Inspection on 29/07/08 for Beechey House

This inspection was carried out on 29th July 2008.

CSCI found this care home to be providing an Adequate service.

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

Beechey House 12/11/07

Beechey House 27/07/07

Beechey House 23/01/07

Beechey House 14/08/06

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Beechey House 14 Beechey Road Charminster Bournemouth Dorset BH8 8LL Lead Inspector Martin Bayne Unannounced Inspection 29th July 2008 09:00 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 Beechey House DS0000064864.V365224.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. Beechey House DS0000064864.V365224.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beechey House Address 14 Beechey Road Charminster Bournemouth Dorset BH8 8LL 01202 290479 01202 290479 beecheyhouse@aol.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 Dhanjaye Damhar Miss Nisha Devi Damhar, Mr Dhanjaye Ravi Damhar Miss Nisha Devi Damhar Care Home 16 Category(ies) of Dementia - over 65 years of age (16), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (16) Beechey House DS0000064864.V365224.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Any residents accommodated on the second floor must not be dependent on staff to evacuate the building. The schedule of requirements must be completed within the agreed timescales. 12th November 2007 Date of last inspection Brief Description of the Service: Beechey House is a large detached property, situated in the Charminster area of Bournemouth. Beechey House is registered under Mr Dhanjaye Damhar, his daughter Miss Nisha Devi Damhar and his son Mr Dhanjaye Ravi Damhar. Miss Damhar is the registered manager responsible for the day-to-day running of the home. A maximum of 16 people can be accommodated there. The home is within walking distance of the local shopping area of Charminster, local buses are available close to the home to travel to nearby towns, including Poole and Bournemouth. The property is set back from the road and approached via a short driveway. On street parking is available for visitors. A secluded garden at the rear of the property is accessible to residents. Beechey House is registered to accommodate people over age 65 who have dementia or a mental disorder. The accommodation is arranged over three floors, with a passenger lift available to assist access between floors. There are 15 bedrooms (one shared room), all bedrooms have a wash hand basin and 12 bedrooms have ensuite toilet facilities. A lounge/dining room is available to residents and is on the ground floor. Weekly fees (reviewed at least annually) range from £492.00 to £505.00. Fees include all care and accommodation costs, including meals, laundry and activities. Additional charges are made for hairdressing, dry cleaning and chiropody. People are expected to pay for their own personal items such as private telephone, toiletries and newspapers. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at www.oft.gov.uk. The home hold a copy of the most recent inspection report, which is available, on request. Beechey House DS0000064864.V365224.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. We, the Commission, carried out a key inspection of the Beechey House, the aim of which was to follow up on the three requirements and four recommendations made at a random inspection in May 2008, and to evaluate the home against the key National Minimum Standards for older people. Miss Damhar, the Registered manager and her deputy, assisted us throughout the inspection. During the inspection we carried out a tour of the premises, spoke with residents, one relative visiting the home at that time and looked at records that the home is required to keep by Regulation. We also obtained feedback from a community Psychiatric Nurse (CPN) and a district nurse. Information was also obtained through the returned Annual Quality Assurance Assessment, (AQAA). What the service does well: Residents’ needs are assessed before they are offered a place at the home to ensure that their needs can be met. Residents’ health needs are now being met at the home with medication generally being administered in line with good practice. Residents’ social and recreational needs are assessed with action taken to provide stimulation for residents. Residents can receive visits from relatives and friends at any time and they are made welcome at the home. The home has a complaints procedure that complies with standards and relatives and residents are made aware of how to complain. Staff have received training in adult protection and the home has copies of relevant ‘safeguarding’ protocols. The home was found to be in reasonable decorative order and no hazards were found that would pose risks to residents. Beechey House DS0000064864.V365224.R01.S.doc Version 5.2 Page 6 We found that newly recruited staff had been subjected to all the checks required under the Regulations. In general we found that the home is run in the interests of the residents. 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. Beechey House DS0000064864.V365224.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 Beechey House DS0000064864.V365224.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from their needs being assessed prior to being offered a place at the home. EVIDENCE: We looked at the personal files for two residents who had been admitted to Beechey House since the random inspection and used these to track the records that the home is required to keep up to date. In the case of one of these residents, they had moved from another home and we found that Miss Damhar had carried out a pre-admission assessment of their needs before being offered a place at the home. This had been recorded Beechey House DS0000064864.V365224.R01.S.doc Version 5.2 Page 9 and covered all of the topics detailed within the Standards for Older people. The home had also obtained information from the other home on the person’s needs. Concerning the other person, they had been admitted under an emergency situation from hospital. The care manager had provided information and the home had completed an assessment of the person’s needs as soon as they were admitted to Beechey House. Miss Damhar told us that prospective residents or their relatives are welcome to visit the home, to assist in choosing a suitable placement. They can also be provided with a copy of the home’s Service User Guide, which gives detailed information about the home and the services it offers. Beechey House DS0000064864.V365224.