Inspection on 28/07/05 for Beechlands

This inspection was carried out on 28th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Beechlands 10/01/08

Beechlands 06/10/06

Beechlands 21/12/05

Beechlands 05/01/05

Beechlands 24/08/04

Beechlands 11/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Beechlands 42 Alderton Hill Loughton Essex IG10 3JB Lead Inspector Kathryn Moss Unannounced 28th July 2005 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. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Beechlands Address 42 Alderton Hill, Loughton, Essex, IG10 3JB 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) 0208 508 5808 0208 508 1484 Southend Care Ltd Mrs Amanda Austin Care Home 28 Category(ies) of Old age, not falling within any other category 28 registration, with number Both of places Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who only fall within the category of old age (not to exceed 28 persons) Date of last inspection 5th January 2005 Brief Description of the Service: Beechlands is a detached property, located in a residential area a short distance from local shops and facilities. Accommodation is on two floors, accessed by a through floor passenger lift. The home is divided into four units, each with its own lounge/dining area and bathroom facilities, and each accommodating seven service users. The home has 24 single bedrooms and 2 double rooms, all with ensuite toilets. Beechlands is registered to provide residential care for 28 Older People (i.e. over the age of 65), and provides 24 hour personal care and support. It has appropriate aids and equipment (e.g. mobile hoist, assisted bathing facilities, hand rails, etc.) to assist residents with limited mobility. There are currently a few residents who have developed dementia since coming to live at Beechlands, but the home is not registered to admit people with dementia. The home is owned by Southend Care, and the current registered manager is Amanda Austin. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on the 28/7/05, lasting six and a half hours. The inspection process included: discussions with the manager, six staff, six residents, and two relatives; the viewing of communal areas; and inspection of a sample of staff and resident records. 18 standards were inspected, and 2 requirements and 2 recommendations have been made. There were 26 people in residence in the home on the day of the inspection, with a new admission due the following day. Residents and relatives spoken to were all very positive about the staff team and about the care provided at Beechlands. What the service does well: What has improved since the last inspection? There had been significant improvements in the recording of monies held on behalf of residents in a shared residents’ bank account. Records relating this had been updated, and were now clearly and accurately maintained. Since the last inspection, an additional assisted bathing facility had been installed in one of the bathrooms, giving residents a greater choice of facilities on each floor. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 6 Since the last inspection the manager and a senior carer had trained as moving and handling trainers, enabling this important aspect of training to be delivered in-house as and when staff required training or updating. 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. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 4 and 5 The home is able to meet the needs of the people it aims to accommodate. Appropriate information is available to prospective residents, and they have opportunity to visit the home to assess its suitability. EVIDENCE: The home had a current statement of purpose and a revised service user guide had been submitted after the last inspection, and feedback on this has been provided to the manager of the service. Residents and relatives spoken to were confident that staff had the skills to meet their need, and the staff spoken to showed good awareness of residents’ needs. The home provided staff training relevant to the care the home aimed to provide; a few residents had developed dementia and a senior carer was due to attend dementia training later in the year. The home’s premises are suitable for its purpose, and the home had appropriate aids and equipment. A new resident and their relative spoken to were aware that the resident could have visited the home before their admission, but had been unable to due to their circumstances. However, their relative had visited the home on their behalf, and said this had influenced their choice of home. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 Residents’ personal care and health needs were being well met at the time of this inspection. However, documentation (care plans) did not satisfactorily describe all of the assistance required by staff to meet key care needs. Residents felt that they were treated with respect, and practices in the home promoted people’s privacy and dignity. EVIDENCE: Residents seen appeared to have their personal hygiene needs well met, and were dressed in clothes that were clean and reflected personal choices. Residents and relatives spoken to were all very positive about the support and assistance that staff provided with personal care, and felt that this was provided competently and appropriately, that staff were very caring, and that their privacy and dignity were respected. Staff were seen to be attentive to residents’ needs; files contained recorded contact with healthcare professionals that showed that medical advice was sought about health issues. One visitor particularly commented on the way that staff had worked with their relative (a resident), taking time to get to know then and treating them as an individual. Only one care plan was inspected on this occasion, belonging to a person who had mental health needs and also needed assistance with all person hygiene Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 10 and daily living activities. A general assessment of need was being reviewed and updated monthly, and more detailed assessments (including pressure areas, nutrition and moving and handling) were being reviewed monthly or when required. There was a good range of care plans present on the person’s file, covering all key personal care needs. However, some care plans did not contain sufficient detail of the action required to meet the person’s needs (e.g. a care plan for incontinence did not detail the pads to be used; one for toileting did not refer to the frequency of assistance required, or to the fact that the individual needed to use a commode). There were care plans present on the file relating to social and mental health needs, but these also needed more detail of the action required to meet those needs (e.g. a care plan for dealing with challenging behaviour did not detail the action to address one known cause of this behaviour; a care plan for the inability to engage in social interaction did not describe the action required of staff). There was evidence that the care plans were being regularly reviewed (monthly). Issues relating to continence and to pressure area preventive care were not specifically discussed on this occasion. The manager reported that the home has good support from local district nurses, and that they can access a continence advisor if required. It was noted that there were jugs of cold drinks available in communal areas, and a relative visiting confirmed that this was usual practice in the home. