Inspection on 07/10/08 for Beeston View Dementia Unit (Iddenshall Hall Care Home)

This inspection was carried out on 7th October 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

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Beeston View Dementia Unit (Iddenshall Hall Care Home) Rode Street Clotton Near Tarporley Cheshire CW6 0EG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Maureen Brown     Date: 0 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Beeston View Dementia Unit (Iddenshall Hall Care Home) Rode Street Clotton Near Tarporley Cheshire CW6 0EG 01829732454 018929730684 ann.hull@barchester.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Patricia Ann Hull Type of registration: Number of places registered: Barchester Healthcare Homes Ltd care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The registered person may provide the following category/ies of service only: Care home with nursing - Code N To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia Code DE The maximum number of people who can be accommodated is: 48 Date of last inspection Brief description of the care home Beeston View is a purpose built care home for people with dementia requiring personal and nursing care run by Barchester Healthcare Homes Limited. The care home is on the same site as Iddenshall Hall Residential Care Home. It is in a rural location in the village of Clotton, near Tarporley. The grounds and gardens are accessible to people who use the service. The accommodation comprises of forty-eight single rooms all with en-suite shower rooms. The bedroom accommodation is on two floors with stair and lift access to the first floor. Care Homes for Older People Page 4 of 25 Over 65 0 48 Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We carried out an unannounced visit to the home on 7 October 2008 and the visit lasted six and a half hours. This visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about the home. We sent out questionnaires to people living in the home and staff to find out their views about it. Other information received about the home was also reviewed. During our visit we looked at various records and the premises. We looked at care records of a number of people who live in the home, to see how their needs were being met. We spoke with a number of people who live at the home, the manager, staff Care Homes for Older People Page 6 of 25 members, visiting family members and one visiting professional. They all gave their views about the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 8 of 25 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive enough information about Beeston View for them to make an informed decision about moving there and their needs are assessed before they move in so they know these can be met at the home. Evidence: Information about the home is provided in one folder that includes the homes statement of purpose, service users guide, the complaints procedure, a copy of the most recent newsletter regarding the home and quality assurance processes used at the home. The documents are written in plain English and available in a large print version. The manager told us they were looking at producing a picture version. One person who lives at Beeston View told us, I visited the home with my son and daughter and decided in the next few days that I would like to live here. Care Homes for Older People Page 11 of 25 Evidence: There is a document for staff to use with people before they move into the home to find out what their needs are and other relevant information. This is completed with each person who is interested in moving into Beeston View. The document enables staff to gather personal details about each person as well as information about their GP, next of kin, social interests, communication needs, mobility and personal and health care needs. This is used, together with the assessment carried out by staff at the home, to make sure that people who move in to Beeston View can be well supported by the staff team. The manager confirmed that intermediate care was not provided at Beeston View. Care Homes for Older People Page 12 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, personal care and social needs of people living at Beeston View are met effectively by the staff in a way that enables people to maintain their privacy and dignity. Evidence: We looked at the care plans of three people who live at Beeston View, to check the care they receive. There were very well written and each file was sub-divided so it was easy for staff to find all relevant information about the person, their needs, what staff have to do to meet them, their progress, activities they had done, any treatment or advice provided by healthcare professionals and risk assessments relevant to that person. The files also contained a complete personal profile with a life history that detailed aspects of the persons life, their achievements, likes and dislikes. It was a very good document, useful for the staff team to get to know each person and what they preferred. The daily records were good and staff noted any changes to people and activities they Care Homes for Older People Page 13 of 25 Evidence: had done. Details of visitors they had were also recorded so that staff and others could see easily whether people were well and active. All the files had reviews of the care plans to make sure that these were up to date and still effective. Many of the people in the home were not able to confirm that they had been involved in planning or reviewing their own care. They were able to confirm that staff helped them when they needed it, for example with personal care tasks. People told