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improved care planning now better informs the staff on how to care for residents. Medication is administered to residents in line with good practice. EVIDENCE: At the last key inspection in November 2007 a requirement was made concerning care planning. This requirement was followed up at the random inspection in May 2008, when it was found that some progress had been made in rewriting care plans into a new format, as had been agreed. The requirement remained in force as this piece of work had not been completed. At this inspection we were told that all plans were now up-to-date and in the new format. We looked at the care plans for the two residents who we tracked Beechey House DS0000064864.V365224.R01.S.doc Version 5.2 Page 11 through the inspection. We found that there was a photograph at the front of their care plan, so that the person could be easily identified. Care plans were organised in a consistent and easy to follow format, covering all of the areas of need for that person. We also saw that of social history had been obtained for each resident, to assist in meeting their social and recreational needs. There was evidence that the care plans were being updated and reviewed, thus informing staff of any changes. Due to the mental frailty of the residents, they had not signed their care plan. We saw within the personal care plans that risk assessments had been completed to ensure that the risk of harm is minimised in meeting the care needs of residents. We saw that better care planning was now better meeting health needs of residents. Whilst we were inspecting the home, we had the opportunity to speak with a community psychiatric nurse and a district nurse who were visiting residents on that day. We were told that the home made appropriate referrals to health professionals to meet residents’ health needs. We saw evidence that chiropody, dental and eye care needs were assessed and being met. At the random inspection in May 2008 a requirement was made concerning medication administration. We looked at the medication administration records for all of the residents and found that there were no gaps within the records. We recommend that where hand entries are made on medication administration records, a second member of staff signs and checks that the record has been completed correctly. We saw this practice was being adopted but not on all occasions. We saw that there was a photograph of the person concerned at the front of each medication administration record, which is good practice. We also saw that known allergies were recorded on the medication record. We saw that a sample of staff signatures of those staff trained in medication administration was maintained. At the last inspection a requirement was made that the home purchase a designated controlled drugs cabinet that meets the new Regulations. We found at this inspection that the requirement had been complied with. We also saw that the home now had a proper controlled drugs register as required at the last inspection. We saw that the home has a small fridge to store medications requiring refrigeration. Maximum and minimum temperatures were being recorded to ensure that medicines are stored at the correct temperature. We also saw that a record was being kept of the start date for medicines with a use by date, which is good practice. We found that the home has a record of medicines returned to the pharmacist. Beechey House DS0000064864.V365224.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 adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from their social and recreational needs being met. Visitors are made welcome at the home and residents are provided with a good standard of food; however records should reflect what residents have eaten to evidence that specialist diets are provided appropriately. EVIDENCE: We saw that the home had tried to find out about residents’ life histories to better meet their social, cultural or religious and recreational needs. On the day of our visit we saw staff talking and interacting with residents. In the afternoon a person from outside the home visited Beechey House and spent time with a group of residents playing games and quizzes, which residents seemed to enjoy. Mr Damhar told us that once a fortnight an accordion player visits the home. We were told that two of the residents had formerly played Beechey House DS0000064864.V365224.R01.S.doc Version 5.2 Page 13 the accordion and so they enjoyed this entertainment. We were also told that once a week an ‘Extend’ exercise session is held in the lounge. A person also visits the home every six weeks for an arts and crafts session and we saw examples of art done by residents on the wall in the lounge. One resident is taken out once a week to go to the shops. Mr Damhar showed us that she had bought a sketchpad for one of the residents who used to be an art teacher. Another resident used to own a florist and enjoys looking after the plants in the home. We saw that there was the occasional outing arranged such as two residents being taken to the pub at the weekend. We recommend however, that more detail be recorded in the daily record of the time and activities that staff spend with residents, to better evidence that recreational needs of residents are being met. We had the opportunity to speak with one relative who was visiting the home on the day of the inspection. They told us that they had no complaints about the home and that they were very pleased with the way their relative was being looked after. They told us that they were free to visit at any time unannounced and there were no restrictions on visiting. Concerning respect and dignity, we saw that all the residents were well groomed with the attention paid to their personal appearance. The relative we spoke with told us that residents always appeared to be well looked after. Residents appeared at ease with the staff. We were told that the resident who was admitted as an emergency, the home had arranged with the care manager to go to the person’s home to get some personal belongings and clothes that the resident wished to wear. On the day of visit we saw the fresh vegetables had been prepared for the main meal of the day of ‘toad in the hole’. We saw that likes and dislikes of food were recorded in care plans together with any specialist diets. We looked at the records of food provided and that reflected a balanced and nutritious diet being offered to residents. We also saw that evening snacks were available to ensure that residents do not go for more than 12 hours without some sustenance. We were told that some residents have specialist diets however the records of food provided did not adequately record that their needs were being met. It is required that more detail be recorded on food provided to demonstrate that residents received the specialist diets. Beechey House DS0000064864.V365224.