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Inspection on 03/11/05 for Beeches Retirement Home

Also see our care home review for Beeches Retirement Home for more information

This inspection was carried out on 3rd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The atmosphere of the home is open and relaxed. Residents spoken with all said that staff are kind and caring and they feel comfortable raising any concerns either with them or the manager. The premises are safe, clean and well maintained throughout. The senior member of staff spoken with was knowledgeable about residents care needs and daily living preferences. The home has a satisfactory care planning system that ensures residents` needs are met. Routines are flexible enabling residents to maintain control over their daily lives. A suitably qualified person has assessed the premises and sufficient equipment is provided to enable residents to remain independent.

What has improved since the last inspection?

A great deal of work has been undertaken to ensure care planning documentation is detailed and that residents are involved in reviews of the plans. Satisfactory risk assessments are now carried out for all residents for activities both within and outside the home. A planned programme of varied activities is provided that is based on residents` preferences. There are systems for regularly consulting with staff and residents. Some progress has been made in respect of staff training and quality monitoring systems.

What the care home could do better:

All staff need to be trained in adult protection procedures to promote the protection of residents. Recruitment practices needs to ensure that all staff undergoes an up to date Criminal Records Bureau check.The implementation of formal quality assurance and quality monitoring systems would enable the provider to critically evaluate the service. A programme of maintenance and renewal needs to be created to ensure any minor repairs are carried out without delay.

