Inspection on 15/07/08 for Beechwood House

This inspection was carried out on 15th July 2008.

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

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 House 29/01/08

Beechwood House 07/09/07

Beechwood House 29/06/06

Beechwood House 29/11/05

Beechwood House 15/06/05

Beechwood House 19/11/04

Beechwood House 23/06/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

1 Marten Road

St Joseph`s

Ridgemount

Wingham Court

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Beechwood House Woodberry Lane Rowlands Castle Havant Hampshire PO9 6DP Lead Inspector Sue Kinch Unannounced Inspection 15th July 2008 10:00 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 House DS0000049982.V366959.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 House DS0000049982.V366959.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beechwood House Address Woodberry Lane Rowlands Castle Havant Hampshire PO9 6DP 023 9241 3153 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) Rowland Court Healthcare Ltd Frances Hudson Care Home 37 Category(ies) of Dementia (10), Dementia - over 65 years of age registration, with number (37), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (9), Old age, not falling within any other category (37) Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of ten service users may be admitted in the category Dementia (DE), all of whom must be aged over 45 years. 29th January 2008 Date of last inspection Brief Description of the Service: Beechwood House is located in a quiet residential area, close to the centre of Rowlands Castle and within easy reach of local shops, amenities and public transport. The home has a range of shared spaces including lounges, a dining room and walk through areas offering people living in the home a range of places to relax or have visitors. Bedrooms are available on all floors of the home. Most are single and have ensuite facilities. The home is situated in pleasant garden surroundings which are accessible to people living in the home with plans in place for a raised garden. The home provides services to older people with dementia, altzheimer’s disease and other mental health issues and includes a range of entertainment and activities. The current fee charged is from £465-£550 per week with additional fees for items such as chiropody and hairdressing. Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection visit took place for six and a half hours following a review of the information held by the commission about the home, information received since the last inspection and details provided by the manager in the Annual Quality Assurance Assessment (AQAA). We also had information in six surveys from relatives, people living in the home in the home and staff. We had verbal feedback from some of the people living in the home on the day of the visit. We also observed care practices using our observational tool, Short Observational Framework for Inspection (SOFI). Four care staff, the cook, the manager and the company’s advisor were spoken with during our visit. Some records and a sample of areas of the home were viewed. What the service does well: There is a good process of pre-admission assessment, which includes consultation with the people moving into the home and relevant others such as health professionals so that people know their needs can be met. A respectful and caring staff team obtained by thorough recruitment practices provides the service. They are well supported, feel they can contribute to the service and are in receipt of appropriate training. Health and care needs are well documented with increasing evidence of consultation and a person centred approach. Medication is well managed. Care is provided in pleasant surroundings inside and out with plenty of spaces for leisure. The home has a rolling programme of maintenance and refurbishment and redecoration and with adaptations this provides a comfortable, bright and fresh environment. A range of activities and entertainment happen in the home including group and individual support. We heard about bingo, exercises, singing, shopping, chatting, hairdressing, reading, hoopla and art. Plans are being in made to involve some people in cooking favourite recipes. Visitors are welcomed to the home and a choice of food is provided taking individual needs into account. The home creates an environment in which concerns and issues can be raised and the management and staff have a positive attitude towards addressing them. Staff are aware of their responsibilities in safeguarding people. Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 6 People feel able to talk to the manager and staff say that she knows the needs of the people living in the home and she is approachable and supportive. Work carried out on the medication and care planning in the home has improved the quality assurance, which is now good. Attention is given to health and safety issues. 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 House DS0000049982.V366959.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 House DS0000049982.V366959.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre-admission assessment process is good and ensures that the needs of people considering moving in, are assessed and that the home can meet them. EVIDENCE: We noted that the admission process, found to be thorough at the last inspection, has continued to be followed. In the sample of records viewed we noted that assessments had been completed before two admissions including obtaining information from health professionals to the home and care- plans were in place for those people. The manager said that a visit prior to admission for a four week trial, can take place but the two people discussed had decided not to take the opportunity to do this. She said that the attention of people who may move in and relatives Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 9 is drawn to written information including the statement of purpose, contract, complaints procedure and the companys new website. Lots of information about the home is placed in the entrance hall to the home. The manager said that prospective residents and their relatives are encouraged to be involved in the admission process. She also said that issues of equality and diversity are included at this stage to ensure that individual needs are met and the requirements of the Mental Capacity Act are planned by her to be addressed in the admission process. The and one The manager said that the statement of purpose has been recently reviewed a contract is held for each person on his or her file. In the files sampled contract was available and was signed by the person living in the home. manager said that the other one was with the funding authority. The statements of purpose and service user guide documents are available in the front entrance hall for observation alongside other information. Other more easily accessible formats are not immediately available but the manager said that these could be produced. In our survey we asked for feedback about admissions. In the two written surveys from people living in the home they said they had enough information about the home before moving in to decide that it was the right place and said that they had received contracts. Two staff said that they are given enough information about people that they care for. The home does not provide intermediate care. Beechwood House DS0000049982.V366959.