Inspection on 09/08/05 for Homebeech

This inspection was carried out on 9th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Homebeech 27/07/09

Homebeech 18/11/08

Homebeech 08/01/07

Homebeech 31/01/06

Homebeech 26/01/05

Homebeech 01/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Homebeech 19/21 Stocker Road Bognor Regis West Sussex PO21 2QH Lead Inspector Mrs L Riddle Announced Tuesday, 9 August 2005, 09:00 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 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. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Homebeech Address 19/21 Stocker Road, Bognor Regis, West Sussex, PO21 2QH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01243 823389 01243 841295 Homebeech Ltd Miss Marie-Claire Vallerich CRH(N)-Care home with nursing 66 Category(ies) of OP- Old Age, 50 places registration, with number of places PD-Physical disability, 16 places PD(E)-Physical disability -over 65, 16 places Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users in the PD and PDE(E) categories to reside only in the Daffodil Suite. Date of last inspection 26th January 2005 Brief Description of the Service: Homebeech is a care home registered to provide accommodation and nursing care for fifty older people and for sixteen people aged 18 to 65 years of age who have physical disabilities. The home is privately owned by Homebeech Limited for whom the Responsible Individual is Mrs Sandra Ellis. Miss MarieClaire Vallerich is the registered manager in charge of the day to day running of the home. Homebeech is located in Bognor Regis, close to the seafront, shops and other amenities. It is a large extended property which was originally four houses. The majority of rooms have en-suite facilities and are for single occupancy. There is a separate unit forming part of the home known as the Daffodil Suite which is purpose built for the physically disabled. It has its own communal space, living accommodation and staff complement. Catering and laundry facilities are shared with the main home. Homebeech has two passenger lifts. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This annual announced inspection was carried out over ten hours by one inspector. Prior to the inspection the previous two inspection reports were read along with various correspondence and other documentation held on file. A pre-inspection questionnaire had been completed by the manager and information provided in this contributed to the inspection process. Comment Cards were sent out by the Commission for completion by or on behalf of residents and also for relatives/friends. Comments in those returned were positive. In view of the two registration categories which apply to this home, National Minimum Standards for Older People (OP) and Younger Adults (YA) were reviewed as part of the inspection process. Records, policies and procedures were examined during the inspection. Fourteen residents and six members of staff were spoken with and there was discussion with the registered manager, her deputy, who is responsible for training and with the care manager. Three visitors were also spoken with. A tour of the premises was undertaken. Residents were found to be well cared for by staff who are competent, trained and knowledgeable about their needs. Policies and procedures to underpin the care are in place and good recording systems contribute to an efficiently run home and business. The building both internally and externally is well maintained and residents live in pleasant, cheerful and comfortable surroundings. Good staffing levels ensure that residents needs and wishes can be met and a professionally recognised staff training programme is on-going in the home. The inspection generated just one requirement in relation to staff recruitment procedures. What the service does well: The home provides good staffing levels and ensures that staff receive appropriate training and supervision in order to be able to undertake the work and responsibilities expected of them. The home generates a happy and welcoming atmosphere for residents and visitors. Residents are enabled to be as independent as possible and where able to direct the way they wish their care to be delivered. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 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 standard(s) OP4, 5 and YA 3, 4 Residents and their representatives know that the home will be able to meet their needs and provide any specialist support that may be required. EVIDENCE: Care plans examined showed how individual residents are supported. There was written evidence of support services being available and used for specific residents with specialist needs such as physiotherapist, speech therapist, dietician and others. Discussion with the deputy manager in charge of training and records seen provided evidence that staff are suitably trained, competent and skilled to administer to those in their care. The registered manager confirmed that wherever possible and desired, prospective residents are invited to visit the home prior to moving in. Policies and procedures relating to admissions and emergency admissions were examined. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 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 standard(s) OP 7, 8, 9 andYA 6,19, 20 Good arrangements are in place to ensure that the health care needs of residents are identified and met. EVIDENCE: A total of eight care plans were examined. These contained comprehensive information about resident’s individual needs and identified the action required by nursing and care staff to ensure that those needs are met and the care delivered in accordance with each resident’s wishes. There was evidence to show that the plans are very regularly reviewed and updated as necessary. Staff demonstrated awareness of resident’s individual care needs and of specific risks related to certain residents. Risk assessments, particularly in relation to falls, moving and handling and pressure sores were seen to be in place and kept under review. Significant events and incidents were seen to be recorded such as falls, residents feeling unwell, any small changes in behaviour or normal pattern of daily living which might signify something being amiss or requiring intervention. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 10 Three residents had control of their own medications and had been provided with a lockable facility in their rooms to keep them secure. The reviews and outcomes of the risk assessments in relation to this need to be clearly documented which the care manager agreed to do without delay. Medicines in the control of the home are handled and administered in accordance with the policies and procedures by qualified staff only. Records of receipt, administration and disposal were examined. The home had contracted with an approved company for the disposal of medicines in accordance with recent legislation. All medication is securely stored. One resident commented on how well his pain control is managed, and said that staff ensure that he receives it very punctually. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 11 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 standard(s) OP 13, 14, 15 and YA 15, 16, 17 Residents can maintain contact with family and friends as they wish and are helped to exercise choice and control over their lives. Meals are well managed and provide daily choice, variation and interest for people living in the home. EVIDENCE: All of the residents who commented on the food said how good it is and they welcome the daily choices offered. Comments made included “we have good food and plenty of it” and “the food is very varied, we always have a choice, it’s very good especially as there are so many of us”. A visitor said that she has lunch in the home with her relative every Sunday and it’s always very good. Menus were examined and residents were observed eating their main midday meal. Staff were seen to be assisting residents with feeding in a dignified and discreet manner. The dining areas are cheerful and welcoming. Residents said that they can eat in the privacy of their rooms if they wish or wherever it suits them best. One was observed having his meal in the garden which was his wish. Visitors spoken with confirmed that there are no restrictions on visiting and said they are always made welcome. They can visit privately in the resident’s own room if the resident prefers this or alternatively in any of the communal areas. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 12 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 standard(s) OP 16, 17 and YA 22, Complaints are handled objectively and residents can be confident that their concerns will be listened to, taken seriously and acted upon. Resident’s legal rights are protected. EVIDENCE: The home has a detailed complaints procedure and records seen indicated that this is followed. One complaint had been made since the previous inspection directly to the Commission for Social care Inspection. This had been passed on to the home to investigate in the first instance and notify of the outcome. Documents submitted to the Commission by the home showed that a thorough investigation of the complaint was made with a satisfactory outcome for all concerned. Residents asked knew who they should complain to if the need arose and said they would feel able to do so. One said ”we can go to A if we have any worries or complaints. Yes I am sure he will take any complaint seriously and do something about it. A forum for relatives has been set up when they can meet in the home three monthly to discuss any issues important to them. The registered manager said that the first meeting had included discussion about the complaints procedure, and had been a way of ensuring that relatives could feel comfortable about using it if they felt the need. The registered manager confirmed that all residents are offered the opportunity to vote in the electoral process either by attending the ballot station or by using a postal vote. Residents asked said that this was so. One comment was “we can vote if we want, I don’t bother”. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 13 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 standard(s) OP19, 20, 21, 24, 25, and YA 24, 26, 27, 28, 42 The home is well maintained and in good decorative order providing people who live there with clean, comfortable, cheerful and safe surroundings. EVIDENCE: There is an on-going maintenance and re-decoration programme which ensures the home is kept in good order as was observed. New carpets have been laid in several areas since the last inspection. Bedrooms are usually redecorated and, if necessary re-carpeted before a new occupant moves in. Residents told the inspector that they had been able to bring with them some of their own furniture and other effects and this was much in evidence. All parts of the home are comfortably furnished and well equipped with aids and adaptations to facilitate daily living especially in Daffodil Wing where residents have equipment specific to their needs and disabilities. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 14 Hot water temperatures in baths and hand basins are regulated and regularly tested to ensure safe temperatures are maintained. Windows are fitted with restrictors in the interests of safety and security. Documents seen showed that the home meets the requirements of the local fire and environmental health departments. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) OP 27, 28, 29, 30 and YA 32, 33, 34 The number and deployment of staff throughout the day and night is sufficient to meet the needs of the residents. The procedures for the recruitment of staff are not sufficiently robust to provide the safeguards to offer protection for people living in the home. Residents are cared for by staff who are suitably trained and competent EVIDENCE: Residents spoken with said that staff are very kind, caring and patient. They considered that there are enough staff to care for them properly and said they do not feel rushed or ignored. They said staff make time to talk to them and take people for walks whenever they can. Comments included “there are always plenty of staff and they come quickly when we need them”. A visiting relative said “staff ratios seem to be good, there are always a good number of staff about whatever time I come”. Staff were observed to approach residents in a courteous manner and there was no feeling of anyone being rushed. Duty rotas were examined which confirmed that staffing levels in both units are appropriate. Six staff files were examined, and a discussion took place with the administrative staff member responsible for recruitment documentation. According to records and information provided it was found that Criminal Record Bureau checks had not been applied for on behalf of thirteen members of staff. Whilst some of these staff members had been recruited in recent months some had worked in the home for some time. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 16 In some cases the references from most recent employers had not been obtained or chased up where they had been applied for and no reply received. The registered manager confirmed that all staff work under supervision until such time as all checks have been made and clearance obtained. However, due to the delays in obtaining these residents could be put at risk. A requirement has been made in relation to this matter. Discussion took place with the deputy manager who has the delegated responsibility for staff training and development. Records of training were seen. New care staff undertake a recognised induction training programme followed by Foundation training. Oversees staff receive English lessons in the home provided by a teacher from Bognor College. Once they are suitably proficient and, for oversees staff, their language skills are sufficient, they can progress to National Vocational Qualification training. Qualified nurses are given opportunities to attend whatever relevant training they need or wish to attend to maintain their registrations. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) OP 31, 32, 33, 36, 38 and YA 37, 38, 39, 42 The registered manager provides leadership, guidance and direction to staff to ensure residents receive consistent quality care. Policies, procedures and appropriate training for staff result in practices which promote and safeguard the health, safety and welfare of people living and working in the home. EVIDENCE: The registered manager is currently undertaking the Registered Managers Award. She is a qualified nurse and has a great deal of experience both in care of the elderly and in caring for people with physical disability and cancer. Residents, staff and visitors made very positive comments about the management of the home. All grades of staff said that they receive very clear direction and know what is expected of them. They said that communication throughout the home is good and they feel well supported and valued. Care staff confirmed that they receive regular formal supervision which covers all aspects of their working practice as well as their career development needs. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 18 Relatives felt able to approach the manager and other senior staff at any time and said they had every confidence in them and the staff in general. Documentation was available to show that all equipment and installations in the home including medical equipment and wheelchairs are regularly tested, serviced, and repaired as necessary. Staff receive training in health and safety topics such as infection control, moving and handling, first aid, food hygiene and fire safety. Risk assessments in relation to the building have been carried out as part of a full Health and Safety audit undertaken by an outside agency under contract to the home. The audit encompasses all matters of health and safety in the home/workplace. Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x x 3 3 x STAFFING Standard No Score 27 4 28 4 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 4 3 x 4 4 3 x x 3 x 3 Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 20 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. 1. Standard OP 29 and YA 34 Regulation 19(1)(b) Requirement The registered person shall not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in paragraphs 1-7 of Schedule 2. Timescale for action 30th September 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Homebeech H60-H11 S24153 Homebeech V234721 090805 Stage 4.doc Version 1.30 Page 22 - 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!