CARE HOMES FOR OLDER PEOPLE Beeches Retirement Home 4 De Roos Road Eastbourne East Sussex BN21 2QA Lead Inspector Gwyneth Bryant Unannounced Inspection 03 November 2005 08:00 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 Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 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 Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beeches Retirement Home Address 4 De Roos Road Eastbourne East Sussex BN21 2QA 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) 01323 731307 Mrs Joan Sinclair Mr Darren Sinclair Mr Darren Sinclair Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twenty (20) Service users must be older people aged sixty-five (65) years or over on admission. 28th April 2005 Date of last inspection Brief Description of the Service: The Beeches is a detached two-storey Victorian property set in its own grounds in a residential area. The home is registered to provide care and accomdation for up to twenty older people, comprising of fourteen single rooms and six doubles. It is situated approximately half a mile from the town centre and is close to all travel routes and local amenities. The home aims to provide a homely and friendly service with the emphasis on comfort and care. Access to all floors is via a passenger lift. The home has one assisted bath and a portable hoist to enable residents to bathe in any of the homes baths. All rooms have en-suite facilities and two also have a bathroom. Various aids and adaptations have been made to promote independence. Communal areas consist of a dining room, large lounge and conservatory. There are well maintained front and rear gardens. The home has a pet bird and residents are encouraged to assist with its care. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act2000 and Care Homes Regulations`2001 uses the term ‘service users’ to describe those living in care home settings. For the purpose of this report, those living at Beeches will be referred to as ’residents’ at their own request. This was an unannounced inspection carried out over 5.5 hours. The purpose of the inspection was to check compliance with the requirements made at the last inspection and inspect additional standards. There were fourteen residents in residence on the day and two in hospital. Four were spoken with individually and eight as a group. One senior carer and the Registered Manager were spoken with. A tour of the premises was carried out and a range of documentation viewed including care plans, personnel and medication records. What the service does well: What has improved since the last inspection? What they could do better: All staff need to be trained in adult protection procedures to promote the protection of residents. Recruitment practices needs to ensure that all staff undergoes an up to date Criminal Records Bureau check. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 6 The implementation of formal quality assurance and quality monitoring systems would enable the provider to critically evaluate the service. A programme of maintenance and renewal needs to be created to ensure any minor repairs are carried out without delay. 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. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 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 Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 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, 4 and 5. Standard 6 is not applicable Satisfactory pre-admission assessments are carried out prior to residents moving into the home that ensure that their assessed needs can be met. Visitors are made welcome to the home at all reasonable times. EVIDENCE: Pre-admission documentation was viewed for recent admissions and it is evident that these documents are used effectively to ensure the home is able to meet the needs of prospective residents. Residents spoken with confirmed that they and their family were encouraged to assess the suitability of the home prior to admission. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9, 10 and 11 The care planning system is clear and consistent and provides staff with the information they need to satisfactorily meet residents’ needs. Residents are protected by satisfactory systems for the recording, handling and storing of medication. Residents’ healthcare needs are fully met and their privacy and dignity is protected. EVIDENCE: Six care plans were viewed and found to contain comprehensive information on residents care needs. Daily notes were also informative and give clear direction to staff on how best to meet residents’ daily care needs. The care plans are reviewed on a regular basis; the Manager and staff have a good understanding of residents care needs. Residents spoken with all mentioned the care and kindness of staff and that they felt all their needs were met. One resident said she did not want male carers giving personal care to her. This was discussed with the registered manager who said he was unaware that male carers attended to this lady but would ensure it did not happen in the future. He agreed to ensure that her care plan included clear instructions to all staff in this matter. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 10 Throughout the inspection staff were observed to treat residents with care and respect and it was evident that staff and residents are comfortable with each other. Residents are registered with GP’s and can access other health professionals as required, including chiropodist, district nurses and dentist. Medication records and storage arrangements were viewed and both aspects were satisfactory. Medication administration charts were up to date, accurate and clear. One resident prefers herbal remedies and this was discussed with the senior carer who is currently taking advice from the GP to ensure this resident remains healthy while at the same time respecting their wishes. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14 and 15 Residents benefit from a daily programme of activities and are encouraged to exercise choice over their daily lives. Visitors are welcome to the home at all reasonable times to ensure service users maintain links with family and friends. The meals in the Beeches are good offering both choice and variety and catering for special dietary needs. EVIDENCE: On the day of the inspection some residents remained in their rooms while others sat in the lounge areas relaxing or watching the television. When asked residents knew the activity that afternoon was a visit from the Salvation Army. Throughout the year the manager arranges outings to local attractions or to the shops. As part of the service provided, a retailer visits the home with a selection of clothing to ensure residents who are unable to go out are given the opportunity to choose their own clothes. Residents spoken with confirmed that family and friends visited regularly and were made welcome by the manager and staff. Other residents said they enjoyed going out with family for meals and outings. All residents spoken with said that the food was excellent and they were offered a choice at all mealtimes. Menus were viewed and they were varied and well balanced. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 12 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 and 18 The home has a satisfactory complaints procedure with some evidence that residents feel that their views are listened to and acted upon. Residents would be better protected if all staff were trained in adult protection procedures. EVIDENCE: The complaints book was viewed and it was seen that all complaints are recorded and include actions taken and outcomes. No complaints had been received since the last inspection. Residents said that they would be happy to speak to the manager or staff if they had any concerns. The home has policies and procedures on adult protection and staff are expected to be familiar with this document. Some staff have received training in adult protection, however, all staff need to be trained in recognising abusive practices to ensure residents are protected. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 13 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, 24 and 26 The standard of decor within the home is generally good, with most areas homely and comfortable for residents. Resident’s bedrooms are comfortable and they are able to bring in their own possessions. Satisfactory systems of infection control are in place to protect residents and staff. EVIDENCE: A tour of the premises was carried out and most parts of the home are well maintained and décor is generally good. Most residents’ bedrooms were clean, tidy and attractive. One bedroom was found to be in need of redecoration and refurbishment. This was discussed with the manager and senior carer and they agreed to address this matter without delay. Residents are encouraged to personalise their rooms and many have done so with ornaments, photographs and items of furniture. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 14 Laundry facilities are clean and hygienic. Systems are in place for the control of infection and all staff have been trained in this area. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 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 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 and 29 The number of staff and the skill mix is such that residents’ needs are met and consistent care is provided. The recruitment practice is not robust and does not provide sufficient safeguards for the protection of residents. EVIDENCE: Staff rotas were viewed and there are at least three carers on duty each morning and at least two during the afternoon and evening shifts. One waking night staff member is employed. Five staff have NVQ 2 or above with a further two due to begin NVQ 2 in early 2006. All staff undertake induction and foundation training that meets the requirement of the Skills for Care specifications. Recruitment records were viewed and it was found that one member of staff did not have an up to date Criminal Records Bureau check. This was discussed with the manager who agreed to address the shortfall without delay. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 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 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, 32, 33, 35 and 38 The manager provides good leadership and direction to staff to ensure residents receive consistent care, thus residents benefit from a supported and appropriately supervised staff team. The introduction of formal quality monitoring systems would enable the Provider to critically evaluate the service. There are systems in place to ensure residents financial interests are protected. Practices in the home are such that not all aspects of residents health, safety and welfare is promoted and safeguarded. EVIDENCE: The Manager is in the process of gaining the Registered Managers Award and intends to begin the NVQ 4 in Care before the end of 2005. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 17 Regular residents and staff meetings are undertaken ensuring both groups are consulted and have a say in how the home is run. Residents spoken with said they felt listened to by staff and that they were satisfactorily consulted. The introduction of formal quality assurance and quality monitoring systems would enable the provider to critically evaluate the service and ensure it is run in residents best interests. This was discussed with the manager and senior carer who stated that they have begun to gather documents that will form the basis for a quality monitoring system but had yet to collate and evaluate them. Appropriate insurance cover is provided with a certificate evident at the entrance to the home. Residents are encouraged to handle their own finances if appropriate; relatives and solicitors support others, while the home does not handle the financial affairs of residents. When items are bought on behalf of the service user a receipt is obtained and appropriate records maintained. Evidence was available to demonstrate that electrical and gas systems and appliances have been serviced and are safe. Documents relating to safe working practices and Health and Safety were available and found to be satisfactory as were accident records. Fire equipment is regularly serviced and all staff have been trained in fire safety procedures. Mandatory training is provided for all staff and includes moving and handling, infection control and first aid. Smoke alarms and emergency lighting is not tested regularly and this needs to be rectified. Failure to meet this requirement poses a potential risk to both residents and staff. Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 18 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 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 1 X 3 X X 2 Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? yes 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 Standard OP18 OP19 OP29 Regulation 13(6)(7) (8) Requirement Timescale for action 03/12/05 03/12/05 03/12/05 4 5 OP33 OP38 That all staff be trained in adult protection. (timescale of 22.12.04 not met). 23(1ab) That all parts of the home are (2ab) kept properly maintained and in a good state of repair. 19(1)(a-c) That all staff have an up to date (2-7) Criminal Records Bureau check as under Schedule 2 prior to appointment. 24(1)(ab) That formal quality monitoring (2)(3) and quality assurance systems be created and implemented 23(4abc) That emergency lighting and (ii) smoke alarms are regularly tested. 03/02/06 03/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. Extracts may not be used or reproduced without the express permission of CSCI Beeches Retirement Home DS0000021045.V252526.R01.S.doc Version 5.0 Page 21 - 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. 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