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have been made in the care plans to give staff clear information about how the assessed care and health needs of people using the service are to be met and to ensure that they are met. Improvements have been made to the medication practices in the home and people living there are now safeguarded by a more rigorously monitored system, which ensures that people are consistently receiving their prescribed medication. The home’s staff treat the people using the service with respect and support the maintenance of privacy. EVIDENCE: Following the last two inspections of the home requirements were made of the Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 11 service in respect of care plans and an improvement plan was requested by us to show how this was to be addressed. It was required that the service users’ plan set out in details how all the assessed needs of the people using the service would be met. Evidence of service users/ family involvement in the formulation of care plans was to be included. At this visit discussions were held with staff about the needs of some of the people living in the home. We observed the care provided for some of the people during the morning of our visit and care plans for those people were viewed. We found that care plans have been redesigned and are more person centred as stated by the manager in the AQAA. We found that a sample of care needs, noted in our observations of care practices, were recorded in the care plans and that staff were aware of the needs of the people they were asked about. Each care plan viewed has a summary sheet at the beginning for quick reference, followed by more detailed information. The full care plans state needs more clearly than at our last visit, including those relating to health, diet, continence, mobility, risks, social needs and specific individual needs with evidence of recent updating and monitoring. These records also include guidance for staff to follow and in places, indicating what people are able to do independently. There is information about likes and dislikes, although further work could be done to expand on this. We found information about the routines that people living in the home prefer including times of rising and going to bed. Information entitled ‘Family tree and background ‘ was recorded in two files and the manager said that this is being gathered for all people where possible. This is to provide staff with more background information about people. Each of the four files we looked at were similarly organised with space for new information and, recording sheets, which were being used regularly. There is also evidence that the home is working to involve more people in care planning and one had been signed by the person receiving the service. The manager spoke of involving families but taking the rights of people living in the home into account. She also spoke of the records now being held securely. We obtained views of staff about care plans. We found evidence that they use them. One said that they were okay, up to date, useful and full of information. Another said that the previous ones were hard to understand and that these were easier to find information in and they had started helping with care plans. A staff meeting was planned for the day after the inspection and the manager said that she would be talking with staff about care planning and increasing their involvement. The manager was asked if she had a system in Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 12 place to ensure that the standard of care plans will continue and she said that her regular auditing would include this. The manager said that people are able to select their own GP and all people living in the home are supported to access local health services with staff or family members. On our visit in the files viewed we noted that health needs are recorded. There are also periodic dietary assessments with dates for review. In one set of daily notes it was noted that one person had been eating and drinking less well. We observed that staff had prompted the person several times to drink in the morning and the manager said that the review of the dietary intake was planned to be brought forward in light of the current situation. Visits by health professionals were also recorded on a separate recording sheet and we noted visits from a range of professionals, including chiropody, doctor and a district nurse. In the four surveys returned people living in the home and relatives said that medical needs are either usually or always met and that support for meeting health care needs is sought after by the home. Medication issues were raised in the inspection report of 7/9/07 and an improvement plan was sent out with four medication issues in it and therefore a pharmacy inspector assessed practices again on 29/1/08. In the inspection report we raised a number of requirements related to ensuring that there were risk assessments for people who were managing their own medication, that all people received their prescribed medication, accurate recording (repeated form the previous inspection) and storage of controlled drugs. Following the report we requested an improvement plan including four requirements about medication (one a repeat), which was sent to us reporting that the requirements had been met. The manager in the AQAA sent to us before this inspection said ‘We have also reviewed our medication policies and practices to ensure full compliance with standards. Furthermore, medication storage facilities have been upgraded to ensure that the home now meets the Misuse of Drugs Act.’ ‘We also plan to closely monitor the medication records to ensure they are always completed contemporaneously and accurately.’ At this inspection we examined aspects of the system to check if the requirements had been met. We looked at the storage of medication including controlled drugs. We looked at a sample of the records of medication received and administered and checked some of these against medication held in the home and of changes to medication. We found that the significant progress had been made to meet the requirements in the previous inspection report. One error was found in the records and one tablet was missing but this Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 13 appeared to be an error when adding previous stock to new stock. One tablet (antacid) was signed as taken but was still in the blister pack and the manager agreed to check with the member of staff. We noted that three risk assessments have been completed for those people who manage their own medication and the manager spoke of how she checks that the people involved are able to continue to do this safely. She was advised to ensure that these checks are recorded. The manager said that the home now has the updated version of the Royal Pharmaceutical Society Guidelines. At our visit staff were noted to be polite and respectful to the people receiving a service. They were seen to speak with people quietly when giving support and mostly waited for responses. They were gentle in their approaches, warm and caring. People verbally and in surveys were positive about staff approaches. Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are benefiting from increased attention to their individual, social and recreational needs and a range of types of mental stimulation and activities are being provided. They are supported to maintain family links and individual dietary needs are regularly catered for. EVIDENCE: Verbal and written information gathered as part of this inspection of the home showed that people are being offered a range of group and individual activities on a continuous basis taking individual needs into account. The manager said the range of activities offered on daily/weekdays by the occupational therapist includes sing-a-longs, arts and crafts and exercise sessions. During our visit we noted that these are advertised on the notice board in the main corridor to the lounge and a range of activities were taking place during the morning and afternoon of our visit. This, in the morning, included bingo and the staff Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 15 member leading the session was said to come in daily in the week for an hour and a half in the morning for activities. People were also: heard in conversation with the staff, doing armchair exercises and singing. Several people were also having their hair done. Staff said that people living in the home make choices about where they want to sit. Our observations supported this. Some people had chosen to sit in the smaller, lounge where the television is. The manager said that the people in there do not always have the television on and some do use other rooms. We noted that some people watched the television some of the time and some were dozing, another person was reading. There was also some conversation between some people living in the home and interest in the caged birds. The manager said one person always chose not to be actively involved in activities but preferred to watch. Staff members were regularly in and out of the smaller lounge to provide support with health needs and drinks. Staff were mostly task orientated with people in this lounge during our observation. The manager said that it is the quieter lounge and people had the television on and that staff did at times spend one to one time with people. Staff agreed. It was recommended that when support is given in this situation, such as to help some one drink or raise their legs, when they have finished staff could take a bit more time to provide a little more stimulation such as prompting conversation or providing a magazine or book. The manager said that they strive to provide people with plenty of support and stimulation but agreed to give this some consideration and to increase the recording of mental stimulation of people with higher needs. In separate conversations staff agreed that there is time for talking with people living in the home but more time in the afternoon. Staff time with people on a one to one basis includes manicures, chats, walks in the garden, walks to the local village, and light exercises and stimulation through games. It was also noted in the small lounge that at times the noise level from the television conflicted with the activity in the main lounge, and was quite high with the potential to cause discomfort or to be confusing. The manager said that normally the staff did usually turn the television off when an activity took place in the large lounge but one person in the small lounge usually wanted the television on. Contact is encouraged with families. Areas for people to meet within the home are available for this. People are encouraged to go out with friends and relatives. The manager is encouraging involvement of families in care-planning taking rights and data protection into account. Family members were visiting during the inspection visit. Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 16 The manager promotes choice in as many aspects of their daily lives as possible such as: meals, clothing, how, where, and with whom to spend their day. Their wishes are recorded in their care plans. At the last inspection we noted that people living in the home are able to lead the lifestyles that they wish and that independence is supported but we questioned that this was not sufficiently documented for people with higher needs. At this inspection we noted that documentation had increased. It was also noted that the manager has an assessment for mental capacity, which is intended to be introduced. The manager intends to have more training in this area to assist with this. The manager and staff encourage mealtimes to be a social occasions but people are able to choose where they wish to eat. As found at the last inspection choice is given, variety and dietary needs are catered for and specific needs are recorded and supported. One relative spoke of attention to individual needs being addressed regarding food. Dietary needs are documented in the care plans and assessments have been carried out with dates for review. We noted that the manager is collecting recipes from people living in the home and relatives with plans are being made for cooking them in the future. Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are confident that their views are sought and that they are listened to and the manager works to resolve concerns raised. Training of staff in safeguarding offers protection of people living in the home. EVIDENCE: At the last inspection we noted that the home was responding well to complaints although not all people felt that concerns were fully dealt with. For this inspection we gathered information from people about how the home responds to complaints and concerns. Two people living in the home said that they know how to make a complaint and who to speak to if not happy about something. They also said that staff listen and act on what people say. Two relatives responded and one said that the home always responded appropriately if they raised a concern about care. Another said sometimes and raised the issue of staff being positive but not always following things through such as when people received the wrong clothes. The manager informed us that a laundress has been recruited and was aware that this issue needed to be addressed. The person also said that soiled furniture or bathroom items were not always cleaned although reported to staff. In the AQAA the manager said that she has an open style of management to Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 18 encourage people to raise matters on a day-to-day basis. She said that the complaints procedure is drawn to peoples attention at admission and is held near the visitors’ book. She said that any complaints are followed up with progress reports and are responded to within timescales. No complaints were recorded in the logbook since the last inspection. CSCI has not received any complaints for the same period. The home does not have alternative versions of the complaints procedure readily available. At the inspection we noted that staff had a positive attitude to the fact that concerns may be raised and considered it to be their role to address matters where possible or pass it on to seniors. They said that the people living in the home were listened to. The manager said that policies and procedures are available in the home for staff regarding safeguarding and they are trained in induction and then there is an ongoing training programme. Understanding the potential for and risk of abuse was discussed with a member of staff who was aware of some of the possible types that could occur and of their responsibility to respond and report any concerns to management. They were also aware that social services would be involved. The manager said that all staff are given some training in adult protection during their induction and there are plans to use the same DVD to give staff refresher training. The training also includes a question and answer section and includes the way that staff should respond to suspected abuse. Evidence of training was noted in the training records viewed. Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with an attractive, well decorated, well -furnished, clean and hygienic environment to live and relax in. EVIDENCE: Before our visit the manager said that there is evidence of reinvestment in the home and visitors comment positively on the facilities. She said that the home has a part time handyman who completes regular of maintenance. She stated that necessary equipment to meet peoples needs is in the home with a choice of areas to sit in, up to date working on call system, personalised bedrooms, pushbutton access at the front door and radiator temperatures can be altered. During the site visit several of the shared areas of the home including bathrooms and toilets were viewed, as were four bedrooms and it was noted that the above were provided where checked. Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 20 The manager says has had praise from visitors for refurbishments, which include the exterior of the home, new armchairs, and coffee tables for the lounge. She said that ‘television aerials have been repaired/replaced to all the bedrooms and lounges so the residents of Beechwood House as “digital ready”. A new old style CD/record player has been purchased to allow old vinyl records to be played. Two new garden seats have been purchased. The manager said that there is a rolling plan of decorating and refurbishment. We noted that the external work commencing at the last inspection had finished. We noted that some of the bedrooms viewed have been earmarked for painting and new carpets. Other areas were clean, well decorated, bright and free from odours apart from one shared bedroom that needed attention before people could use it again. The manager agreed to address this. We noted various adaptations in areas of the home and that there were many spaces for people to use including a secure garden area with table chairs and parasol in well maintained gardens. The manager says there are fully working laundry facilities and a member of staff confirmed this whilst showing u the facilities and said that the washing machines could reach a high temperature for disinfection. The manager also said that there are plans for new machines and a laundress to work part-time starting in the next week. The manager said that specialist advice is sought regarding infection control regularly. She said they have experienced few infection control issues. Staff infection control training is evidenced in the training records. We spoke with one member of staff about the provision of yellow sacks and bin for waste disposal, disposable gloves and aprons and it was confirmed and shown that these were in place. The manager confirmed that there is a contract for this waste. Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are receiving service from a caring and friendly staff team recruited through thorough procedures. They are trained routinely and regularly to equip them with the skills and knowledge for their responsibilities in meeting people’s needs. EVIDENCE: Manager said that staff levels have increased since the last inspection demonstrating that levels are reviewed. She said that there are four staff in the morning and afternoons and a manager/senior with two waking staff and a sleep in staff member who works a waking shift until midnight first. This is recorded on a fixed two-week rota. A rota was viewed and where checked recorded these care staffing levels. The manager reported that the home has lost eight staff in the last twelve months but has a lot of regular staff and has a low use of agency staff meaning that they have support from staff that they know. In four survey forms returned we asked about staff levels and feedback was mixed, one person said there was usually staff available when needed. One person said there were sometimes. One staff member said there were usually Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 22 enough staff and another said sometimes. Relatives said that needs were usually met. When we visited the staff levels were as identified on the rota and an activities person and hairdresser were also meeting the needs of people living in the home. We noted at the last inspection that there had been an improvement in the recruitment practices and pre-employment checks had been completed in the sample of records that we looked at. At this inspection we looked at a further sample