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 The home provides an environment and lifestyle to meet residents’ choices and interests. Practices in the home ensure that residents can maintain contact with family and friends. The home provides a health and balanced diet in pleasing surroundings. EVIDENCE: During the inspection, residents reported being able to make choices in their day-to-day routines, particularly in relation to meals, when to get up or go to bed, whether to join in with activities, etc. Those spoken to were generally quite positive about their lives at Beechlands. On the day of the inspection, activities were seen taking place: one carer was seen doing a quiz with a group of residents on one unit, another carer was encouraging a resident to play the piano, and elsewhere nail care was seen to be in progress. Staff observed related well to residents, and one was observed showing good interaction with a resident who suffered with dementia. The manager reported that there had been a couple of outings, and that they had also had some music afternoons and done some cake making with residents. Photos were displayed showing a recent trip to Southend and an Easter Bonnet competition, and there were notices showing a forthcoming summer fete and a ‘Shoe Party’. One resident reported that they had enjoyed the trip to Southend, and would like more opportunities to go out. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 12 Activities records were maintained on residents’ files, showing the activity and whether they had enjoyed it. The home also maintained a monthly record of the type of activities carried out each day: this demonstrated a good range and frequency of activities taking place. Care records provided information on any particular interests, likes or dislikes a resident had; as noted in the previous section, care plans needed further development to show what action was required of staff to help a resident occupy their time or receive stimulation. Relatives spoken to confirmed that they were able to visit at any time, and that they were always made welcome. One said that they were free to make themselves a cup of tea, and also stated that the manager is available and approachable if they need to speak to her. They said that they had chosen the home because of its homely atmosphere. The home has a payphone available to residents in a quiet location, to enable them to make personal calls and to maintain contact with family and friends. Lunch observed on the day of the inspection provided residents with a choice of main course, and looked and smelt appetising. Residents spoken to were positive about the meals, and were clear that they had a choice and could ask for something different if they did not fancy the menu choices. One resident liked the meals, but said that they felt the tea-time meal choices could sometimes be quite repetitive. The cook stated that a better range of product choices is now available for the home to order, and was able to evidence that she could make changes to the menu to suit the Beechlands’ residents personal preferences. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 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) 18 The home has appropriate policies in place to promote the protection of residents, and staff are aware of these. EVIDENCE: The manager confirmed that the home now has a revised Protection of Vulnerable Adults (POVA) policy, incorporating details of the action to be taken on suspicion of abuse, and that staff had seen this and had also signed to confirm receipt of a copy of a booklet on Protection. Evidence of staff POVA training was not viewed on this occasion, but staff spoken to showed an appropriate awareness of issues relating to the protection of vulnerable adults, including whistle blowing. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 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, 25 and 26 At the time of this inspection, Beechlands provided a safe, comfortable and well-maintained environment. The home was clean, pleasant and hygienic. EVIDENCE: Since the last inspection, Southend Care has appointed someone with a corporate responsibility for staffing and facilities, and the manager reported that this person had carried out an assessment on the home with the manager to identify short and long-term work required. A new assisted bathing facility had been installed on the ground floor, and longer-term improvements included some areas of decoration. The manager confirmed that most outstanding maintenance tasks noted at the last inspection had now been completed, with only a replacement shower room floor still outstanding (therefore just one shower was out of use). The home is central heated, and has appropriate lighting, including emergency lighting. With regard to systems to prevent risk from Legionella, the manager confirmed that the central boiler temperature was now being monitored regularly, to ensure that hot water is stored at above 60 degrees centigrade. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 15 At the last inspection it was noted that room temperatures could not be controlled in residents’ rooms, as there was no access to the radiator controls. The manager reported that no action had been taken regarding this to-date; it was acknowledged that some radiators did not have individual controls. Laundry areas were not inspected on this occasion, or infection control policies. It was noted that hand wash facilities (soap and towels) were now present in the sluice room, and the manager had sought advice from the infection control team regarding separate hand washing facilities in shower rooms, and been advised that these were not required. All communal areas in the home were visited several times during the day, and at all times they were clean, tidy and free from any unpleasant odour. Visitors and residents spoken to confirmed that the home was always kept clean and tidy. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 16 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, 28 and 30 The home provides an appropriate level of staffing to meet current residents’ needs. The home provides appropriate training for staff, and appeared to have a competent staff team; however, the level of completion of NVQ training was not yet satisfactory to provide evidence of staff competency. EVIDENCE: On the day of the inspection, the agreed minimum care staffing level (six staff throughout the day and three at night) was seen to be maintained; rotas were not viewed on this occasion. The manager felt that they were managing to maintain staffing levels satisfactorily, and staff confirmed this. The manager was ensuring that staff were not working too many long days each week (also confirmed by staff). Residents felt that the current staffing levels were meeting their needs, reporting that there were generally staff available to attend to them promptly when they needed assistance. No staff working in the home at the time of this inspection had been recruited since the last inspection, and so evidence of recruitment practices could not be inspected on this occasion. The home did not currently meet the level of NVQ training detailed in National Minimum Standard 28 (i.e. 50 of staff trained to NVQ level 2). Four care staff had completed NVQ level 2 and a further four were currently undergoing this training, but their training was on hold due to funding difficulties. A further three staff were waiting to start NVQ level 2, and senior staff were Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 17 waiting to do NVQ level 3. One senior carer was an NVQ Assessor, and was doing NVQ level 3 independently and had almost completed it. Training records were not inspected in detail on this occasion, but requirements relating to Health and Safety training from the last inspection were discussed. The manager and one of the senior carers were now trained as moving and handling trainers, and plans were in process to update all staff in this subject. The manager had also attended fire marshal training, and was delivering the fire safety training within the home; she reported that she was making progress in updating staff in this subject. First aid training was planned for August 2005. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 18 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) 31 and 35 The home is managed by a person who is competent and fit to do so. Practices for looking after residents’ monies protect them and safeguard their interests. EVIDENCE: During the inspection, the home’s manager demonstrated an appropriate awareness of the issues involved in the running the home. She is currently in the process of completing her Registered Manager’s Award (NVQ level 4 in management), with several units already completed. Throughout the inspection, staff, residents and relatives spoke positively about the manager, finding her approachable and responsive when they had any concerns. Staff were all very positive about working at Beechlands, and one of them attributed this to feeling that they were part of a staff team who co-operated and worked well together, and to having good management. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 19 The home had secure facilities for looking after money on behalf of residents, and maintained clear individual records of this, and receipts for any purchases made. A sample record inspected showed that records, receipts and cash all balanced. Records also showed evidence of monies being periodically audited by senior staff. The home also operates a shared residents’ bank account in which larger sums of money can be placed in for safe-keeping. The provider had previously confirmed to the CSCI that this is a non-interest account that is only used for residents’ monies, and could not be considered part of the company’s assets. Since the last inspection, records for this had been updated, and there were now clear, individual, current ‘account’ records being maintained for the six residents who held money in this account. Health and safety issues were not specifically inspected on this occasion, other than issues already noted under the sections relating to environment and staffing. It was noted that the HSE poster displayed in the home now showed the name of the staff member (one of the senior staff) responsible for Health and Safety within the home. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 20 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 x x 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 3 x x x 3 x x x Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 21 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15 Requirement It is required that care plans are developed further, to provide detailed information on the action required by staff to meet each identifed need. This is a repeat requirement (previous timescale 31/3/05) 2. 23(2)(p) 25 The registered person must ensure that service users are able to control the temperature in their rooms by enabling access to radiator controls. (N.B. if a room has a radiator of a design that does not have individual controls, this should be identified and prospective residents advised of this). This is a repeat requirement (previous timescale 31/1/05) 31/10/05 Timescale for action 31/10/05 Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 22 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 15 28 Good Practice Recommendations It is recommended that the home consults with service users regarding tea-time meal choices, and revises menus if required. It is recommended that the registered provider implements NVQ training plans to ensure that 50 of care staff are trained to NVQ level 2 by December 31st 2005. Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Fairfax House Causton Road Colchester CO1 1RJ 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 Beechlands I56-I05 s17764 Beechlands v241640 280705 stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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