Inspection on 27/07/06 for Beechwood

This inspection was carried out on 27th July 2006.

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 28/02/06

Beechwood 15/09/05

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 Beechwood Road Liverpool Merseyside L19 OLD Lead Inspector Julie King Unannounced Inspection 26th July 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beechwood Address Beechwood Road Liverpool Merseyside L19 OLD Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0151 427 5963 02077248086 European Wellcare Homes Ltd Mrs Mary Regan Care Home 60 Category(ies) of Dementia (36), Dementia - over 65 years of age registration, with number (24) of places Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 24 DE(E) PC to be accommodated in the Beechwood Unit. 36 DE(N) Residents under the age of 65 years with Early Onset Dementia accommodated in the Hunter Unit The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 28th February 2006 Date of last inspection Brief Description of the Service: Beechwood is made up of two units. The Beechwood Unit provides care and support for 24 elderly mentally infirm residents; and the Hunter Unit provides nursing care for 36 younger adults with early onset dementia. A small number of day care places are also provided for at Beechwood. The home is located in the Aigburth area of Liverpool, directly overlooking the River Mersey at Otterspool prom. The home is set in it’s own grounds, and has ample parking spaces for parking at the front of the building. Most bedrooms are single, and each unit has adequate communal space and bathing / toileting facilities; and the home was in process of a complete renovation at the time of this inspection. Fees range from local social service rates to privately agreed rates on an individual basis. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection took place over five and a half hours. A full tour of both units 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 residents 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: Please contact the provider for advice of actions taken in response to this inspection. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents assessed needs are being met, and the home is able to provide assurances to residents and their representatives that assessments will be a continuous process throughout the resident’s stay. EVIDENCE: Pre admission assessments provide a holistic assessment of actual and potential needs of each prospective resident; thus allowing a comprehensive care plan to be developed. These assessments care completed by either the registered manager or deputy manager, and include demographic details of the prospective service user – next of kin, past history both medical and psychological / mental health; a specific mental health assessment and involvement of representatives as needed. Multidisciplinary healthcare team (MDT) input is evident in resident’s care files, and include reference to NHS out-patient’s appointments, opticians, dentistry, and tissue viability nurse specialist (TVNS) input at the home when needed. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 9 Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a care planning system in place for all residents. This provides staff with the information they need to meet the resident’s needs. Medication management was compliant with current good practice requirements and guidelines, thus helping to ensure the safety of residents. EVIDENCE: Recently admitted residents, and those requiring a high amount of care were case-tracked (followed from pre-admission into the home in all aspects to date), and spoken to in order to establish a holistic view of what that resident’s lifestyle is like at Beechwood & Hunter. The residents said that they had had the opportunity to meet someone from the care home “for a chat” prior to admission; and that their families were involved. The care plans are loosely based on the Roper, Logan and Tierney model of nursing care; and evidence input from the resident, their representative and the multidisciplinary healthcare team as needed. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 11 Monthly reviews and evaluations were evident on most care plans seen, and the plans were based on needs identified on the pre-admission assessments. Multidisciplinary healthcare team (MDT) input was evident in all necessary care plans. Some of the care plans required updating with what was actually being recorded on the daily report records – this was discussed with the manager who assured the inspector that this would be done. Medications were examined as part of this site visit, and it was evident that the medication management was satisfactory, with the exception of the medication room temperatures which had been consistently over the allowed maximum of 25°C. The manager assured the inspector that this problem would be rectified without delay, and suitable arrangements would be made for the correct storage of medications within the next 24 hours. Residents spoken to said they were “happy living here”, and “the staff are lovely”. Staff appear to have a good rapport with residents and their relatives, and were observed sitting talking to some of the residents and their relatives during the afternoon. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Links with the local community are good, and support and enrich the resident’s lives. Meals in Beechwood & Hunter are good, offering choice and variety, and cater for resident’s special dietary needs. EVIDENCE: Residents in the home are asked on admission about their lifestyle, choice of foods, and choices and preferences of the social activities they would like to participate in, such as outings, bingo and manicure therapy. Activities are offered on a daily basis, by the two in-house activities co-ordinators, who organise a wide variety of activities, including outings to local places of interest. On admission to the home the resident with help from a family member completes an initial care plan, which includes a social history as well as referring to hobbies, food likes and dislikes information, etc. This information is used to plan organised activities for the resident. Visitors are allowed in the home at any reasonable time of day, residents may entertain their visitors in the communal lounges, or in their own bedroom. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 13 The gardens are accessible and tidy, and are an ideal setting for residents to sit with their relatives, especially in the summer months. A number of residents regularly participate in gardening activities, and some have been growing vegetables in ‘the allotment’, others growing tomatoes in the greenhouse. Residents have also had a large input into the planting of the main garden areas, and were observed doing gardening during this site visit. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaint and adult protection policy and procedure was in place that helps ensure the safety and welfare of residents. EVIDENCE: The residents, relatives and staff can access complaint policies and procedures as and if necessary. The procedures includes information on ‘whistle-blowing’, in accordance with current Department of Health guidelines. The CSCI has not received any complaints about this service since the previous inspection. Most of the staff have, or are in the 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. Residents are enabled to exercise their right to vote, either via post or in person; and there is no religious or political persuasion in the home. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Most resident’s rooms are personalized, providing these residents with an attractive and homely place to live. EVIDENCE: The Hunter Unit has benefited from having most areas refurbished and redecorated. Some areas still require attention and refurbishment, but generally the standard on this unit is good. The Beechwood (elderly person’s unit) is still in need of redecoration in some areas, with these areas evidencing wear and tear. Some areas had a slight malodour, however the overall standard on this unit has improved since the previous site visit, in both communal and private areas. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 16 The main environmental findings on Beechwood unit are as follows• • • • Shower room on ground floor had a large hole where the drain should have been Most window frames are rotten and urgently require replacement before the winter Some bedrooms require refurbishment and redecoration, and new floor coverings Satellite kitchens require suitable storage, not open cupboards for all to access Outside – • • Security light not working at the front of the building Inadequate fencing around grounds Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a consistency of care within the home provided by permanent staff, which helps to offer safety and stability for the residents. EVIDENCE: A selection of staff personnel files were examined as part of the case-tracking process. Most files now contain all the required documents and records, but some are still in process of completion. CRB and POVA evidence was available, as were references, some training information, NVQ training, proof of identification and basic inductions. The manager was able to evidence that most of the staff have now completed mandatory training (training that is required by law to do the job), and some resident specific training (such as care of the resident who has Parkinson’s Disease, Korsakoff’s Syndrome, etc.) had taken place, with more planned. This care home also benefits from having specialist trainers that not only produce guidelines, policies and procedures; but conduct staff training and development to a nationally recognised level. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38. Quality in this area is good. This judgement has been made using available evidence including a visit to this service. This home benefits from a competent manager and good quality assurance, thus helping to improve the quality of care given to residents. EVIDENCE: Beechwood & Hunter benefits from having an experienced, qualified, registered manager who has been in post for many years. The manager was clearly able to demonstrate her ongoing professional development, and ensures senior staff also are kept up to date with relevant changes and training as needed. The deputy manager (not on duty during this site visit) has continued to improve his unit in all aspects, and must be commended for his standards of record keeping and ‘team spirit’ on Beechwood unit. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 19 Quality assurance is in place for the auditing and improving records and care; and regular reviews were evident in most records seen. Sensitive records are kept in accordance with the Data Protection Act 1998, with limited access to specific personnel only. It was strongly recommended to the registered manager that all actual or potential head injuries are clearly recorded, along with all necessary observations and follow ups, in residents care files. Maintenance is ongoing, and records and service contracts are in place for gas, electric, fire, risk assessments and lifting equipment. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 3 3 3 3 3 Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP26 Regulation 16 Requirement The registered person must ensure that the care home is kept clean and free from malodour at all times. • The registered person must ensure that the environment of the care home, both internally and externally is well maintained in good order at all times- Refer to:• Shower room on ground floor had a large hole where the drain should have been • Most window frames are rotten and urgently require replacement before the winter • Some bedrooms require refurbishment and redecoration, and new floor coverings • Satellite kitchens require suitable storage, not open cupboards for all to access Outside – • Security light not working at the front of the building Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 22 Timescale for action 30/08/06 2 OP19 23 30/09/06 • Inadequate fencing around grounds 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 OP3 Good Practice Recommendations It was strongly recommended to the registered manager that all actual or potential head injuries are clearly recorded, along with all necessary observations and follow ups in residents care files. Beechwood DS0000059323.V296317.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 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 DS0000059323.V296317.R01.S.doc Version 5.2 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. 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!