any particular issues. In addition there are three monthly relatives meetings. None of the residents who were spoken with, said they had ever made a formal complaint, but they all had copies of the procedure, as it formed part of the service user guide, and was also on display in the foyer. The two relatives spoken with also said that they were aware of the complaints procedure, but had never had need to make a complaint. A review of the staff training records showed that the majority of staff at The Beeches had completed training in safeguarding adults, which will ensure that staff are up-to-date with the latest practice, and are also aware of the issues involved, so that they can safeguard residents from abuse. Discussions with three members of staff confirmed that staff had received training in safeguarding adults. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at The Beeches live in a safe, clean and comfortable home, with their personal possessions around them. EVIDENCE: A partial tour of The Beeches showed it to be well maintained, and comfortable. Approximately half of the bedrooms have en-suite facilities, and there is a good range of bathing options, with assisted bathing and showering available. The fixtures and fittings were found to be of a good quality, and the layout of The Beeches is spacious Throughout the inspection The Beeches was found to be clean and tidy, with cleaning staff seen to be hoovering and cleaning. Discussions with cleaning Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 16 staff indicated that there were cleaning routines in place, and that the staff thought they had enough cleaning materials to be able to do their job properly. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 & 30 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Staff at The Beeches have been recruited professionally, and are competent and trained to do their jobs. EVIDENCE: A review of the staffing rota and staffing levels at The Beeches showed that there were enough staff currently employed to meet the resident’s needs. Two residents were asked about staffing levels, and both said that they thought there were enough staff, while three members of staff when asked the same question all said they too thought that staffing levels were sufficient. The recommended standard training course for staff working in care is the National Vocational Qualification (NVQ) level II. Of the seventeen care staff on the team, four people have their NVQ level II, four are currently studying for the qualification, while four more are about to start. Ideally there should be 50 of the staff team qualified to a minimum of NVQ level II. The indication is that while this 50 has not yet been achieved, The Beeches is working towards achieving it. The Beeches also employ eight qualified nurses. Three staff files were seen, and each one contained all of the necessary documentation to indicate that staff had been recruited in a manner, which Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 18 would protect residents – this would include: written applications, formal interviews, two written references, and a criminal records bureau check. Each of the three members of staff who were spoken with said that they had been through a formal recruitment process, and had supplied references, and been criminal records bureau checked. A review of the staff training records showed that The Beeches does have a training plan for its staff. A matrix printed out from the computer showed that Southern Cross was highlighting staff training needs, and that their needs were being analysed and addressed. The records showed that staff were receiving the skills training to be able to do their jobs, and discussions with three members of staff supported this view. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 & 38 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. The Beeches is a safe, well-managed care home with good systems for ensuring its quality and development in place. EVIDENCE: Currently The Beeches does not have a registered manager in post. The acting manager, who was in the process of applying for registration is currently on long term sick, and Southern Cross have moved another manager across to The Beeches to manage in the short-term on a day-to-day basis. The Beeches operate a wide-ranging quality assurance system, which includes customer survey response forms (questionnaires), and regular internal audits. Evidence was seen with regard to the analysis of the information gathered Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 20 during the quality assurance process, and the production of an improvement/ development plan. The Beeches operates a system for resident’s personal finances. The records for four residents were checked at random, and were found to be correct, and with receipts in place to show expenditure. Two residents when asked said that they could get their money when they wanted it, and that they were quite happy for the staff to look after their money. The Beeches operate a supervision and appraisal system, with staff having formal supervision approximately six times a year. Records relating to the staff’s formal supervision were seen and these indicated that staff members were properly supervised. The two staff members who were spoken with said that they were having a formal supervision session approximately every eight weeks. Both members of staff said they felt they were well supported, and both felt they could ask for help if they needed it. A range of health & safety records were seen, and all found to be correct and up-to-date. These included the fire safety records, the Control of Substances Hazardous to Health (COSHH) records, and the water testing records for Legionella. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 21 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 X X X X X X 3 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 2 X 3 X 3 3 X 3 Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 22 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, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP31 Regulation Requirement Timescale for action 30/08/07 Regulation The situation with regard to the 8 registered manager needs to be clarified, so that a manager is in post at The Beeches who is able to apply for registration with the Commission for Social Care Inspection. 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 OP7 OP7 Good Practice Recommendations Care plans should be legible, and ideally be printed so they can be read and understood by the staff. Care plans should be evaluated on a monthly basis, with dated entries, which clearly relate to specific care plans. Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Beeches Care Home (Arnold) DS0000026418.V335452.R01.S.doc Version 5.2 Page 24 - 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. 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