Inspection on 15/09/05 for Beechwood

This inspection was carried out on 15th September 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 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

Beechwood 21/05/08

Beechwood 27/11/07

Beechwood 27/07/06

Beechwood 28/02/06

Beechwood 14/03/05

Beechwood 08/09/04

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

CARE HOMES FOR OLDER PEOPLE Beechwood Care Home Beechwood Road Liverpool L19 0LD Lead Inspector Miss Julie E King Unannounced 15 September 2005 13.00hrs 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. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Beechwood Care Home Address Beechwood Road, Liverpool, L19 0LD 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) Category(ies) of registration, with number of places 0207 723 7071 0207 724 8086 Wellcare Nursing Homes Ltd Mrs Mary Regan Care Home with Nursing 59 DE (E) Dementia 36 DE Dementia 23 Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. 36 DE(E) PC 2. 23 DE(N) Service Users under the age of 65 years with Early Onset Dementia accommodated in the Hunter Unit 3. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 14 March 2005 Brief Description of the Service: Beechwood is made up of two units. The Beechwood Unit provides care and support for 36 elderly mentally infirm service users. The Hunter Unit is registered to provide support to 23 younger adults with who have early onset dementia. A small number of day-care places are provided at the Hunter Unit.The home is located in the Aigburth area of Liverpool directly overlooking the River Mersey. The home is set in it’s own grounds, with ample car parking space for staff and visitors. The home accommodates service users on two floors in mainly single bedrooms. Sufficient toilet and bathroom facilities are provided throughout the home. Communal space is provided in the lounge, dining, recreational areas and conservatory. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection took place over six and a half hours. A full tour of the premises took place. A range of records such as care plans, staff personnel files, policies & procedures and medication charts were examined. A selection of staff on duty, and a number of service users were spoken to during the course of this inspection. What the service does well: What has improved since the last inspection? What they could do better: Some improvements in the detail of some records is needed, especially regarding notifications to CSCI. Staff personnel files also are in need of completion regarding having all the required documents and records available for inspection. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 6 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. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 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 Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 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, 2, 3, 4 & 5. The service users assessed needs are being met, and the home is able to provide assurances to service users and their representatives that assessments will be a continuous process throughout the resident’s stay. EVIDENCE: Service users are only admitted into the home on the basis of a full assessment is carried out prior to they move in. All pre-admission assessments are carried out by either the registered manager or senior care worker, and include direct input from the prospective service users’ family / representative as agreed. Multidisciplinary healthcare team members such as the service users’ social worker, physiotherapist or NHS ward nurse, are part of this process. Specialist healthcare professionals continue to be involved in the care of service users after they are admitted into Beechwood and Hunter Units. All the service users spoken to during this unannounced inspection told the inspector that they felt “it’s like a family here”, and “everyone is involved”. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 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, 9 & 10. There is a consistent care planning system in place for most service users. This provides staff with the information they need to satisfactorily meet the service user’s needs. EVIDENCE: Individual care plans had been documented for each service user, and all seen were in the process of being updated and reviewed with the involvement of the individual service user as far as possible. Some improvements are needed in the way the care plans are recorded on a daily basis, and greater detail is also recommended regarding the recording of observations following falls by service users. Systems are in place to ensure good communication between the care home, the NHS and other professionals involved in the care of all the service users. The service users spoken to during the inspection commented on the standard of care they received. They confirmed they had access to various healthcare professionals as necessary, and stated that the nursing and care staff always respected their privacy and dignity by “treating me well” and “asking me what I want”. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 10 Medications, the medication room and related records and documents were examined as part of this unannounced inspection. On some transcriptions, there was a lack of signatures by the member of staff who had written the medication on the charts. This is not in accordance with current good practice guidelines. The medication room temperatures in Beechwood Unit were consistently near to, or over the maximum temperature that drugs should be stored at (25 degrees Celsius). The registered person must give some consideration to installing a system of cooling, or other ventilation means, to reduce and control the temperature in this room. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 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, 14 & 15. Links with the local community are good, and support and enrich service user’s social lives. The meals in this care home are good, offering both choice and variety, and catering for special dietary needs. EVIDENCE: The daily routines provided were flexible as far as possible, and service users are encouraged to exercise choice and control over their lives. Friends and family are actively encouraged to participate in the service user’s lives. A varied and nutritious diet was provided with specialist service user’s medical needs (such as diabetes) being catered for. Service users told the inspector that they were “listened to”, and the staff “always knocked” on the door before coming in. They also told the inspector that they felt able to “choose” what they wanted to wear, where to sit, what to eat, what to do, etc. Activities are offered on a daily basis, buy the two in-house activities coordinators, who organise a wide variety of activities, including outings to local places of interest. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 12 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 & 18 An efficient complaint and adult protection policy and procedure is in place to help ensure the safety and welfare of service users. EVIDENCE: Beechwood and Hunter Unit has an efficient complaint and adult protection policy and procedure in place to help ensure the safety and welfare of service users that they, their relatives and staff can access when necessary. This procedure includes information on ‘whistle-blowing’, in accordance with the Department of Health ‘No Secrets’ guidelines. Most of the staff have, or are in process of completing training in adult protection, with the remaining having training planned for the near future. However all staff do receive basic training in the protection of vulnerable adults during induction. The service users all spoke highly of the staff team and said they “have no complaints about how I’m treated”, and “nothing is too much trouble”. Some advocacy information was available if required by service users or their relatives. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 13 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, 20, 21, 22, 23, 24, 25 & 26. The overall fabric of the building is of a good standard, with most service users’ rooms being highly personalized. EVIDENCE: All areas of the care home were seen, including communal areas and individual bedrooms. Most areas evidenced ongoing decoration and / or refurbishment, but a couple of bedrooms are in need of new floor coverings and redecorating. These areas were identified by the registered manager prior to this unannounced inspection, and are planned to be done in the near future as part of the major refurbishment that was nearly completed at the time of this inspection. Both units have benefited from a complete refurbishment, including floor and wall coverings, furniture and fixings. The service users have been consulted about what colours and what layout they would like their bedrooms, and choice was clearly evident regarding the consultation process of moving units. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 14 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, 29 & 30. Staffing levels are adequate to ensure the safety and welfare of the service users. Pre-employment checks are thorough, helping ensure the protection of the service users. EVIDENCE: The home is staffed with satisfactory levels of staff required to meet the needs of the service users, with the registered manager, qualified nurses and care staff on duty. Additional staff are brought in to accompany service users to hospital appointments, etc. The staff rota evidenced minimal use of agency staff, with the homes own staff covering the majority of hours. Staff spoken to during the inspection confirmed that a range of mandatory and specialist training was now available, with the majority of the cost being paid for by the care home. This approach to training is a positive aspect of the care home, as it helps ensure that service users are being cared for properly and their needs are being met in accordance with current good practice guidelines. Staff personnel files were examined, all now evidenced training records, preemployment checks, references, inductions and most had some record of supervision. The inspector was informed that CRB and POVA checks were not kept in the home, but were at head office. It is a requirement under the Care Homes Regulations 2001 that all documents as listed in paragraphs 1-7 of Schedule 2, are available for inspection at the care home. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 15 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, 33, 36, 37 & 38. The service users benefit from a manager who is qualified and competent to discharge their duties and who ensures the health and safety of service users is promoted. The home regularly reviews aspects of its performance through a programme of self-review and consultations, which include seeking the views of service users, relatives and staff. EVIDENCE: The manager was been in post for many years. The manager has completed an NVQ Level 4 qualification in management, and has obtained their Registered Manager’s Award. The manager reported that both herself and the senior staff have attended training to keep their knowledge and skills up to date. An examination of the induction and follow on training schedule indicated that staff are provided with sufficient training to ensure that all senior staff are Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 16 familiar with the conditions/diseases associated with old age, and the specific needs of the younger service users. The records of fire safety checks, electricity and gas were in order. Training records showed that staff are given appropriate training in safe working practices. There are policies and procedures in place to promote the health and safety of service users and staff. Service contracts and required safety certificates were in date and valid. Regulation 37 (notification of incidents) forms were found not to be forwarded on to the CSCI as required for all incidents as listed under the regulation. Also Regulation 26 (provider visit forms) are not being received by the CSCI on a regular basis. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 17 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 N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x 3 2 3 Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 18 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 9 Regulation 13 Requirement The registered person must ensure that medication management is in accordance with current requirments and good practice guidelines. The registered person must obtain all the documets and records as listed in paragraphs 1-7 of Schedule 2, of The Care Home Regulations 2001, for all persons employed; and must have these records availabel for inspection at all times. The registered prson must ensure that Regulation 37 notices are completed and forwarded to the CSCI in accordance with this regulation. Timescale for action 31 December 2005 31 January 2006 2. 29 19 3. 37 37 31 December 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. Refer to Standard 7 Good Practice Recommendations It is strongly recommended that all entries in daily reports are signed in full, dated and have the time of the entry using 24 hour clock. F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 19 Beechwood Care Home 2. 3. 9 38 It is strongly recommended that all transcriptions are double checked, signed and dated. It is recommended that a Carbon Dioxide fire extinguisher is obtained for the hairdressing room. Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Liverpool Office 3rd Floor, 10 Duke Street Liverpool L1 5AS 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 Beechwood Care Home F52 F02 S59323 Beechwood V227959 150905 Stage 4.doc Version 1.30 Page 21 - 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!