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 good. This judgement has been made using available evidence including a visit to this service. Residents benefit from there being a well publicised complaints procedure and through staff being trained in adult protection. EVIDENCE: We were told that there had been no complaints made to the management of the home since the last key inspection. No complaints have been brought to the attention of CSCI. The home has a full complaints procedure that is detailed within the Service User Guide and this document is made available to all relatives. The home has both adult protection and whistle blowing policies that link to local safeguarding arrangements. We saw through looking at a sample of staff training records that the staff are trained adult protection as part of their induction training. Beechey House DS0000064864.V365224.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 benefit from a homely environment that is clean and hygienic. EVIDENCE: The home has a keypad on the front door linked to the fire safety system to ensure that residents cannot wander and get lost away from the home. The home has an enclosed garden to the rear that residents can access safely. We carried out a tour of the premises and found the home to be clean with no adverse odours. We found the home was in reasonable decorative order with Beechey House DS0000064864.V365224.R01.S.doc Version 5.2 Page 16 furniture and fittings in a reasonable state of repair. We found the bathrooms to be clean, providing paper towels and soap. The home has a dedicated laundry area fitted with commercial washing machine and dryer. Hand washing facilities are available in the laundry area. We saw that the staff are provided with gloves, aprons and protective clothing to meet infection control policies of the home. Beechey House DS0000064864.V365224.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. Residents benefit from adequate staffing levels being provided and through the staff being trained appropriately. Staff recruitment complies with Regulations. EVIDENCE: We enquired about staffing levels and were told that between 7:30am and 6:30pm there are three carers on duty, between 6:30pm and 8pm two carers and between 8pm and 9pm four carers. During the night time period there are two awake members of staff on duty in the home. The manager told us that she was satisfied that the staffing levels met the needs of the residents and we saw a duty roster that reflected the above staffing. In addition, Miss Damhar works in the home Monday to Friday and is supported by a part-time deputy. The home employs cleaning staff for 25 hours per week. The laundry and cooking duties are carried out by the care of staff. All of the staff who prepare food have been trained in basic food hygiene. Since the random inspection in May 2008 one new member of staff has been appointed to the staff team. We looked at this person’s recruitment records. Beechey House DS0000064864.V365224.R01.S.doc Version 5.2 Page 18 We saw that all the required checks and records were in place as required by Schedule 2 of the Regulations. We saw the training records for the new member of staff and found that they had received induction training compliant with standards set by Skills for Care, including training in adult protection. We looked at the training undertaken by two other members of staff and found that all of the mandatory training had been provided. We saw that this included moving and handling training. We also found that training had been provided in the care of people with dementia, and challenging behaviour. The recommendation of the random inspection that more training be provided in dementia had been complied with. Beechey House DS0000064864.V365224.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 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Management have taken action to make improvements and to meet requirements; however failure to record and monitor accidents could lead to care needs not being met EVIDENCE: We saw that the registration certificate was displayed together with a copy of the home’s employer’s liability insurer’s certificate. Beechey House DS0000064864.V365224.R01.S.doc Version 5.2 Page 20 Mr Damhar has gained the Registered Managers Award and has started training in NVQ level 4. As reported at the last inspection she has also completed a 12 week distance learning course in dementia care. We found at this inspection that there had been improvements in recordkeeping and also generally in outcomes for residents. We were told that the home carries out annual surveys with relatives, residents and people who have an interest in the home, as part of their quality assurance. We received a completed AQAA, as requested. The home has carried out a fire work place risk assessment and we found that tests and inspections of the fire safety system were being carried out to the required timescales. We also saw evidence that the portable electrical equipment testing had been carried out. We spoke with the deputy manager who told us that they had taken over some responsibility for supervising staff and that supervision sessions were taking place as required. We saw that radiators were covered to protect residents from the risk of burns and that thermostatic mixer valves had been fitted to the hot water outlets, to protect residents from scalding water. We found that one of the residents who we tracked through the inspection had sustained bruising to their eye after a suspected fall. This had been recorded in the daily notes, however an accident record had not been completed. It is required that all accidents are recorded so that they can be monitored and action taken to reduce the likelihood of further accidents. Beechey House DS0000064864.V365224.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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 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 X X 1 Beechey House DS0000064864.V365224.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 OP15 Regulation Schedule 4 (13) Schedule 3 (j) Requirement A record must be maintained of food provided to residents in sufficient detail to determine whether the diet is satisfactory. A record must be maintained of all accidents affecting residents Timescale for action 10/09/08 2. OP38 10/09/08 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 OP9 Good Practice Recommendations We recommend that where hand entries are made on medication administration records, a second member of staff signs and checks that the record has been completed correctly We recommend that more detail be recorded in the daily record of the time and activities that staff spend with residents, to better evidence that recreational needs of residents are being met. Nisha Damhar should complete her National Vocational Qualification Level 4 in Care. This recommendation has been carried forward from DS0000064864.V365224.R01.S.doc Version 5.2 Page 23 2. OP12 3. OP31 Beechey House previous inspections. Beechey House DS0000064864.V365224.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Beechey House DS0000064864.V365224.R01.S.doc Version 5.2 Page 25 - 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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