CARE HOMES FOR OLDER PEOPLE
Beechfield 22 Hanger Hill Weybridge Surrey KT13 9XS Lead Inspector
Fiona Cole Unannounced 03 May 2005 10:00 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. Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Beechfield Address 22 Hanger Hill, Weybridge, Surrey, KT13 9XS 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) 01932 842380 Beechfield Trust Limited Mrs Audrey Claire Sentinella CRH Care Home 16 Category(ies) of OP Old Age, 10 registration, with number PD Physical Disability, 1 of places PD(E) Physical Disability - Over 65, 4 SI(E) Sensory Impairment - Over 65, 1 Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The number of persons for whom residential accomodation and personal care is provided at any time shall not exceed SIXTEEN (16). 2. The age range of the persons to be accommodated will be: 15 persons (OP) 65 years and over up to 4 may be in the category PD(E), one in the category PD under the age of 64 and one in the category SI(E). Date of last inspection 23 December 2004 Brief Description of the Service: Beechfield is a residential care home for active Christian Scientists. It opened in 1946 and was the first Christian Science care home in Britain. Service users rely on bible-based methods of spiritual healing rather than on conventional western medicine and care. The reliance of Christian Scientists on prayer alone for their health care is an integral part of their worship of God and practice of their religion. No medical processes, remedies or interventions are used at Beechfield. The home is registered as a care home not providing medicines or medical treatment. It is registered for up to 16 people. The age range of the persons to be accommodated is 15 older persons aged 65 years and over; up to 4 may be in the category of physically disabled and elderly. One may be in the category of elderly with a sensory impairment. The home is situated in Weybridge opposite the cricket green and close to shops. The railway station and several bus routes are also in close proximity. The home stands in its own well appointed grounds. There is a lift serving the upper floor. There are sixteen single rooms; all but one has an en-suite toilet. Two have showers and two have baths. The major part of the home is wheelchair accessible. The Beechfield Trust administers the home; several of the staff and management are active Christian Scientists themselves.
Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This visit was the homes first inspection for the year 2005/2006. This was an unannounced visit, which meant that staff and residents were not aware that it was due to take place. Inspectors arrived at 10.30am, to avoid interrupting the daily bible class. All 14 service users were in residence at the time of the inspection. Inspectors spent the first part of their visit in discussion with two Senior Care staff who kindly acted on behalf of the manager and head of care in their absence, checking care plans and reports, policies and procedures. Care and health plans were found to provide a good level of information about each service user based upon a sound assessment of their needs and wishes. The second part of the inspection was spent, observing staff, talking to residents looking around the home, following up on previous environmental recommendations and requirements from the last inspection. Residents with whom the inspectors spoke, were very complimentary about life at Beechfield. The home was clean and tidy, tastefully furnished and in reasonable decorative order. Staff were observed interacting with residents in a manner that respected privacy and dignity. What the service does well:
The relationship between residents and staff was observed to be relaxed and friendly creating a warm and homely feel. Residents are actively encouraged to be as independent as possible where they are able and some leisure activities outside of the home and are able to walk in to Weybridge town centre to access shopping areas. At the time of inspection a number of residents had attended the hymn service and bible lesson which takes place daily. The home benefits from having a part time activities coordinator who organises theatre trips as well as programmes in the home. These include arts and crafts gardening knitting music and movement needlework and poetry, a volunteer supports some of these sessions. Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 6 All service users have an individual care plan and risk assessment where applicable drawn up with input from the Head of Care resident professionals and relatives. These are very well written and regularly reviewed by care staff as well as management. It was evident from the signed documents that residents maintained control of their lives. Training and development of staff has been of high priority with the manager and head of care undertaking NVQ4 and the registered managers award. Several staff have obtained their NVQ level 2 and all staff have undergone Surrey County Councils POVA training including the handyman/gardener. English lessons organised by Brooklands College are attended by 4 members of staff on a weekly basis at Beechfield. What has improved since the last inspection? What they could do better:
The home was generally operating to a good standard, however inspectors detected two areas where a distinctive odour was present. In one residents room the key to the French doors was missing and locked preventing the residents means of escape in the event of a fire. A number of the environmental issues raised in the last inspection still had not been completed and additional environmental requirements have been made. The numbering and naming of residents rooms was inconsistent, One system was recommended. Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 7 Handwritten care plans look scruffy and the inspectors recommended typed ones, and the removal of post stick notes. 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. Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 8 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 Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 9 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) 1 2 3. The home was found to be operating effectively in respect of these standards. Inspectors were impressed by the quality of information about the home that had been reviewed and improved, and felt confident that this would help prospective residents to make an informed choice about the suitability of the home. EVIDENCE: The home have reviewed and improved their terms and conditions. People considering taking up a vacancy at Beechfield have assessments undertaken prior to admission. There is input from others supporting the prospective resident for example a Christian Science Practitioner and family members as appropriate. An invitation to visit the home and sample lunch or tea is strongly encouraged as is a short stay prior to making a firm commitment. Once admitted there is a more detailed assessment that takes place reflecting the holistic needs of the resident enabling the development of a more detailed plan to meet those assessed needs.
Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 8 9 and 10. Personal care, and healthcare support and assistance is planned, and was seen to be provided when needed in a respectful and sensitive manner. EVIDENCE: Care plans inspected were comprehensive and clearly set out actions which need to be taken by care staff to ensure that all aspects of the health and personal care needs of the residents are met. The care plans were drawn up in conjunction with each individual resident and signed accordingly. As a nonmedical home, residents are still encouraged to register with a local GP and use the services of the visiting dentist podiatrist and optometrist as appropriate. During the tour of the home staff were observed to always knock before entering a residents room and all interactions between staff and residents were seen to be sensitive and respectful. One resident described the care staff as “displaying great kindness and warmth”.
Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 11 All residents spoken to during the course of the inspection were complementary regarding all of the staff, expressing their readiness to help at all times. Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 The part time activities coordinator, ensures that activities provided will meet the preferences and expectations of all residents at Beechfield. EVIDENCE: The activities coordinator contributes a very positive aspect to the daily lives of the residents at Beechfield, all without exception participating in one or more of the various activities on offer. One resident said she had particularly enjoyed the reminiscing activity. The activity coordinator has identified with each individual resident previous hobbies and interests, and from this a weekly activity plan has been drawn up. The inspector congratulates the home on the very positive approach it has towards ensuring that the social care and activity needs of residents are met. A volunteer also supports a number of the sessions. Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 13 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) 16 The home operates a clear and accessible complaints procedure which includes timescales. EVIDENCE: All of the residents spoken to on the day of inspection knew how to complain and said they would have no hesitation in doing so if the need arose. All residents had a copy of the procedure in their service user guide. The home has a copy of the latest Surrey Multi-Agency Procedure for the Protection of Vulnerable Adults. All staff have undertaken the training and have been encouraged to read the manual which underpins the practice. Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 14 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 location and layout of the home and gardens are suitable for their stated purpose. An ongoing maintenance and redecoration programme provides the residents with clean, pleasant and homely surroundings in which to live. EVIDENCE: During the tour of the home the premises were on the whole seen to be well maintained, some work has yet to be completed and inspectors required certain works to be undertaken with immediate effect as it constituted a health and safety risk, (see requirements section.) Residents are able to access all areas of the home and gardens. On the day of inspection the home was found to be warm and bright with a homely atmosphere and a high standard of housekeeping. The gardens are well established and well kept. Two residents expressed their delight in being able to sit and admire the garden in the summer as well as contributing to its upkeep.
Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 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 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) 28 29 30. Evidence gathered on this inspection showed a good recruitment programme in place based on equal opportunities and including the required checks and documentation to ensure the protection of residents. Positive action on behalf of the registered manager is being taken to provide staff with the training they need to do their jobs effectively. EVIDENCE: Since the previous inspection the registered manager and head of care have worked hard to develop a training and recording programme for all staff members. They have both been active in supporting staff members through a number of training programmes including; elder abuse, dementia, health and safety, food hygiene, moving and handling, reporting and recording. All staff have participated in the Surrey County Council POVA training. Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 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 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 34 36 and 38 The home has a quality assurance and monitoring system in place. Regulation 26 visits resident surveys, relative and visitor surveys all contribute to this process. The home also has a comprehensive policies and procedures manual and excellent record keeping. EVIDENCE: Since the previous inspection the home has implemented a structured supervision programme and it has been rolled out to all staff to ensure two monthly supervision sessions. All staff spoken to confirmed this process was working well. Overall, the standard of record keeping at Beech field is good with documents well maintained easily accessible and safely stored. However, there were a number of handwritten entries on care plans with crossings out making the text difficult to read and no date entry. Many entries were not signed and also
Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 17 contained post stick notes that seemed to override the text but this was unclear. Staff assisting with the inspection were unsure themselves and on one instance believed the information contained on the post stick to be at least 2 years old. An immediate requirement is for these records to be updated and the practice of using post stick notes eliminated, has been issued. Overall there was a positive approach to health and safety within the home. Most requirements from the previous inspection had taken place, with the exception of the kitchen where the requirements will be carried forward to this report. In addition four immediate requirements were made;. Of particular concern the loss of a key preventing a residents escape in the event of a fire. Carpet on three stairs to be replaced threadbare patches and repairs to the existing carpet constitutes a hazard and looks unsightly. Odour was detected in two communal areas. Numbering and naming of residents rooms was inconsistent and confusing and A decision needs to be made over which system applies. Requirements have been made regarding these concerns. Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 N/A 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 1 2 3 N/A 3 3 1 2 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 Standard No 16 17 18 Score 3 3 3 3 3 3 N/A N/A 3 3 1 Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 19 NO 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 OP25 Regulation 23(2b&c) Requirement That the premises, are of sound construction and kept in a good state of repair externally and internally; that all aprts of the care home are kept reasonably decorated. That the registered person ensure that all the required records are maintained in a good order and regularly reviewed and updated. That the registered person must ensure that all parts of the home to which the residents have access, are kept free from hazards to ensure the the health, safety and welfare of the service users at all times Timescale for action 31 May 2005 2. OP37 17(2) Sch(4&3) 03 May 2005 3. OP38 13(4a&c) 31 May 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP1 OP38 Good Practice Recommendations The Registered Manager discusses with the board a minor variation in respect of a dementia category for 3 people. The kitchen wall has reinforced material to protect it from
H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 20 Beechfield the meal trolley continuing to collide into it and causing damage and exposing bare unhygienic walls. Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Beechfield H58_s13566_Beechfield_v217329_030505_stage 4.doc Version 1.30 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
