Inspection on 25/11/05 for Beechwood Care Home

This inspection was carried out on 25th November 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 Care Home 04/07/06

Beechwood Care Home 07/06/05

Beechwood Care Home 07/03/05

Beechwood Care Home 11/08/04

Beechwood Care Home 31/03/04

Beechwood Care Home 17/12/03

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Beechwood Care Home 60 Burlington Road Sherwood Nottingham NG5 2GS Lead Inspector Jayne Hilton Unannounced Inspection 25th November 2005 10:45 Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 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 Care Home DS0000002245.V266524.R01.S.doc Version 5.0 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 Adults 18-65. 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 DS0000002245.V266524.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Beechwood Care Home Address 60 Burlington Road Sherwood Nottingham NG5 2GS 0115 924 5893 0115 960 9077 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) Nottingham Regional Society for Autistic Children and Adults Mr Wesley Williams Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: Beechwood is situated in the Sherwood area of Nottingham and is a large older adapted property, with much of its original character maintained. Arranged on 2 floors, the accommodation consists of 8 single bedrooms with shared bathing facilities, and communal lounge and dining rooms. It is close to local amenities and bus routes into Nottingham. Focusing on assisting service users to attain maximum personal development. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 25th November 2005 and lasted two hours. There were two service users at home initially and the arrived back at the home for lunch their daily activities shortly after the inspector arrived. The methodology used at this inspection was by speaking with the manager, the service users and two staff and by examination of records in the home. The service users appeared happy and relaxed on the day of the inspection and were looking forward to the impending arrival of snow. What the service does well: What has improved since the last inspection? Care planning, risk assessments, training standards, recruitment practices and health and safety issues are improved. Medication records were completed on every occasion. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 6 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. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, 3, 5 Prospective service users have the information they need to make an informed choice about where they live Prospective service users needs are assessed, and these are reviewed and kept up to date as required by regulation. Each service users has an individual contract and service users can be confident that the home will meet their needs. EVIDENCE: A Service User Guide including the Statement of Purpose has been produced and contains all the required elements. A copy of the complaints procedure is included. Three care plan files were examined. There is an assessment and admission procedure that includes professionals from multi disciplines on a panel chaired by an independent clinical psychologist. Service user case files contain assessment material the views of relatives are taken into account. There is an emphasis on the placement being able to meet individual needs, and initial care plans have been drawn up in accordance with assessed needs. There was much evidence by the methodology used to identify that service users needs are well met. Service users were dressed in their individual style and appropriate to the season. Service users were offered individual choices for lunch and care plans reflected individual needs and preferences and were well documented in how these needs were being met. Contracts were seen in care plans. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 9 Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6-9 Service users are involved in their care plans, which reflect the individual’s personal goals. The care plans are up to date and new formats are in the development process. Risk taking is clearly promoted both in the home and out and about in the community. EVIDENCE: Care/ support plans are drawn up based on initial assessments, and cover aspects of both personal and healthcare. Communication needs are clearly addressed. There is evidence of some reviews conducted by the local authority, each service user’s plan is thoroughly reviewed and updated at least six monthly The format of the care plan structure has been be reviewed and is under development to current National Minimum Standard expectations and include service users preferred term of address; whether the service user is to be issued with a key to their bedroom door, front door and lockable facilities etc. There was some good overview progress reports for both daily life and activities seen. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 11 There was evidence of service user consultation and signatures of service users, with photographs and a personal profile. Any restrictions on freedom or choice are based on risk assessments. Several of these are recorded on files and show appropriate action to be taken. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12-17 Service users clearly live a busy and fulfilled lifestyle, where their rights are respected. Service users enjoy their food. EVIDENCE: Service users follow individual programmes of daytime activities, and day services staff work in partnership with the residential staff. A separate education centre is used and a local college. Cookery and Music are available. Communication systems are used effectively, and speech and language therapists are consulted. Some service users are currently involved in a gardening project. Independent living skills are developed and encouraged within the home environment with regular times for household tasks. Holidays are arranged, and some risk assessments for these were seen. Recent holidays included Center Parks, Skegness and a trip to Spain is planned. NORSACA are confident that their risk assessments regarding one to one staffing arrangements are sufficient to protect service users and staff where only one service user and one staff go on holidays abroad. Service