Inspection on 18/12/06 for The Beeches

This inspection was carried out on 18th December 2006.

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 no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Beeches 17/11/08

The Beeches 22/11/07

The Beeches 30/11/05

The Beeches 02/06/05

The Beeches 06/07/04

The Beeches 27/02/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

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

CARE HOME ADULTS 18-65 Beeches The Frodingham Road Brandesburton Driffield East Riding Of Yorks YO25 8QY Lead Inspector Ms Wilma Crawford Unannounced Inspection 18th December 2006 14:00 Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 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 The DS0000019735.V297724.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 Adults 18-65. 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 The DS0000019735.V297724.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beeches The Address Frodingham Road Brandesburton Driffield East Riding Of Yorks YO25 8QY 01964 542459 01262 424563 jekcunning@btopenworld.com 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) Mr John Charles Kunning Susan Melvin Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th November 2005 Brief Description of the Service: The Beeches is a care home providing care and accommodation for up to 11 people under the age of sixty-five who have learning difficulties. The home is located on one of the exit roads from the village of Brandesburton, close to local amenities and within easy access of public transport. The home has been registered for a number of years and is a two-storey building. It was previously part of the local hospital for people with learning difficulties. There are 11 single rooms all without en-suite facilities, although one room has a shower. There are 4 toilets and 3 bathrooms available. The home has large gardens and is surrounded by open countryside. Car parking is available to the front and rear of the property. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over eight hours during two visits to the home. A tour of the premises was conducted with a member of staff. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with the residents, the care staff and observation of care practices. The manager assisted the inspector during the second site visit. Ten residents and two staff members were spoken with during the two visits. A Pre Inspection Questionnaire asking for information about home was sent out before this visit and information from this was included as part of the inspection process of this service. Comments from replies to questionnaires that were sent out to relatives and professionals are also included in the report. The range of fees charged is from £296.50 to £940.98 per week. What the service does well: What has improved since the last inspection? The quality assurance system has been further developed. An additional 60 staffing hours are to be provided in the home each week, (these hours are currently being advertised.) Staffing levels are regularly reviewed to ensure that additional staff are available to support residents with appointments and outings. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 6 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 The DS0000019735.V297724.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4,5 Quality in this outcome area is adequate. This judgement has been made using available evidence including two visits to this service. Service user’s are assessed and provided with some information to assist them to make an informed choice prior to moving into the home. EVIDENCE: Each resident has an individual care plan, which contains an assessment and gives a detailed description of particular care needs. Risk assessments for all areas of daily living are included where necessary. The manager explained that all residents are visited and assessed prior to moving into the home. They also are given the opportunity to visit, have a meal and an overnight stay before moving into the home. Residents and staff were also able to confirm that this happened. Two contracts of residence were seen, one was not signed and neither included details of charges. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,and 9 Quality in this outcome area is good. This judgement has been made using available evidence including two visits to the home. Service users are able to make decisions and everyday choices as part of an independent lifestyle. EVIDENCE: Care plans are detailed. Evidence was available that residents are involved in drawing up the care plan and that they sign consent for. Staff and residents spoken with also confirmed this. Care plans are regularly reviewed. Residents’ interests are recorded and those activities in which residents are involved are risk assessed. Risk assessments are responsive to varying levels of capacity. Residents said they could become involved in activities according to their interest. One service user said they wanted to go out alone but had been told they needed to be accompanied and was aware of the reasons behind this decision. The risk assessment clearly showed why this was necessary. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including two visits to this service. Residents have some opportunities for leisure activities, are supported to maintain relationships and have their nutritional needs met. EVIDENCE: Residents have the opportunity to participate and engage in a wide range of structured activities, however, the majority of these, are provided by day services, local adult education and colleges. One service user has a work placement, while another chooses to use the community facilities travelling daily on the train or bus to Beverley or Bridlington. The home has a car available for transporting residents. Residents are able to develop and maintain personal relationships of their choosing and are supported by staff. Staff spoken with had a good understanding of their responsibilities in supporting residents with relationships and the issues relating to consent. Residents have a choice at mealtimes; this was observed during the visit and documented in minutes from Residents’ meetings. Lunchtime was observed and seen to be relaxed. