Inspection on 06/01/06 for Beehive

This inspection was carried out on 6th January 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Beehive 09/03/07

Beehive 06/07/05

Beehive 03/03/05

Beehive 07/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Beehive 2b Wycombe Road Gants Hill Ilford Essex IG2 6UT Lead Inspector Jackie Date Unannounced Inspection 6th January 2006 1pm Beehive DS0000025943.V277133.R01.S.doc Version 5.1 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 Beehive DS0000025943.V277133.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 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. Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beehive Address 2b Wycombe Road Gants Hill Ilford Essex IG2 6UT 020 8550 1032 020 8550 2422 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) Maidstone Community Care Housing Society Limited (MCCH) Michelle Steward Care Home 6 Category(ies) of Learning disability (5) registration, with number of places Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person over the age of 65 years. Date of last inspection 6th July 2005 Brief Description of the Service: Beehive is a home for six people with severe learning disabilities. Residents have little or no verbal communication skills, and limited ability to make decisions about their lives. The home was purpose-built on one level and is accessible to wheelchair users throughout. There is a lounge/dining area leading to a conservatory and the garden. The garden has a patio and is well kept. Some of the residents like to sit in the garden. Each resident has a single bedroom. The house is in a residential area near to public transport and local shops. The residents go to some day activities outside the home on one or two days of each week. Bedrooms are individually decorated and personalised, according to the residents likes. At the time of the visit three ladies and three men were living at the home. Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection lasted for about five hours and took place during the afternoon. It was the second of the two inspections that each home must have during the inspection year. During the two visits all of the key standards have been checked. The manager, staff and all of the residents were spoken to. All of the rooms in the house were seen and care and other records were checked. The main purpose of this visit was to monitor the progress of the requirements from the previous inspection. Before the visit some of the relatives and other professionals were sent letters asking for their opinions of the service. What the service does well: What has improved since the last inspection? What they could do better: A very good service is given to the residents and the house is, in general, comfortable. Some areas require redecoration and this was scheduled for the week after the inspection. When this has been completed some carpets require cleaning and others replacing. Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 6 Residents’ goals need to be reviewed and updated so that they are appropriate for each person. The recording system for the goal needs to be used regularly so that any progress or deterioration can be reviewed and adjusted if needed. The organisation must make sure that monitoring visits are carried out each month. 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. Beehive DS0000025943.V277133.R01.S.doc Version 5.1 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 Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not tested on this visit. However evidence from the last inspection was that information is available to enable the staff team to meet residents’ needs. If a vacancy arose the required information would be gathered on a prospective resident and they and their relatives could spend time in the home to find out what it would be like to live there and to enable the resident to make a choice about living in the home, within their capacity to do so. EVIDENCE: The above standards were not specifically tested on this visit, as there were no outstanding requirements in relation to the five standards. At the time of the last inspection standards two, three and four were tested and assessed as met. Beehive DS0000025943.V277133.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Residents’ plans focus on their individual needs and abilities and contain detailed information so that staff can meet their needs and these exceed minimum standards. EVIDENCE: Each resident has a care plan. These are very detailed and give clear information about each persons strengths, needs, likes and dislikes. There are also “primary care guidelines” that describe each persons preferred morning routine and also what personal care they need and how they like to have this care. For example “I like a cup of tea first thing, if not I get grumpy and might slap my face; does not wear makeup but likes beaded necklaces and perfume.” The staff team have now completed communication passports for all of the residents. The communication passports seen were very good and contained a lot of detailed information that showed that staff know residents well. The degree to which residents can be involved in the development of the plan is very limited due to their severe learning and communication difficulties. Each resident has a diary and the staff record details of what the person has done. Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 16 & 17 The residents are encouraged to take part in activities and to be part of the local community. Residents are given meals that they like and that meet their needs and individual preferences. Goals set to help residents to develop their skills are not being reviewed and updated in conjunction with care plans and therefore may not be up-to-date or appropriate. EVIDENCE: Each resident has goals that have been set for staff to support them to develop their skills. There are also monitoring sheets specifically to record the progress towards these goals. However in some cases these goals had not been updated since 2002. Additionally the monitoring sheets were only completed periodically and not regularly. Therefore it was not possible to confirm that residents goals are up to date or appropriate. Any goals set for residents must be reviewed and updated regularly. Progress towards achieving goals must be Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 11 recorded regularly. This will provide the information required to properly review goals and to measure any progress on regression. Most of the residents go to day services for part of the week. One resident also has one to one support from an outreach worker and visits different places in the community. All of the residents had a holiday last year. All of the residents need support from the staff team when they go out. The residents go out for lunch and go to the local shops and markets and they also do activities in the home. The staff said that it depended on how the residents felt. One of the residents goes to church every Sunday and staff said that she appears to really enjoy this. As at previous inspections staff said that the residents have freedom to make choices even though they cant talk and that they all have their own ways of showing what they want. One residents plan says, “ when I am ready to go to bed I go to my room and get under the duvet, staff should then come in and help me to get ready for bed”. Menus are based on staffs knowledge of residents’ likes and dislikes. One of the residents is Jewish and kosher meals are prepared for him. There is also a separate fridge for his kosher food. Staff meeting minutes contained a reminder that staff should make sure that there was a kosher alternative for his meal on Christmas Day. During the course of the afternoon residents were offered a choice of fruit or biscuits with their drink. Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 19 EVIDENCE: The residents require support with their personal care and details of the help that they need and how they prefer to be supported are in their “ primary care” guidelines. The guidelines for one resident states “I like to be changed quickly when wet or if soiled. If not I may slap my head or grab at staff” Residents are encouraged to choose what to wear. When appropriate residents are supported to get up in time to attend their day activities but at other times they get up when they choose. All of the residents go to the local doctor and specialist help is received when needed. Staff take residents to all of their medical appointments. Care plans indicate how individual residents might express pain. Residents’ files have details of health care issues and show that residents have regular access to health care professionals. Records are kept of medical appointments and these show that residents have checks from the optician, dentist and when needed the chiropodist Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Staff are aware of issues of abuse and work to protect residents from abuse. EVIDENCE: The organisation has produced a detailed adult protection policy that tells staff the actions to take in the event of abuse/suspected abuse being discovered. Staff have attended a course on protecting residents from abuse and are aware of their responsibility to residents. A placing social worker said that the staff have a good awareness of adult protection issues and have communicated concerns to the learning disability team in the past year. One of the residents slaps his face and head when he becomes distressed and on occasions this has caused injury to his face. There are some guidelines/interventions for dealing with this behaviour. There have been two occasions in the last couple of months when this resident has had an injury that has required a visit either to the hospital or to the GP. In both cases it is believed that he caused the injury himself when he was agitated. Although these incidents have been written up there was no reference to the guidelines being followed or any feedback about the effectiveness of the guidelines/interventions. Therefore it is not possible to confirm that staff have done everything possible to prevent this resident from harming himself. Any guidelines/interventions must be implemented and recorded to ensure that residents are safeguarded. The first incident was not reported to the placing social worker or to the Commission and was raised as an area for improvement by the placing social worker. The second incident had happened the day before the inspection and staff on duty and the manager were informed of the need to report this and Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 14 any future significant incidents as required by regulation 37 of the Care Home Regulations 2001. Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 and 27 The residents live in a home that is suitable for their needs. Some redecoration and recarpeting are required to ensure that residents’ accommodation is of a good standard. EVIDENCE: The house is near to the local shops and bus routes. The communal space consists of a large lounge/diner, kitchen, laundry room and a garden. The building is accessible for wheelchair users throughout. Each resident has a single bedroom. These are decorated and furnished to meet individual needs and likes. The office is also used as a sleeping in room with a separate shower for staff. The previous inspection indicated that several parts of the home required redecoration. Although this work has not been completed the decorators had already been to the home to carry out preparation work and the redecoration was due to be started on the following week. Therefore the timescale to meet this requirement has been extended to allow for decoration to be completed. A new suite and cupboard has been purchased for the lounge and this combined Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 16 with the redecoration should mean that the residents have a more comfortable and homely lounge. The carpet in the hall was damaged when work was carried out to repair damp and this has been taped to make it safer for the residents but must be replaced. The carpets in some of the bedrooms require cleaning or possibly replacing. The manager said that the carpets would be cleaned once a decoration has been finished. There are enough baths, showers and toilets to meet the residents’ needs and repairs have been carried out to the shower as required by the previous inspection. Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 36 Staff are properly recruited and the necessary checks carried out. This helps to protect residents and keep them safe. Although staff receive a lot of informal support regular formal supervision is needed EVIDENCE: The organisation operates an appropriate recruitment procedure. Jobs are advertised, application forms completed and interviews held. The necessary checks are undertaken prior to staff commencing employment. Staff supervision has not been taking place regularly and this must happen to ensure that staff individually have the opportunity to discuss problems and to be involved in the development of the service. However staff spoken to say that they receive good support from the manager and from each other. They also said that the staff team work well together and that the residents benefit from this. Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 The home provides a safe environment for the residents. Although the organisation monitors the quality of the service provided the monitoring visits are not carried out frequently enough. EVIDENCE: The quality of the service provided to the residents is monitored by the home manager and by the organisation. At the time of the previous inspection the service manager was carrying out monthly monitoring visits to assess how effectively the home was operating to meet its stated aims and objectives, and reports were written. These indicated the action to be taken when deficiencies are identified. Copies of these reports were available in the home and copies were sent to the Commission. However since the last inspection there was only evidence that two visits had been carried out in August and November. These monitoring visits must be carried out each month to ensure that the residents are provided with a good quality service that meets their needs. Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 19 All of the necessary health and safety checks are carried out and a safe environment is provided for the residents. Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 20 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 X 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 X 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 3 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 X 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 X X X X LIFESTYLES Standard No Score 11 2 12 3 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X X 2 X X 3 X Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 21 YES 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. 1 Standard YA11 Regulation 12, 15 Requirement Any goals set for residents must be reviewed and updated regularly. Progress towards achieving goals must be recorded regularly. Any guidelines/interventions must be implemented and recorded All significant incidents must be reported to the Commission without delay. The home must be in a good state of repair and all areas must be reasonably decorated. (Previous timescale of 31/10/05 not met) The hall carpet must be replaced. Stained bedroom carpets must be cleaned and if necessary replaced All staff must have regular, recorded supervision meetings at least six times per year in addition to regular contact on day-to-day practice. A representative of the organisation must visit the home unannounced at least once each month to check on the standard DS0000025943.V277133.R01.S.doc Timescale for action 30/04/06 2 3 4. YA23 YA23 YA24 13 37 23 31/03/06 31/01/06 31/03/06 5 6 7 YA24 YA26 YA36 23 23 18 30/04/06 30/04/06 30/07/06 8 YA39 26 30/04/06 Beehive Version 5.1 Page 22 of care provided. A written report must be made and a copy of this lodged with the home and a copy sent to the Commission. 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 Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Beehive DS0000025943.V277133.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!