users go out in the minibus and take part in leisure activities with staff. Most leisure activities are individual, or in small groups to meet specific needs Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 13 of the service users, though this is not clear within care plans. Regular swimming and bowling take place. Encouragement and support is given to maintain relationships with families, and weekend visits and telephone contact are recorded in daily notes.There was a detailed family birthday dates list on service users files. The provider organisation is, led by parents. It was found that all service users did not have a key to their own rooms and one service user did not have a lockable facility. This was reported to be an oversight as the service user had only recently had new bedroom furniture. Service users have access to all communal areas including the rear garden. The staff member on duty demonstrated commitment to ensuring care plans were in place with risk assessments regarding access to keys and lockable facilities. When at home, service users choose whether to stay in their own rooms or the lounge. On the day of the inspection service users were observed to move freely around the home and spend private time in her room as she wished. Service users were noted to have varying responsibilities within the home from laying the table to their own bedroom cleaning. A service user confirmed that she went to bed and got up when she wanted. There is an 8 weekly cyclical menu, which demonstrated cooked breakfasts are provided at weekends. The menu only offers one choice of main meal and there was evidence that service users could take alternatives in the form of records kept. A recommendation made at the last inspection that alternatives are offered as a menu item for instance a meat item and a vegetarian option has been met, menus were being typed up ready. The meal options offered appeared nutritious and varied, however the inspector recommends that nutrition is covered within then care plan process alongside weight evaluation. The cook works in the daytime, and prepares the main meal for the afternoon care staff to reheat and serve. As service users are out most of the day and take their main meal on an evening the inspector recommends that the catering hours be reviewed. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18-21 Service users receive personal support in the way they prefer and require, Service users healthcare needs are met. There is some improvement in the organisation of medicine management within the home, medication records were found to be completed satisfactorily. Care plans contained information regarding arrangements for service users at the end of life. EVIDENCE: Health care is well monitored, and notes are kept of advice given by medical professionals. There were notes of frequent consultations with a General Practitioner on the files sampled. There is a book to record accidents. One service user who was clearly at risk of falls had A care plan and running record of falls within her planning documents. Service users are encouraged to have an annual well-person check, and other checks such as regular smear tests, breast screening and hearing checks and these are evidenced within the care plan structure. Service users wishes for the end of life are obtained and recorded. Weight charts were completed well, but these did not identify issues regarding weight gain and weight loss. The record should be reviewed and incorporate an action/comment box which staff would use to identify significance of Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 15 changes in the service user’s weight, including well being and mental health or used in conjunction with a nutritional assessment and care plan. Behaviour management plans were seen. There was information regarding medication in the service users’ files and this is to be further developed into a medication profile section, and include details of medication reviews and changes of medication. Consent forms for medication should also be part of this section. The Boots blister pack system is used. The drug errors policy includes a prompt to report medicine errors under regulation 37 to CSCI. Photographs are used for identification on Medicine administration sheets. Medication record sheets were completed satisfactorily. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Complaints procedures are accessible to service users. Service users are protected from abuse, neglect and self harm and the provision of training for staff in adult protection is underway. EVIDENCE: A complaints procedure was displayed in the hallway, there are additional copies in pictorial/symbol formats. The procedure states that complaints will be responded to within three weeks. The complaint poster displayed near the front door needs updating to read CSCI as it currently states NCSC. A service user confirmed she knew how to make a complaint. There is a comprehensive set of policies and procedures relating to protection of service users. Staff have been trained in handling challenging behaviour, and are currently all developing skills in using safe methods of intervention. Each event of using physical intervention is clearly recorded. The deputy manager is an accredited trainer in these methods. There is now a training programme for staff that includes adult protection training. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24-30 Beechwood provides a homely,comfortable, clean and well furnished environment for service users. There are some safety issues identified to complete but work is currently underway to address regarding surface temperatures of radiators and window restrictors. Overall the home is well maintained. EVIDENCE: All areas of the premises are accessible to current service users. The home is well maintained, furnished and decorated in a domestic style. The lounge and dining room have ceiling fans. There is a small garden, consisting of a lawn and paved area. No changes have been made to sizes of bedrooms. The service users have single rooms. One bedrooms was seen as part of this inspection and three at a previous inspection. Bedrooms are clean and well personalised. There are individual nameplates on all bedroom doors. A Service user spoken with was satisfied with her bedroom and all had the furniture and equipment to meet their needs, apart from a lockable facility and key to the bedroom door. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 18 A lounge to the front of the building is well furnished and comfortable with CD player and television. There is a pleasant dining room with sufficient seating for service users and staff and there is a serving hatch from the kitchen. It was noted that some chairs were sited in front or close to unguarded radiators. The manager confirmed the providers action plan to action this was underway and work would e completed by January 2006. It is strongly recommended that this work be carried out promptly and that interim action be taken where service users bedroom radiators and bathrooms are going to be hotter during the impending cold snap. The inspector discussed ideas with the manager of how to protect service users from surface temperatures, where protective cabinets would not be practicable. There were still no window restrictors on the dining room window, which presents a security risk to the home, this should be rectified promptly. The manager reported that this work was also in hand and would be completed with the radiator covers. The premises were found to be very clean upon inspection. The training plan now includes Infection Control. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, 34, 35, 36 Service users are supported by a well supported and supervised, committed staff team training and recruitment issues were improved. EVIDENCE: Staff have job descriptions and roles, and their limitations are discussed within regular staff meetings as well as individual meetings. The staff rota was not examined at this inspection. There are always two residential staff on duty at all times. This is supplemented with day staff to meet individual needs and activities throughout Monday to Friday. There is a waking staff member and another sleeping in. A further member of the management team for all NORSACA homes is available on call for support. Domestic staff for cleaning and cooking, are employed in addition. The manager works supernumery. The manager reported that a recent recruitment drive resulted in staff being successfully recruited in minimal timescales within limitations of CRB Disclosure returns. The training programme 2005/2006, demonstrates that mandatory training subjects and other specific identified training is provided for staff. All staff receive mandatory training in Infection Control, fire safety, first aid, food hygiene, manual handling and health and safety. [Medicines management training is also provided for those authorised to dispense medication and competency assessments] Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 20 Other training required for good practice includes challenging behaviour, physical intervention, adult protection and learning disability training specifically for autism. There were examples of some staff undertaking training in these subjects and NVQ’s etc. Evidence was seen of a training request application, which covers all of the required training specification. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39, 41, 42 Service users benefit from a well run home and record keeping on the whole was good. Attention is needed to ensure that staff remember to undertake fire safety tests weekly. Service users are confident their views underpin all self- monitoring review and development by the home. The health and safety and welfare of service users is generally well promoted and protected, again there are some areas to address to meet the standards completely. EVIDENCE: The manager is experienced and qualified in social care. He has recently completed the Registered Managers’ Award. Quality monitoring was evidenced by Quality network, Quality Tree and regulation 26 visits. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 22 There are records of refrigerator and freezer temperatures being monitored; all substances hazardous to health (COSHH) have been assessed for risks and are held securely. The Gas safety and electric circuit test certificates were up to date. Weekly fire tests were not satisfactory as some weeks had been missed and attention to this is recommended.. There was evidence of systems in place to prevent legionella and records regarding water outlet temperatures were seen. Evidence of generic risk assessments were seen and evidence of fire safety risk assessments had been forwarded to CSCI after the last inspection, however there were no copy held in the home. A security review of the premises is reported to have been be carried out taking into account where window restrictors are not in place etc. Portable appliance tests were examined and found to be satisfactory. A contingency plan for emergencies should be devised. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Beechwood Care Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x 3 2 x DS0000002245.V266524.R01.S.doc Version 5.0 Page 24 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. Standard Regulation Requirement Timescale for action 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 3 4 Refer to Standard YA6 YA6 YA17 YA19 Good Practice Recommendations Include the service users prefered term of address in care plans. Include issue of keys, use of lockable facilities, within the care plan format. Review the catering arrangements to minimise food having to be reheated. Add a section on the weight record for action taken regarding weight gain/loss or develop care plans and risk assessments on nutrition. The proposal from the security review should be undertaken and include the provision of window restrictors to ground floor windows promptly. The authorised action regarding radiator covers should be followed up to ensure work is commenced promptly. Ensure a copy of the fire safety risk assessment is kept in the home and that a contingency plan is in place for DS0000002245.V266524.R01.S.doc Version 5.0 Page 25 5 6 7 YA42 YA42 YA42 Beechwood Care Home 8 YA42 emergencies. Test the fire alarm weekly. Beechwood Care Home DS0000002245.V266524.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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. 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