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Inspection on 16/03/06 for Beechwood Nursing Home

Also see our care home review for Beechwood Nursing Home for more information

This inspection was carried out on 16th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home continues to provide a good standard of care for the very vulnerable needy and sometimes challenging group of residents. Ms Carole Hardy who is well respected and regarded by all to whom the inspector has spoken, including the nurses, care staff as well as the general practitioners manages it. Her exchanges with the inspector continue to be open, honest and comprehensive with all queries being answered readily and with candour. Conversations with the care and nursing staff again confirmed that they are committed to doing all they can to make the lives of the resident`s fulfilling and comfortable.

What has improved since the last inspection?

More staff has been enlisted in the NVQ training programme with several achieving Level 3 and another embarking on this level of training. Grab rails have been ordered for the shower and bathrooms.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Beechwood Nursing Home Romanby Road Northallerton North Yorkshire DL7 8FH Lead Inspector John McGarva Unannounced Inspection 16th March 2006 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 Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 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 Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beechwood Nursing Home Address Romanby Road Northallerton North Yorkshire DL7 8FH 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) 01609 777733 01609 780692 Premier Nursing Homes Limited Ms Carole Agnes Hardy Care Home 60 Category(ies) of Dementia - over 65 years of age (60), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (60) Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: Beechwood is a purpose built home and registered to care for up to 60 residents who are suffering from dementia and require nursing or personal care. It was opened in October 2000 and is brick built and on two floors including the ground floor. The first floor is designated for 32 nursing cases and the ground floor for 28 residents requiring social and personal care only. There is an eight person vertical lift providing level access to the first floor. It is located close to the centre of the County Town of Northallerton and is convenient for the shops and other facilities. The area surrounding the home has been redeveloped with new housing and the home has its own enclosed garden area to the rear and south side with parking provided at the front, west-facing elevation. Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection, which took place on Tuesday 16th March 2006, and the manager; Ms Carole Hardy was available to assist with the process throughout. The inspection Commenced at 10.00hrs until 13.00 hrs, 3 hours in total. There were 58 residents in residence with two vacancies, one on the first floor nursing unit and the other on the ground floor residential unit. The inspection focused on issues raised at the last inspection in November 2005. An inspection of some of the resident’s rooms, lounges, bathrooms and showers took place. Discussions took place with the manager, nurses and care staff. The residents are unable to give a coherent account of their experiences given their mental debility but they looked well cared for and appeared content. There were no distressed or noisy residents, which can occur with this client group and testifies to the careful and considered management of their care. What the service does well: The home continues to provide a good standard of care for the very vulnerable needy and sometimes challenging group of residents. Ms Carole Hardy who is well respected and regarded by all to whom the inspector has spoken, including the nurses, care staff as well as the general practitioners manages it. Her exchanges with the inspector continue to be open, honest and comprehensive with all queries being answered readily and with candour. Conversations with the care and nursing staff again confirmed that they are committed to doing all they can to make the lives of the resident’s fulfilling and comfortable. Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Additional activity/ diversionary therapy hours should be provided. Some upgrading of the facilities in the bath and shower rooms should be considered: • • • The water pressure problems in the bathroom should be addressed. Grab rails should be fitted in the bathrooms and additional rails provided in the shower rooms. Although commodes have been provided for the bathrooms, more permanent and satisfactory arrangements should be made Power assisted hoists should be provided for both units. A ‘Stand-aid’ should be provided. More adjustable –height beds should be provided for the nursing unit. 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 Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 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 Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12. The residents would benefit from greater input from an activities organiser. EVIDENCE: There is an activities organiser who works 15 hrs per week, 1.5 hrs on each floor from Monday to Friday and helps provide social activities for the residents. The resident’s would benefit from more input of an activities person and this was discussed with the manager again who undertook to discuss this further with the provider. Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 Additional equipment and grab rails for the bathrooms are required to help ensure a safer environment for residents and staff. EVIDENCE: As the client group being admitted are increasingly frail, the layout and provision of facilities in the bathrooms would benefit from some improvements: There are no grab-rails provided in the bathrooms and these have now been ordered. Only one bathroom on each floor has benefit of a hoist. The bath hoist is a water pressure powered ‘swing-seat’ device and the resident has to be transferred onto it by a mobile mechanical / hydraulic ‘Oxford’ hoist, which needs to be ’ pumped up ’ by hand. Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 13 There is no mobile hoist in the downstairs bathroom from which transfer to the ‘swing seat’ from a chair could be affected. Both bathrooms should have power assisted hoisting facilities or a hoist tracking system provided so that bathing can be undertaken with the minimum of effort for the staff or residents. There are no toilets provided in the bath or shower rooms and as this can present practical problems prior to bathing, this is something that should be considered. There is sufficient space for toilets to be installed and the staff has confirmed in the past that this would help them in their work. Commodes have now been located in the bathrooms to assist with this eventuality but it is not an ideal permanent solution. The shower rooms have some grab-rails around the actual shower area and extending this to around the whole room would be of benefit and these have now been ordered. The water pressure is low and in consequence the baths are slow filling and this has not improved since the last inspection. Showers are used increasingly. There are six height-adjustable profiling beds provided in the nursing unit and more will be required to cope the increasingly frail and sometimes bedfast cases. Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 The provider and manager have a commitment to staff training and thereby helping to ensure that good care is provided. EVIDENCE: The home have managed to access funding from the Social Skills Council for NVQ training for care staff who are over 25 yrs so that they can benefit from this training traditionally only provided free for staff younger than this. Eight of the care staff has achieved NVQ Level 2 training standard and five Batchelor of Nursing nurses (more than NVQ equivalent) from the Philippines are working as care assistants until their registration procedures are complete. Three of the care staff have achieved NVQ Level 3 and another has commenced this training. Eleven of the care staff has now commenced the NVQ Level 2 programme. Should all staff who have commenced this training complete and no one leaves, then the 50 standard for care staff so trained will have been achieved. Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 16 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x 2 x x x x x STAFFING Standard No Score 27 x 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x x Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 17 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. Refer to Standard OP12 OP21 Good Practice Recommendations The provider should consider providing more activities person hours. The water pressure supplying the baths should be improved. The provision of toilets should be considered for the bath and shower rooms. Grab-rails surrounding the bathrooms should be provided. Additional grab-rails should be installed in the shower rooms. More up-to-date power assisted hoists should be provided for the bathrooms in both units. A ‘Stand aid’ should be provided for the nursing unit. 3. OP22 Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Beechwood Nursing Home DS0000028024.V283755.R01.S.doc Version 5.1 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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