and found that this has continued although there was no written evidence of a ‘POVA First’ check completed for one person who was working without a full Criminal Records Bureau check. The manager said that this person was working in supervised way as required and provided evidence following the inspection visit. Positive approaches to people living in the home by staff are noted in the section on Health and Personal Care. Staff spoken with talked about Beechwood House being a good place to work .One person said there was good communication, organisation, and support and staff meetings. Another really enjoyed the work and felt supported and more confidant. Both spoke about training received since working in the home and one about planning to do a National Vocational Qualification. The manager said that there is a dedicated training room. Staff said that supervision is regular. Induction is based on the common induction standards and the manager said this is used for all staff and records of this for one person was asked for and viewed. A training calendar is displayed in the home and recent training has included health and safety, infection control, first aid, bereavement, and falls prevention. These are taught courses that are held for staff across the organisations homes. The manager said there is a moving and handling trainer in the staff group. Other training is planned including fire and food hygiene. The manager said that staff had asked for more training on dementia. It was raised that adult protection was recorded in the last report to be planned for 2008 and the manager said that refresher training would take place. The manager encourages staff to work towards a National Vocational Qualification and said that out of fourteen care staff for days and nights eleven are assessed to level two or above and three are working towards level two. Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from regular consultation about the service they receive. Improved quality monitoring and a new care planning system have made care practices in the home more effective in meeting peoples’ needs. The residents are safeguarded by adequate attention to health and safety in the home. EVIDENCE: Frances Hudson has been registered as manager since the last inspection and has several years of management experience and has recently completed her Registered Managers Award. She said she plans to have training to update or Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 24 develop her skills in areas including dementia, medication and the Mental capacity Act. In the AQAA it was reported that she is active in implementing best practice and understands equality and diversity. At the last inspection we found that the home had systems in place for consulting people about the service including the use of surveys and meetings. We note that these systems have developed further and the manager, in the AQAA said stakeholder meetings are being held. These include friends and relatives and involve sharing and asking for feedback. The manager said that menu changes have been made as a consequence of consultation. Also that support has been provided regularly for people to go to the pub and to the shops. A further meeting is also planned. The manager said that they receive few complaints and feedback obtained in their quality assurance systems is positive showing that residents are happy with care provided. Surveys have recently been sent out (twenty four) and we noted that the manager had (twelve) responses. She plans to collate the information included but raised the issues of problems in the laundry and clothes going to the wrong people .She said that a laundress had been recruited from the week after the inspection and anticipated these errors decreasing. A relative said ‘Since Francis has taken over since Christmas 07, the standard of care has risen dramatically. The staff seem much happier in their work.’ Comments from the staff about management included that they had the right amount of support. One said that the manager was ‘brilliant and understanding’. They also said that they could give their opinions and felt listened to. Another that they had good support in staff meetings and could raise issues. We found, on our previous visit that more quality assurance was needed to ensure that all aspects of care are full monitored and deficits acted on. We drew attention to care plans and medication. At this inspection we found that action had been taken to rectify these matters and the manager plans to include checks in her regular auditing of the service to ensure that the improvements are sustained. The manager reported that all policies and procedures have been updated. The manager said that Residents monies are safeguarded; small amounts of cash are stored in the homes safe, which only a very limited number of staff have access to. Each resident’s monies are signed in and out and the accounts are audited monthly by the manager. At the visit we sampled the records for Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 25 four people and found that they were accurately maintained. Health and Safety is promoted in the home and the manager said that training in this area ‘forms an integral part of the homes general training plan and the staff are aware of its importance.’ At the last inspection we found that good health and safety practices were in place. During this inspection we sampled some aspects of health and safety in the home. We found that staff are receiving training in areas of health and safety including moving and handling, hazardous substances, first aid, food hygiene and infection control. Our information came from talking with the staff and training records. We noted that the home received an excellent in the food hygiene rating system from the Hampshire Food Authority on 12/6/08. The certificate was viewed. A fire risk assessment was completed by an external agency in January 2008 and identified a number of action points for the manager. The manager said that all action required had actioned with one door left to be replaced. A general risk assessment has been carried out in the home but some aspects have not been reviewed since 2005. The manager said that this would be reviewed in 2008. Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 26 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 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 27 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. 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. Refer to Standard Good Practice Recommendations Beechwood House DS0000049982.V366959.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone ME16 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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