us, The staff always treat me well, I like the staff and I have fun with them and Staff listen to what I say and act on it. Family members we spoke with confirmed they were involved in care planning and reviews for their relatives and that they could have a say in how the care was provided. Risk assessments were included in the care plans. These were up to date and had been carried out for moving and handling and for falls. These are done to make sure that people who live in the home are safe in their daily activities and to identify any help they might need. Each persons medicine is kept securely in their own room. When staff give medicines to people, they complete the medication administration records. Staff had received training so they could give out medicines safely, correctly and without errors. Some of the training was provided in house and some staff had completed other medication courses. We saw the unit manager giving out medicines to people during the lunch time. She carried out the task safely so that everybody received their correct prescribed medicines. Visits from health care professionals were recorded. The records showed that GPs, district nurses, opticians, chiropodists, physiotherapists and continence advisors visited the home regularly to make sure people remain well. Care Homes for Older People Page 14 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live at Beeston View have a range of activities available so they can stay active and staff help people so they can keep in touch with their family and friends. Evidence: An activities co-coordinator is employed to work at Beeston View. A list of weekly activities is displayed on the notice board. Activities available included baking, a newspaper discussion group, reminiscence, film shows, exercises and armchair exercises, sing-a-long, craft mornings and walking in the garden. There is a trolley shop twice a week providing toiletries and other items for people living in the home to buy. Events such as coffee mornings and cheese and wine evenings are held. The home has its own chapel next door where services are held and people can attend if they wish to. A record is kept of each activity and peoples individual interests are noted in their care plans. The activities co-coordinator uses this information to tailor activities to peoples preferred interests. Recent trips out of the home have included a visit to a local art exhibition and visit to the local ice cream factory, both which were well enjoyed by those who went. Planned activities for later in the month we visited included a tea Care Homes for Older People Page 15 of 25 Evidence: dance at a local hotel and trip to Blackpool to see the lights. The hairdresser visits the home each week, and a specialist hairdressing room is available on the ground floor. People who live at the home were offered choices in various ways, such as in the time they get up or go to bed at night, by choosing the clothes they wear, by deciding whether or not to join in activities and by deciding how they wished to be addressed. This enables them to keep some control over what they do each day and to stay as independent as possible. We looked at samples of menus, which were on display for people to see. These showed a varied diet of popular, traditional dishes. There was a wide choice available at each meal time with at least three choices of main course and dessert. All the food was home cooked, including speciality breads to be served with homemade soup. Families and friends are encouraged to stay for meals with the people who live at Beeston View. There are drinks and snacks available in between mealtimes and fresh coffee is available to all in the foyer. People told us the lunch on the day of our visit was excellent and they said the food provided at Beeston View is very good. Visiting family members we spoke with confirmed that they had been offered meals at the home and said that the food was superb. Care Homes for Older People Page 16 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes procedures for complaints and safeguarding adults are effective so that the concerns of people who live at Beeston View are listened to and they are protected from abuse or harm. Evidence: The staff files we looked at during our visit showed that training had been completed on safeguarding adults from abuse. The manager confirmed this and showed that she was aware of the policy, procedures and guidance of safeguarding. There were also policies available on management of violence and aggression against staff, and whistle blowing. No referrals had been made under the local authority safeguarding adults procedures from the home. The complaints procedure for Beeston View was satisfactory and contained details of how to contact us. We have not received any complaints about this home since it began operating and the home had not received any complaints either. People who live at Beeston View said they would contact the manager if they had any problems. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well maintained so that people who live at Beeston View live in a clean, safe and comfortable surroundings. Evidence: During our visit we walked round the building. We saw all the shared (communal) areas as well as a number of bedrooms. All the bedrooms are single and have an ensuite shower room. The standard of decor and furnishings is excellent. The home was clean and odour free. People who live in the home had made their rooms more homely using ornaments, pictures, photographs and some furniture they had brought with them when they moved in. People who live at the home said they liked their bedrooms and told us, The home is always fresh and clean and I like my room very much. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff recruitment procedures are thorough and staff have done a wide range of training so people who live in the home know that staff are suitable to work with them and they are protected from poor practice. Evidence: The staff rotas showed the number of staff on duty over the week. The staffing levels appeared to be sufficient to meet peoples needs. People who live in the home told us there were enough staff around to help them and during the visit we saw that staff were attentive to peoples needs. People living in the home said, All the staff are sweet and kind, The staff always treat me well and I have fun with the staff. One member of staff thought that there were sometimes enough staff on duty to meet peoples needs. However this was not confirmed by either the staff rota or the numbers of staff seen on the day of this visit. We checked five staff records. They had all the necessary pre-employment checks in place, including identity checks, Criminal Record Bureau checks, references, health checks and application forms. These checks are carried out to make sure that staff are suitable to work with the people who live in the home. The training staff had completed included a full induction which is linked with Skills for Care Homes for Older People Page 19 of 25 Evidence: Care and can be used to lead into NVQ level 2 in care. Other courses included moving and handling, fire awareness, first aid, food hygiene and safeguarding adults. Other courses undertaken by staff include customer care, resuscitation, Visiting Mum, communication skills, skin and wound care, introduction to palliative care and health and safety. Each member of staff had a separate training file. This enabled the manager to show that the staff team had completed the training they needed to provide good care for people living in the home. One staff member stated, I am not given training relevant to my role whilst another told us, I meet with my manager regularly and I have access to appropriate training. Good progress has been made with NVQ level 2 training. Ten out of twenty-one staff have NVQ level 2 or above in care and five people have currently applied for NVQ level 2 or 3. This means that a good percentage of staff have a nationally recognised qualification in care to help them provide good quality support for the people who live in the home. Regular staff meetings are held and these help make sure that managers and staff know what is happening in the home, any changes needed and that things continue to be run in the best interests of the people who live there. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures within the home are thorough so the health, safety and welfare of the people who live there are protected. Staff are well supervised and there are processes in place to make sure the home is run in the best interests of the people who live there. Evidence: The manager of Beeston View is a qualified nurse with many years experience in providing care for people. She also has the Registered Managers Award NVQ level 4. She has worked for Iddenshall Hall (the home on the other part of this site) for twelve years and has worked for Barchester Healthcare for five years since they took over the home. She knows the service well and can make sure that it is run well for the people who live there. There is an established quality assurance process for the home which includes a residents family support group, which meets each month to support the families of Care Homes for Older People Page 21 of 25 Evidence: people with dementia. This group decided to keep brief notes and to keep things on an informal basis. Surveys to find out the views of people who live at Beeston View and their families about the home will be done annually. At the time of this visit, the home only been operational six months so these have not been completed yet. Monthly in house checks are carried out on various aspects of the home. The one done in the month of our visit was on infection control procedures and the one before that was on person centred planning. These checks make sure that processes in the home continue to be well run. A bi-monthly newsletter is produced and shows what has been going on in the home, what the people who live there have been doing, and where they have visited. The manager told us that no money is kept at the home on behalf of people who live there. The cost of any purchases made by people living at Beeston View or on their behalf is included in a monthly invoice to their next of kin or other representative. Day to day supervision of staff was good and they also receive regular formal supervision with records kept. Annual appraisals will be undertaken and at the time of our visit, a six month review is being undertaken with each staff member. This makes sure that staff have a chance to discuss their work with managers, so they can continue to provide good quality care for the people who live in the home. Safe working practices were in place in the home. There were up to date safety checks on the homes gas installation and electrical system. There were policies available in the home about safe working practices including a range of risk assessments, dealing with hazardous substances, moving and handling, health and safety, food safety and first aid. We also saw the fire safety equipment tests logbook and up to date checks had been made on the fire safety system and extinguishers. Staff had received regular fire awareness training. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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!