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 11 A resident was on holiday in Turkey at the first visit with two staff members During the second visit, one resident had been out with his family, whilst other residents were out at day services, however no in house activities were observed at either visit. When this was discussed with residents they said that they preferred to do things outside of the home and had their own televisions, DVD and CD players and could use them whenever they chose to. They also said that they felt there were not enough staff to do activities in the home as they had cleaning, cooking and washing to do. When this was discussed further, residents’ said that they were involved in domestic tasks with staff support. Residents acknowledged that some outings took place, for example shopping, pub visits, but they would like more. The staffing rota evidenced that there are occasions where additional staff members are brought into the home to support individuals on a 1:1 basis with outings or appointments. Residents have their own kitchen, but felt that it is not suitable to use in its current state, as the doors of the units are missing. This presents an image of the kitchen looking untidy. They are unable to use the main kitchen. The manager explained that the doors had already been replaced once and then damaged again. It may be that alternative types of storage need to be considered for example open fronted units, which may be more suitable for individual needs. Residents would welcome the opportunity to have the kitchen repaired, so that they could use it to develop their individual cooking skills. Residents are involved in menu planning through the Residents’ meetings and were aware of the choices available on the day. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Residents receive appropriate health care and personal support. EVIDENCE: Residents said they received the support they needed in the way they wanted it to be given. For example, residents who prefer to receive personal care from a female carer have this written in their care plan. Residents also receive support to choose what to wear and to buy new clothes. Resident’s emotional well being is monitored through file notes by staff or any professional healthcare workers. Professionals spoken with felt that the staff provided emotional support to individuals well. Residents are assisted to attend outpatient and other appointments and additional staff members are brought in to facilitate this. Medication is suitably kept and administered. Only staff who have received appropriate training are able to administer this. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is adequate. This judgement has been made using available evidence including two visits to the home. Residents feel able to air their concerns without any fear of repercussions. The staff vetting procedure is not sufficiently robust to ensure the safety of the residents. EVIDENCE: The manager has an open door policy and the residents are free to see her when they please. This was observed at the inspection when residents present freely approached her. Regular residents meetings are held when residents have the chance to voice concerns. During discussion residents gave examples of how the Residents meeting had been used to air concerns about an individuals’ behaviour in the home and the action that had been taken to resolve this. They were also confident that they could approach any staff member with any concerns or worries. One resident said ‘If I was unhappy or upset about anything, I can talk to the staff about it and they would sort it out. We are a team.’ The home has a comprehensive complaints policy and procedure. All newly appointed staff receive induction training and during this time have training on policies relating to recognising and reporting incidents. Overall, recruitment policies at The Beeches ensure that the staff they employ are suitable to care for the people who use this service. This involves CRB and POVA checks being conducted and two references being taken up, prior to appointment. However, where issues were identified in the recruitment process, no clear recording of decisions made had been retained. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including two visits to the home. The residents have been provided with an environment that is clean and has been decorated to a reasonable standard, with both private and communal space being suitable for their needs. EVIDENCE: The premises continued to be maintained and decorated to an acceptable standard. Residents were happy to show the inspector their bedrooms, which were appropriately furnished and had been personalised to individual taste. All of the residents spoken with said that they had been consulted about decorating their room; one had the walls of their room decorated with the football team that they supported. There is a kitchen used for the meal preparation and a further residents’ kitchen. The Residents’ kitchen had the majority of the unit doors missing, a previous requirement had been made to have these replaced. The manager said that these had been replaced in between visits, but had been damaged again. An immediate requirement notice was made to have the kitchen unit doors replaced. Residents spoken with said that they did not like to use the Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 15 kitchen in its’ present state, but would welcome the opportunity to have somewhere suitable to practice their cookery skills. Fire doors were seen to be wedged open at both visits to the home. This practice has the potential of putting residents at risk, and was discussed with the home manager who agreed to stop the use of these immediately and seek advice from the fire prevention officer as to what suitable alternative devices may be used. None of the bedrooms had en suite facilities. There were adequate numbers of shared toilets and bathrooms available. A resident with a raised bed had a risk assessment in place, which had been completed in consultation with the occupational therapist. Fire alarm and emergency lighting checks are now regularly completed. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including two visits to the home. Residents are supported by staff who are supervised and undertake training. The staff vetting procedure is not sufficiently robust to ensure the safety of the residents. EVIDENCE: 50 of the staff team have a Non Vocational Qualification at level 2 in care or above. A requirement was made at the last inspection to review staffing levels. Although staffing levels are regularly reviewed to ensure that additional staff are available to support residents with appointments and outings; there are some residents in the home who have a contract that includes identified 1:1 time with staff in specific areas. These individuals are also supported by bringing in additional staff. However, usually there are two staff on duty at all times and this number would include the manager when they are on duty. The staff are also responsible for the preparation of all meals, cleaning and laundry duties. Although the home covers all shifts, more staff are required and existing staff are covering extra shifts. The existing staff said they could cover shifts without Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 17 working excessive hours as some were on part time contracts but were working full time. An additional 60 staffing hours are to be provided in the home, (these hours are currently being advertised.). The manager said that she had attempted to recruit suitable staff but had so far not been successful. Staff receive Skills For Care compliant induction and foundation training. Staff supervision notes were seen. Staff said they could talk to the manager at any time and that some supervision was informal according to need. The Beeches ensure that the staff they employ are suitable to care for the people who use this service. This involves CRB and POVA checks being conducted and two references being taken up, prior to appointment. However, where issues had been identified in the recruitment process, there was no record to evidence the decision and rationale which demonstrated why service users are not placed at risk by an individual’s appointment. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Residents’ health and welfare is safeguarded. EVIDENCE: The manager has attained an Non Vocational Qualification in care at level 4 and the Registered Managers Award. She is an experienced manager and has managed the home for a number of years. The home carries out six monthly quality assurance audits, where residents and third parties are surveyed. However the results of these had not been collated and fed back to staff and residents. Residents said they had a say regarding how things were run at the home and that there were regular times when they could air their views about what could be improved. Residents’ meetings are held regularly. Residents have risk assessments in place for all areas of daily living. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 19 Certificates were seen for the maintenance of fire equipment, gas safety and electrical safety. Fire doors were seen to be wedged open at both visits to the home. This practice has the potential of placing residents at risk, and was discussed with the home manager who agreed to stop the use of these immediately and seek advice from the fire prevention officer as to what suitable alternative devices may be used. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 3 5 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 1 X Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 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. 1. Standard YA5 Regulation 5(1) (b) Requirement Timescale for action 28/02/07 2. YA14 16 2 (n) 3. YA23 19(1) b (1) The registered person must ensure that they develop and agree with each prospective service user a written contract/statement of terms and conditions between the home and the service user, which includes details of charges. 28/02/07 The registered person shall consult Residents about the programme of activities arranged by or on behalf of the care home, and provide facilities for recreation including, having regard to the needs of Residents, activities in relation to recreation, fitness and training The programme of activities should be reviewed to ensure that it is adequate to meet the needs of all Residents. The registered person shall 28/02/07 ensure that where issues are identified in the recruitment process, clear recording of decisions made are retained. The record should evidence the decision and the rationale which demonstrates why service users are not placed at risk by an individual’s appointment. DS0000019735.V297724.R01.S.doc Version 5.2 Beeches The Page 22 4. YA24 23 2 (b) 5. YA24 YA42 13(4) c 6. YA33 18 (1)(a) A 28 day notice was made in respect of this requirement The registered person must 28/02/07 ensure that the doors to the units in the Residents’ kitchen are replaced and that the facilities are fit for purpose. A 28 day notice was made in respect of this requirement. The registered person shall 28/02/07 ensure that: unnecessary risks to the health and safety of residents are identified and so far as possible eliminated The practice of holding doors open by a un authorised means (wedges) must stop. Advice must be taken from the fire officer as to what suitable devices can be used. A 28 day notice made in respect of this requirement The registered person must 28/02/07 ensure that the home has an effective staff team, with sufficient numbers to support residents’ assessed needs at all times. (Previous requirement - timescale 1/05/05 - not met timescale 31/07/05 not met.). 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. Refer to Standard YA39 Good Practice Recommendations The registered person should ensure that the surveys completed for Quality Assurance purposes are collated and a report completed including any action taken by the home as a result of the feedback given by Residents and their representatives. Beeches The DS0000019735.V297724.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 The DS0000019735.V297724.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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