Inspection on 13/09/07 for Beechwood Cheshire Home

This inspection was carried out on 13th September 2007.

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 Cheshire Home 26/09/06

Beechwood Cheshire Home 19/12/05

Beechwood Cheshire Home 03/08/05

Beechwood Cheshire Home 04/11/04

Beechwood Cheshire Home 18/05/04

Beechwood Cheshire Home 14/01/04

Similar services:

Snydale Care Home

Staveley Birk Leas Nursing Home

Fairmount Nursing Home

Currergate Nursing Home

Brookfield

Castlethorpe Care Home

Elmleigh Convent

Woodlands Respite Care Centre

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

CARE HOME ADULTS 18-65 Beechwood Cheshire Home Bryan Road Edgerton Huddersfield West Yorkshire HD2 2AH Lead Inspector Helen Battle Key Unannounced Inspection 13th September 2007 09:25a Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 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 Cheshire Home DS0000001109.V351446.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 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 Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beechwood Cheshire Home Address Bryan Road Edgerton Huddersfield West Yorkshire HD2 2AH 01484 429626 01484 455483 beechwood@ney.leonard-cheshire.org.uk www.leonard-cheshire.org.uk Leonard Cheshire 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) vacant post Care Home 27 Category(ies) of Physical disability (27), Physical disability over registration, with number 65 years of age (27) of places Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 2006 Brief Description of the Service: Beechwood is part of the Leonard Cheshire Foundation and it is a well established care home providing personal support and nursing care for up to 27 adults with a physical disability. A number of people attend the home to use the day care facilities. The home is accessible for wheelchair users via a ramp to the front door with an automatic opening device. The home has overhead tracking in bedrooms and in bathrooms and toilets to assist in moving and handling people with mobility problems. The home is a large stone built detached house, set in its own grounds situated on a quiet road in the Edgerton area of Huddersfield. There are adequate parking facilities and the home is conveniently situated close to a major bus route. The Provider informed the Commission for Social Care Inspection on the 13th September 2007 that the fees range from £467.53 to £889.83 per week. There are additional charges for hairdressing, newspapers, chiropody and toiletries. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit to the home carried out by one inspector. The inspector arrived at the home at 9.25 am and left at 15.20 pm. During this visit the inspector spoke to some of the people living in the home, some of the staff and the home’s management. The inspector read care records, audited a sample of medications, reviewed staff recruitment and training records, and carried out a tour of the building. Prior to the inspection, ten questionnaires were sent to people living in the home to obtain their views. Two completed questionnaires were returned. There were twenty- four people living at the home on the day of this inspection visit. Surveys were sent to ten relatives and friends of people living in the home and health professionals. At the time of writing this report, the inspector had received two responses from relatives and two from health professionals. Other information used as part of the inspection process included notifications from the home to the Commission for Social Care Inspection about illnesses, accidents and incidents at the home, copies of the monthly management visit reports produced by the provider, and a pre-inspection questionnaire completed by the manager. The inspector would like to thank everyone for their assistance during the inspection process. What the service does well: People living in the home are supported by a dedicated and competent team of staff. The people living at Beechwood spoke highly about the staff, saying they are kind, caring, pleasant and committed. People are protected by effective policies and procedures for safeguarding (adult protection), medication, and making complaints. All the people spoken to said that they knew who to speak to if they were unhappy about anything. The meals provision at the home is of a good standard. People living at the home stated that the food was good and there is lots of choice. The kitchen staff should be commended on the five star award given by the Environmental Health Officer on 9th August 2007. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 6 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 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 Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit. People have their needs assessed prior to admission into the care home. EVIDENCE: Pre-admission assessments are carried out by senior members of staff working at the home. An agreement is then made as to whether the home can meet an individuals needs. Examples of pre-admission assessments were seen for two people and confirmation was given from people living at the home that they had been invited to visit the home before admission took place. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit. Plans of care are in place and people are aware of the plans regarding their care. People are able to make decisions about their lives and take risks as part of a more independent lifestyle. EVIDENCE: The care plans of three people living at the home were examined. These generally reflected the needs of the individual. However, due to the amount of old information in the files, it was difficult to locate the most up to date information relating to a person’s care needs. This was particularly misleading in relation to wound care. There was clear evidence of people being involved in the formulation or review of their care plans. Entries in the daily records varied in detail. Some entries were very good and detailed what care and support had been given to individuals on a daily basis, other entries, however, were less detailed. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 10 Two people spoken to, stated that they were happy living at the home. Both stated that the staff are very good and that they are able to have a laugh and a joke with staff. They also said that staff are kind and patient. The support provided by staff at the home to enable people to make choices and take risks were reported to be good. This was confirmed by the responses in the surveys by the two health professionals. The two surveys received from people living in the home were very positive about all aspects of the home. One stated that Beechwood is the best home they have lived in. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit. People take part in appropriate activities and are part of the local community. Appropriate relationships are maintained. Peoples’ rights and responsibilities are respected. Meals provided at the home are good. EVIDENCE: People take part in a variety of activities and attend day centres suitable for their needs. These include going out to do their own shopping, going to local restaurants and going out on trips. One person regularly goes for nights out to the town centre. People were observed on the day of the visit to be reading newspapers, spending time in their rooms or seeing visitors. Some of the people joined day care clients in their activities. The home is accessible for wheelchair users via a ramp to the front door with an automatic opening device. The home has overhead tracking in bedrooms and in bathrooms and toilets to assist in moving and handling people with mobility problems. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 12 The post of Volunteer Co-ordinator has continued to develop since the last visit. This was reported by staff and people living in the home to have had a positive effect on the peoples lives and has taken some of the pressure from the care staff. A group of volunteers continue to work at the home and group activities are held regularly. These have included quizzes, bingo, games, building model cars and going out with people. Contact has also been made with a local engineering firm who are supporting their staff to become volunteers at Beechwood. The activities co-ordinator has developed an advertising leaflet to try recruit more volunteers. This has been with the full support of people living in the home. People living in the home stated that the meals provided at the home are of a good standard. The main meal served at lunchtime on the day of this visit was ham, potatoes, sweetcorn, cauliflower cheese followed by profiteroles and chocolate sauce. People confirmed that they are able to choose what they want to eat and where they eat it, whether it be in the dining room or their own room. Staff were seen to provide assistance to those people who required help in a discreet and appropriate manner. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit. People receive support in a way they prefer and require, and emotional and health needs are met. People are protected by the home’s policy and procedure for dealing with medication. EVIDENCE: People spoken to stated that the staff are kind and provide personal assistance in a discreet manner, which promotes privacy and dignity. People also stated that they are able to choose what times they get up and go to bed. It was evident that people living in the home choose their own clothes and hairstyles. A comment from a relative stated that: “Beechwood enables my relative to continue to feel like living despite their 24/7 bed existence. All the staff are great”. There was evidence in the records of people that support is also provided from specialist healthcare services where this is required. The medication of three people was checked and all were found to tally with the records held. Procedures are in place to safeguard people regarding Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 14 medication. All medication is kept individually in individual rooms in appropriate storage facilities. A monitored dosage system is in place. People are encouraged, where possible, to self-administer medication to retain some independence. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit. Generally, people feel their views are listened to and acted on. People living in the home are protected from abuse, neglect and self-harm. EVIDENCE: Two of the people spoken to felt that they could speak to any member of staff and that they would be listened to. Both responses from people living in the home to the surveys indicated that they knew how to complain if they needed to. Any complaints received by the home are fully investigated and comprehensive records were seen of complaints investigations and outcomes. The complaints procedure is displayed in the home. The majority of staff have received safeguarding (adult protection) training. Training records indicate that three members of staff have not had any safeguarding training. This must be addressed. The staff spoken to during this visit showed a good understanding of safeguarding issues and procedures. The personal monies of three people were checked and were found to reconcile with the records held. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit. People live in a comfortable and safe environment and the home is clean and hygienic. EVIDENCE: A sample of people’s rooms was seen. These were found to be personalised according to the personal taste of individuals. Communal rooms are well maintained. Work has taken place to improve the accommodation since the last visit. A number of rooms have been decorated and one of the rooms made into a smoking room with an automatic door and adequate ventilation. In the quiet lounge, there are three computers, two with internet access. New curtains have also been ordered for this lounge. In the extension area of the home, a toilet is in the process of being converted to give easier access for people with disabilities. One of the toilets near the dining room has had a new floor covering fitted, a new handrail and the tiles repaired around a new sink. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 17 A new assisted bath was delivered to the home for the ground floor bathroom during this visit. New beds have also been purchased which are suitable for people requiring nursing interventions and have inbuilt bed sides. Plans are in place for an upstairs toilet to be refurbished when the work is completed on the downstairs toilet. The carpet in room 25 was worn and stained and the bath in bathroom 304 was leaking. The ground floor toilet near the lift needs new flooring. Consideration should be given to replacing the tiled floor in the extension and lino floor in the hallway outside the manager’s office as these can be slippery and look institutionalised. An issue was raised regarding the gardens at Beechwood by a relative and by someone living in the home. The front gardens are not accessible because there are health and safety problems regarding the uneven and loose paths and no kind of safety railing around the pond. The acting manager stated that there had been some enquiries made into the cost and work involved and that this would be a substantial project. Whilst it is acknowledged that this would be a major piece of work, the gardens should be made safe and accessible for people living in the home in order to improve their quality of life. The home was clean and hygienic on the day of this visit. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit. People are supported by competent and qualified staff, and are protected by the home’s recruitment practices. The majority of staff are appropriately trained, and they are deployed in sufficient numbers to meet the needs of people living in the home. EVIDENCE: Staffing levels at Beechwood are now up to the required level. This has had a positive effect on the standard of care provided. Staffing levels at present for 26 people are: 8am – 2 pm = 1 nurse 6 carers 2pm – 5pm = 1 nurse 5 carers 5pm – 9pm = 1nurse 5 carers Nights = 1 nurse 2 carers Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 19 The recruitment records of three members of staff were examined as part of this inspection. All three were found to contain the required information. There is a comprehensive training programme in place at Beechwood, and a dedicated training officer employed by the organisation. Clear records are held on computer of the extensive range of training provided. This includes fire safety, movement and handling, Safeguarding (adult protection). Staff spoken to were positive about the training they had received. The training records provided indicated that there are gaps in training for some of the staff. This is particularly in relation to moving and handling. All staff should have a refresher in moving and handling practice every twelve months, to ensure they are using safe and correct practice. This is of utmost importance as many of the people living at Beechwood have complex moving and handling needs. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit. People benefit from a well run home, and their views underpin development at the home. The health, safety and welfare of people living in the home is protected. EVIDENCE: The acting manager at the home has many years of experience in looking after people with a physical disability. People living in the home and staff were positive about the acting manager and said that the atmosphere in the home continues to improve since she took over the management of the home. The acting manager is to apply to the Commission to be the registered manager of the home. A comment from one relative stated that the managers are always willing to talk at any time. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 21 Peoples’ views are listened to and underpin any development of the home’s policies and practices. This has been particularly apparent in improving the activities provision. Monthly management visits are carried out. The Leonard Cheshire Foundation carries out a four yearly quality audit process. Weekly tests of the emergency lighting and fire alarm systems are recorded, however there were two occasions where this had not been completed this year. Care should be taken to ensure these tests are carried out and recorded to ensure the safety of people living in the home. The work on the fire escape is now complete. A fire risk assessment has been developed for the home, however any work completed to reduce risk should be documented on the risk assessment, dated and signed. The home is currently working on developing an evacuation plan and it is anticipated that this will be completed by the first week in November 2007. This timescale has been set by the Leonard Cheshire regional health and safety officer. The kitchen staff should be commended on the five star award given by the Environmental Health Officer on 9th August 2007. Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 23 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 Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 24 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 YA6 Good Practice Recommendations Care plans should reflect the evaluation of current needs. Daily records should evidence delivery of the care plan and any outcomes. 2. YA24 A rolling programme of decoration should continue to be implemented at the home. The carpet in room 25 should be replaced. The bath in bathroom 304 should be repaired. The ground floor toilet near the lift needs new flooring. Consideration should be given to replacing the tiled floor in the extension and lino floor in the hallway outside the manager’s office. The gardens should be made safe and accessible for people living in the home in order to improve their quality of life. All staff should have a refresher in moving and handling practice every twelve months, to ensure the safe and correct practice. Care should be taken that weekly tests of the emergency lighting and fire alarm are maintained. 3. YA24 4. 5. YA35 YA42 Beechwood Cheshire Home DS0000001109.V351446.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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