Inspection on 14/10/08 for Beecholme House

This inspection was carried out on 14th October 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beecholme House 23/11/09

Beecholme House 09/09/09

Beecholme House 24/04/08

Beecholme House 31/10/07

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Beecholme House 2-4 Beecholme Avenue Mitcham Surrey CR4 2HT     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Elizabeth OReilly     Date: 1 4 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Beecholme House 2-4 Beecholme Avenue Mitcham Surrey CR4 2HT 02086486681 02082889797 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Joseph Benedict Awolowo Kpebi Type of registration: Number of places registered: Sharon Egbo Lartey care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 15 The registered person may provide the following category of service only- Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP (maximum number of places:12) Dementia over 65 years of age - Code DE(E) (maximum number of places:3) Date of last inspection Brief description of the care home Beecholme House is a registered care home for up to fifteen older people. The building is made up of two houses which have been joined together and extended. The home is situated in a residential area of Mitcham with a small number of shops within a short walking distance. Parking is to the front of the building. Public transport bus services are within a short distance of the home. Two double bedrooms and eleven single Care Homes for Older People Page 4 of 27 Over 65 3 12 0 0 Brief description of the care home bedrooms are available. One bedroom has an en suite bathroom. Weekly fees for this service are £550 to £700 per week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was carried out by one Regulation Manager and one Regulation inspector. At the time of this visit six people were using the service. We had the opportunity to speak with four of the six people living at the home, three members of staff, the manager and the service owner. We looked at a sample of the records kept at the service. Information from these sources, as well as our observations on the day have been used to reach the judgements made in this report. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 7 of 27 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information provided on what people can expect from the service when they move in is in need of updating. Before anyone is admitted assessments are carried out to make sure that their needs can be met by the service. This service does not provide intermediate care. Evidence: The owner has produced a service user guide which will need to be updated to take into account the changes in the staff group. We looked at the notes for one new person to the service. We found assessments of this persons needs had been carried out before they were admitted. These assessments assist in making sure that the needs and wishes of the person can be met by the service. The information gathered is also used to set up an initial care plan so that staff have some understanding of individual needs and wishes before they move Care Homes for Older People Page 10 of 27 Evidence: in. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Progress has been made in providing each person with an up to date care plan which sets out individual needs and wishes. Further work is needed to make sure that each person has a care plan and that there is evidence of staff consulting with individuals on how their care is to be given. The health care needs of people who use the service are met. Medication is mainly well managed but a separate fridge needs to be provided for medication. Risk assessments are in place. Evidence: Following the last inspection of this service statutory enforcement notices were served on the owner. This was done because there had been an ongoing failure to provide up to date care plans and risk assessments for the people using the service. At this inspection we looked at a sample of care plans. The new manager has made a good start in updating care plans. An initial care plan was found to be in place for someone who had recently moving into the service. This plan set out the needs of the individual along with information for staff on what the person could do for themselves. Care Homes for Older People Page 12 of 27 Evidence: This will assist in supporting people to maintain their independence as much as possible. Good information on the likes and dislikes of the individual were available. This will assist in providing a more personal service. Staff were aware of some of the social history of the person and the manager informed us that they were planning to work with family members to compile a life history of the person. This will assist staff in viewing and understanding that individuals have varying experiences and lives before moving in. Evidence of consultation with people who use the service and or their representatives on care planning needs to be in place. The new manager has been in post for only a few weeks and she will need to continue as a priority, with updating all of the care planning in the service to ensure that the individual needs of each person are known and can be met. Risk assessments were in place which ensure that staff support people to live the lives they wish in a considered manner. We found improvements in the daily recording kept by staff. These records showed the care provided and the activities which individuals have taken part in. Each person using the service is allocated a keyworker from among the staff group. We found examples of good keyworker notes which summarised the activities and well being of individuals using the service at regular intervals. The owner and manager informed us that improvements were being made in the relationships between the local health care services and the home. Arrangements are in place for regular health care checks to be carried out including dental, optical and chiropody services. People who use the service can, if they are able, attend the local GP practice. If this is not possible arrangements will be made for the GP to visit the service. Community nurses will visit as needed. We saw in the records that staff were taking prompt action to contact the GP where there were concerns about the health of an individual. Staff are keeping regular records of the weight of each person. This assists staff in monitoring the health of each individual. We looked at medication records and how medication is stored in the service. We found records were up to date and accurate. Staff are maintaining a medication profile which assists in providing information on what medication each person has been prescribed, when it was prescribed and when any medication has been discontinued. The majority of medication was stored appropriately however medication which needed to be kept cool was stored in the kitchen fridge. A separate fridge for the storage of medication needs to be provided. We observed staff working with people in a considerate manner with offers of assistance provided in a discreet way which maintained the dignity of individuals. Staff Care Homes for Older People Page 13 of 27 Evidence: assisted people with eating in a relaxed manner and sat with them at the dining table. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are offered a choice of activities. The range of activities on offer could be improved. Improvements have been made in making mealtimes a more relaxed event but further improvements could be made in this area. Evidence: We observed people being offered choices in the activities they took part in. We were informed that people who use the service join in music and singing, bingo sessions, 50s music afternoons and watching films. At the time of our visit two people were playing dominoes and one person was listening to music. Consideration should be given to working on more activities of daily living. One person who uses the service told us he would like to have a job and another person would like to help in the garden. One person told us that they would like to do more during the day. Two nuns visit the service to provide holy communion for those who wish to receive it. A gospel choir visits once a month. Staff informed us that arrangements can be made for individuals to attend local places of worship. Staff told us that friends and relatives could visit at any times and this was confirmed Care Homes for Older People Page 15 of 27 Evidence: by people who use the service. On the day we visited the menu was not being followed as shopping had not been delivered as expected. The manager informed us that arrangements were being made for regular orders to be placed and delivered which should eliminate these problems. Although we found meal times more relaxed and we saw individuals offered choices improvements could still be made to make meal times more of a social occasion. Consideration should be given to providing opportunities for people to serve themselves with support which could assist in promoting independence. Staff told us that people get what they want and that although the menu may need to be changed due to delivery problems they never ran out of food. The cook consults with people who use the service on the meals presented and has made changes to the menu to take into consideration likes and dislikes. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to investigate any complaints about the service. Staff are aware of the need to safeguard people who use the service from harm. Evidence: A record of complaints is kept which will document actions taken and the outcomes of any complaints. No complaints have been received since the last inspection of the service. Staff are aware of their responsibilities to report any accusations or suspicions of abuse. The manager must ensure that as the staff team builds up all staff are provided with training on safeguarding adults. This should be addressed as part of the induction of staff and backed up by training on the local authority procedures. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are provided with a comfortable, homely environment. To ensure that the aids, adaptations and equipment provided are appropriate and assessment of the premises by a qualified therapist needs to be done. The garden needs further maintenance. Evidence: The improvements the new owner has made to the environment have been maintained. We found the service to be free from offensive odours. People who use the service told us that staff kept the house very clean. Although we were informed that a gardener visited the service regularly we found a significant amount of weeds to the front of the service and in the back garden. Following previous inspections a requirement that the service be assessed by a qualified occupational therapist was made. This has not yet been achieved. We provided the home owner with advice on where she might look for this type of service. This assessment needs to be done as soon as possible to make sure that the right aids and equipment is available to meet the needs of people who use the service. Care Homes for Older People Page 18 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements have been made in the checks made on staff before they start work in the service. This assists in safeguarding people who use the service. Progress has been made in ensuring that the training needs of individual staff are met and a records of training kept. To ensure the safety of people who use the service all staff need to be provided with up to date training on moving and handling. Evidence: At the time of the last inspection no clear record of staff training was being kept. The new manager has started the process of gathering this information. This needs to be continued to provide an overview of what training has already been done and where the individual staff members need further or updated training. The manager has booked places on the NVQ in care course at a local college for staff. We were informed that the majority of staff have received training on moving and handling. Action needs to be taken to make sure that those staff who have not received this training over the last twelve months are provided with this training as soon as possible. All staff who administer medication have been provided with appropriate training. Staff have been provided with one day training on dementia care. As the majority of people Care Homes for Older People Page 19 of 27 Evidence: using the service are living with varying levels of dementia this training needs to be more detailed and on going. Training for staff on fire safety has been arranged for the near future. We looked at a sample of staff files. The majority of information needed before someone is employed in a care home was in place. Arrangements are now in place for checks of the protection of vulnerable adults list to be carried out before each person starts work. Criminal Records Bureau checks are also carried out. The manager should make sure that where someone has previously worked with vulnerable adults or children, checks are made with their previous employer as to why they left. This will assist in safeguarding people who use the service. In instances where the previous employer is not providing this information a copy of the letter sent to them requesting the details should be kept on file. Staff meetings are arranged on a regular basis. We saw that staff were discussing issues such as health and safety, keyworking, choices, menus and shift hand overs. These discussions should assist in improving the service and maintaining standards. The manager has introduced a shift working plan with should assist in ensuring all work is carried out and staff know who has taken responsibility for particular areas. Care Homes for Older People Page 20 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The new manager has made good progress in improving the service. The standard of recording has improved since the last inspection. Further work needs to be done to implement a quality