CARE HOMES FOR OLDER PEOPLE
North Yorkshire County Council The Beeches The Beeches Leeds Road Tadcaster North Yorkshire Lead Inspector
Pauline ORourke Unannounced 17 August 2005 _ 09:30- 15:30 LS24 9JZ The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service North Yorkshire County Council The Beeches The Beeches Leeds Road Tadcaster North Yorkshire LS24 9JZ 01937 833603 01937 834772 Address Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) North Yorkshire County Council Mrs Marie Denise Whitelock Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 18th January 2005 Brief Description of the Service: The Beeches is a care home providing personal care and accommodation for 29 older people. It is run by North Yorkshire County Care Services, which is a North Yorkshire County Council business unit. Mrs Whitelock is the registered manager. The home is located close to the centre of Tadcaster and service users can accesss the community amenities. The home was built approximately 30 years ago. It is a modern two storey building which is situated on a site shared with a day centre for up to 12 persons that is also managed by the home’s manager. All bedrooms are ground floor and single occupancy. Bedrooms are arranged on four wings, some of which have a secure inner courtyards and a garden patio area for service users use. North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection including preparation time took place over 12 hours. A tour of the building was conducted. A number of the service users records, staff records and records about the management of the home were inspected. 9 of the 26 service users, and 4 of the 6 staff on duty were spoken with. What the service does well: 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.
North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 7 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The service users can be assured that their care needs will be met EVIDENCE: Service users spoken with during the inspection said that someone from the home had visited them prior to their admission. They also said that they felt it had helped them settle in better as they had a little knowledge of what the home was like and what was expected of them. Management spoken with found the whole process of visiting a prospective service user positive and felt they are able to maintain a workable balance within the home. Records of these visits are kept in the service user files. North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 8 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, and 9 The health and personal needs of the service users are met. EVIDENCE: The service user files seen contained a Promotion of Independence Plan. This document was pertinent to the individual concerned and those service users spoken with were aware of their plans. The plans are reviewed every month by the service users key worker. The service users files contained information about their health needs and details of GP visits; district nurses, chiropodist, optician and community psychiatric nurses are recorded. The service users spoken with said that they could see their GP on request and they are able to see any of the visiting health professionals in private. There is a medication policy in place and all staff who administer the medication have received appropriate training. The storage, dispensing and documentation of the medication is in line with the policy and procedure of the home. North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 9 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13 The service users are able to keep their own routine within the home and join in with social activities EVIDENCE: The service users spoken with said that the routines of the home were flexible enough to allow them to make their own choices about what they wanted to do on a daily basis. One service user spoken with said she is able to spend all her time in her room. She also said she can be picky but the staff always try to accommodate her requests. Social activities are provided by staff and these have included trips out for half and full days, entertainers brought in to the home, once a month they have a fish supper, bought in and last month one of the service users had a curry instead of the fish and chips. The service users said that they enjoyed the variety of activities provided but worried about the staff, as they were always very busy. Visitors spoken with said that they are always made welcome and there are no restrictions as to when they visit. The service users confirmed this was the case. A visitors’ policy is in place and all visitors sign a visitor’s book on entering the home. North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 10 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Service users were confident that any complaints or concerns they had could be raised and acted upon. Service users are protected from possible abuse through staff training and employment policies. EVIDENCE: North Yorkshire Social Services has a detailed complaints policy. This policy is provided to all the service users and is displayed around the home. There have been no complaints made to the CSCI or the home in the last 12 months. Service users spoken with all said that if they had any problems there was someone within the home they would go to. There is an Adult Protection Policy in place. Staff spoken with had received training in Adult Protection issues and they had a good understanding of their responsibilities if they believed any inappropriate behaviour was taking place. Policies are also in place regarding the management of service users money. North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 11 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The service users live in a clean well-maintained environment EVIDENCE: Overall the home was seen to be well maintained and suitable for its stated purpose. During the inspection the corridor carpet was identified as needing professionally cleaning or replacing. All areas of the home seen were clean and free from odour. North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 12 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, and 29 Service users are not fully protected from possible abuse, as the recruitment policy is not properly implemented. EVIDENCE: The staffing levels have not reduced since the home was registered with the Commission. However, discussions with the registered manager highlighted that she is under pressure to reduce the level of cover on a morning as the occupancy levels are down. The reality of the situation was that the dependency levels were quite high on the day of the inspection and the staff on duty were on the go all day to ensure that service user needs were being met. Service users spoken with confirmed that the staff did not always have time to spend with them, as they were always busy. It is the responsibility of the registered manager to ensure the staffing levels are adequate to meet the needs of the service users. The staff records seen showed two instances where staff had commenced their employment before their Criminal Records Bureau disclosure had been received. There was no evidence of a POVAFIRST check. One of the files also contained only two verbal references. North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 13 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38 The service users are consulted about what they want in the home. The health and safety of the service users and staff is promoted. EVIDENCE: North Yorkshire Social Services have introduced an internal quality assurance documentation, ‘procedure and practice review’. This document is completed every three months and the manager has delegated different members of staff to carry out an assessment of each standard. The home also use information from questionnaires completed by the service users. and have subsequently introduced a digital camera so that service user can take their own photographs, the patio area has been identified as needing attention and the service users have identified what they want to be done to it. The quality Assurance Manager from North Yorkshire visits twice a year to assess the results of the questionnaires. North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 14 The staff spoken with during the inspection said that they had received training in, back care, first aid, food hygiene, COSHH, and fire training. Evidence of this was seen in their records and in the office diary. The equipment used in the home is serviced at the prescribed intervals. Health and safety notices were displayed around the building. Accidents are properly recorded and were appropriate reported to the CSCI. Accidents are properly recorded and where necessary reported to the Commission for Social Care Inspection. Information from the accident records is used in the care planning process. All staff can access Induction and Foundation training, this provides them with basic skills required to undertake the role of resource worker. North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 15 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x
COMPLAINTS AND PROTECTION 1 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x x 3 North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 16 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. 2. Standard 19 29 Regulation 23(2)d 19(1)b Requirement The corridor carpets must be cleaned or replaced All staff must have two written references and a POVAFIRST check or a Criminal Records Bureau disclosure prior to being deployed. Timescale for action 30.09.05 with effect from 16.08.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 27 Good Practice Recommendations The registered manager should continue to monitor the dependcy levels in the home and ensure thestaffing levels remain appropriate. North Yorkshire County Council The Beeches J53_J04_S34437_The Beeches_V241639_stage 4_170805.doc Version 1.40 Page 17 Commission for Social Care Inspection Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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