monitoring system which will assist in producing an annual development plan for the service. The majority of health and safety checks are carried out but staff need to take care to monitor the temperature of water supplied and when bathing to reduce the risk of scalding. Evidence: The new manager has the knowledge and experience to manage a service of this type. An application for the registration of the manager with the CSCI should be made as soon as possible. Staff told us they felt well supported by the manager and that improvements have been made in the service over the last few weeks since she has been in post. Staff told Care Homes for Older People Page 21 of 27 Evidence: us they felt the manager was firm but fair and a charming person. Staff told us they now love coming to work and that they now feel the whole team is working together for the people who use the service. We found the manager has implemented working practises which support staff to work as a team as well as taking individual responsibility for tasks. People who use the service can deposit small amounts of cash for safekeeping with the service. We looked at a sample of these records and found them to be well maintained and up to date. People who use the service are consulted through the residents and relatives meetings. The new manager has taken part in one meeting over the short time she has been there. Issues discussed included, the menu, Christmas, improvements, hairdressing, clothes, toiletries and bedrooms. We were informed that the quality assurance and monitoring systems which will include an annual assessment of the service and development plan have not been fully developed yet. Staff made regular checks on the building and equipment to ensure that the health and safety of everyone who lives, works or visits there is safeguarded. We looked at a sample of these records. A record of weekly fire alarm tests was in place. Water temperatures were being checked weekly but they were not well recorded. A list of each sink or bath for each room must be kept along with the temperature of the water. This will assist in making sure the the water supplied is not too hot and does not pose a risk for scalding. We were informed that staff were testing the temperature of the water before assisting anyone into a bath or shower. However this record could not be located at the time of our visit. Staff must make sure this record is kept. A record of regular fire drills needs to be kept which includes the date, time and all those present. This will help in making sure that all staff attend fire drills on a regular basis. A fire risk assessment has not been completed but the service owner informed us that this would be supplied in the near future by the organisation who will be providing the fire training for staff. We found a number of toiletries and one prescribed cream left in the ground floor bathroom. Staff need to make sure that personal toiletries and creams are not left in communal areas. Care Homes for Older People Page 22 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 22 13(5) To ensure that people who use the service are provided with appropriate aids an assessment of the moving and handling equipment in the home must be carried out by a suitably qualified person. Timescale of 01/02/08 not met. 30/04/2009 2 38 13(4) To ensure the health and 27/02/2009 safety of people who use the service staff must check the temperature of any bath or shower before they help anyone into a bath or shower. A record of these temperatures must be kept. Timescale of 15/12/08 not met Care Homes for Older People Page 23 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Each person using the 02/02/2009 service must be provided with an up to date care plan. This must be compiled and reviewed in consultation with the individual concerned and or their representatives. Up to date care plans make sure that individuals receive the support they need in the way they want. 2 9 13 A fridge must be provided for the sole storage of medication required to be kept at a low temperature. The provision of a separate fridge will assist in the safe storage of medicaiton. 02/02/2009 3 29 19 Where staff have previously worked with vulnerable adults or children information on why they left this employment must be sought from their previous employer. 02/02/2009 Care Homes for Older People Page 24 of 27 This further check will assist in ensuring the protection of people who use the service. 4 30 13 All staff must be provided with training on moving and handling. This training must be updated regularly. Training on moving and handling will assist in ensuring the health and safety of people who use the service. 5 38 13 The temperature of hot 02/02/2009 water from all outlets accessible to people who use the service must be tested and recorded on a regular basis. This will assist in protecting the health and safety of people who use the service. 6 38 23 A record of regular fire drills must be kept. This will ensure that staff are aware of the action to be taken should the fire alarms be activated. 24/12/2008 02/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 An up to date Service User Guide needs to be in place to make sure that people who use the service, and those considering moving in, are provided with information on what they can expect from the service. Further work should be done to provide activities which meet the needs and wishes of individuals who use the 2 12 Care Homes for Older People Page 25 of 27 service. Consideration should be given to providing more opportunities to take part in the activities of daily living. 3 15 Further work should be done make meal times a more social event. Arrangements for the delivery of food should be improved so that people who use the service have accurate information on what meals are on offer. All new staff should be provided with information on safeguarding people as part of their induction training. Staff should then be provided with training on the local authority process. This training will assist in ensuring that all staff understand their role in safeguarding people. Further work should be carried out to ensure that the garden area is well maintained. The record of training for each member of staff should be completed and kept up to date to ensure that individuals are provided with the appropriate training to meet the needs of people who use the service. All staff should be provided with on going training on supporting people with dementia at a level appropriate to their role in the service. A quality monitoring system needs to be developed along with an annual assessment of the care provided and a development plan for the service. To ensure the health and safety of people who use the service and visitors staff should make sure that toiletries and prescribed creams are not left in communal areas. 4 18 5 6 23 30 7 30 8 33 9 38 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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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