CARE HOME ADULTS 18-65
Beeches (The) 28 Shell Beach Road Canvey Island Essex SS8 7NU Lead Inspector
Patricia Stanton Unannounced Inspection 10:30 1st March 2006 Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 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 Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 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. Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Beeches (The) Address 28 Shell Beach Road Canvey Island Essex SS8 7NU 01268 515441 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) Kingswood Care Services Limited Michael Frederick Bedford Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Personal care to be provided to not more than 4 adults with a learning disability. Mr Michael Frederick Bedford to complete an approved course in Protection of Vulnerable Adults (POVA) within three months of registration. 19th September 2005 Date of last inspection Brief Description of the Service: The Beeches is a two storey detached property set in a quite residential area in Canvey Island. The home is situated close to the beach, buses, pubs and clubs and within a mile of the town centre. The home offers one lounge, one dining room/ kitchenette and four single bedrooms, three with en suite facilities with additional bathroom and downstairs WC. The grounds and garden are well maintained and accessible offering both lawn and decking area for residents. Residents within the home access a range of day care and participate in a range of leisure pursuits/work based programmes within the local community. Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The routine unannounced inspection took place on the 01/03/06. Two residents were spoken too, three staff members and the registered manager. Records and documents were looked at, including the previous requirements and recommendations from the last inspection. Time was spent in the lounge and kitchen chatting and taking note of the residents daily routine in the home. The residents’ and staff on duty were most helpful, and this was greatly appreciated. The inspector would like to thank residents, staff and registered manager for their time and cooperation during inspection. What the service does well: What has improved since the last inspection?
The home now has a permanent registered manager who has completed NVQ level 4 registered managers award. New healthier meals for residents with pictorial menus have been introduced to give residents more choice and the home monitors residents weight to prevent long-term health problems. The range of activities is wide and residents are encouraged to participate in daily living skills empowering them, giving them a sense of belonging. More pictorial communication has been introduced in the home to improve communication between residents, relatives and the staff. The dining room is now furnished to allow all residents and staff to eat together. Additional key working supervision has been introduced and new staff undertake inductions, which help identify areas of strengths and weaknesses. The homes premises are more secure.
Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 Page 6 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. Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 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 Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 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): 2 Assessments were not reviewed, as the home has had no vacancies in the past 12 months. EVIDENCE: Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 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): 8 Residents participate in all aspects of life in and out of the home. EVIDENCE: At inspection it was observed that residents appeared very happy and able to verbalising much more. The home has encouraged residents to participate in all aspect of life including meetings, menu planning, activities and daily living skills. The registered manager had introduced pictorial boards for menus, activities and household chore, which are on display in the home. Residents appear to enjoy using the boards, which enable them to make more choices. Each resident is able to choose their daily meal by placing pictures and names (if able) of food items on the menu board and also select which activity they wish to participate in. The domestic chore board guides residents to complete one daily chore i.e. clearing the table, washing up or drying dishes. Residents appeared to enjoy daily living skills and rewards gained from this practice. Rewards included cycle lessons and CDs. Residents participate in tidying their own rooms and have ownership of the home and their lives.
Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 Page 10 Communication levels between residents and staff was mutually very positive and more communication was seen from residents who live fulfilling and active lives. One resident stated, “ I am very happy living here, I can have my family around and I enjoy karaoke and the food in the home. It was my birthday and I had a party with the staff and my family with food and a birthday cake”. The resident informed the inspector she would like more parties in the home as she enjoyed hosting and serving drinks”. Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 Page 11 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): 17 The home menus are healthier. EVIDENCE: Since the last inspection the home has tried to make meals healthier for young adults who are not so active. Menus examined contained healthier options. Dessert have been replaced Monday to Friday with low fat yogurts instead of puddings. Sunday roast dinner is now served at lunchtime to allow residents to go swimming in the evening. One resident who liked to eat many chocolate bars and crisps each day had been give a goal to eat only one portion of each daily. The residents enjoyed participating in the reward system ticking his achievements daily so he could be rewarded with cycle proficiency lessons. One residents said “the food is good we like Bevs cooking on a Saturday”. Residents were observed to help themselves to drinks whenever they wished, help prepare meals and clear up plates after breakfast and dinner. Food stock examined confirmed the home has healthier snacks for residents to enjoy. Residents’ weights is now monitored and at inspection residents appeared happy and healthy.
Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 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): 19,20. Residents’ emotional and physical needs are met and medication procedures in the home protect residents. EVIDENCE: Care plans evidenced residents see appropriate health professionals regularly and the home seeks emotional assistance for residents who require it. Records examined confirmed residents emotional needs, which may have caused concern, are assessed by an occupational therapist that gives staff instruction in how to manage the behaviour without causing embarrassing the resident. Action as directed by the specialist was observed to be consistent with all staff at inspection. The homes medication and administration procedures were examined and found to be in excellent order. The home records any medication errors with comments and action taken, signatures of administrating staff, homely remedies which are regularly reviewed, contract for pharmacy advice, Latin abbreviations and terms of medication, photo of each resident on medication charts, drug administration guidelines on files for each residents medication with a personal summaries of possible side effects and appropriate medication stock returns book signed off by the staff and pharmacy. All medication examined was correct and in date.
Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 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): 22,23. Residents are protected from abuse neglect and self-harm. EVIDENCE: Staff receive training in protection of vulnerable adults and one new staff member who had just started in the home was aware of the signs and types of abuse and the procedures for reporting abuse. The home has received no complaints. Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 Page 14 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): 24,30. The Beeches is homely, comfortable, safe clean and hygienic. EVIDENCE: The home is decorated to a high standard and very homely. Residents enjoy the many photos of themselves on activities and holidays on display in the house and like to show visitors and their relatives when they visit the home. The lounge has a large TV and many games and videos for residents to use. Residents have their own music centres in their bedrooms and notice board to display personalised pictures. The home displays photos of all staff for residents to see who is on duty each day. The home is bright and cheerful with adequate space for communal areas. The garden is sunny and pleasant with BBQ and decking with seating for residents. Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 Page 15 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 Residents are protected by robust recruitment checks completed on all staff. EVIDENCE: The agency staff records were examined at inspection and all relevant checks on file. The registered manager ensures the home has copies of all CRB and POVA checks before agency staff members are employed in the home. Copies of identification badges were on file for agency staff with photos. A letter confirming agency staff undertake training in protection of vulnerable adults was on file. The home currently has one vacancy for a deputy manager and two vacancies for care staff. Records confirmed staff receive appropriate supervision and regular appraisals to identify further training needs. New staff undertake a two-week induction programme, which covers all aspects of care in the home monitored by the staff and registered manager who take time to discuss any areas of concern. New staff work in addition to the core staff during induction. One new staff member stated how welcoming the staff were stated, “The manager and staff are very approachable and this helps a lot”
Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 Page 16 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): 37,38, 39,42,43 A qualified experienced and effective registered manager who has the best interest of residents manages the home. Regulation 26 visits are not completed regularly. Quality assurance systems could be further improved. EVIDENCE: The home now has a permanent registered manager who has completed the NVQ level 4 registered managers award and is very competent, efficient and effective. The registered manager is able to delegate and empower his staff team while supporting them to work in a home, which is run in the best interest of the residents. The registered manager monitors the progress of the home and completes regular audits and reviews while being proactive of residents needs. Both residents and the staff find the registered manager approachable and during inspection the registered manager was seen to enjoy spending time with residents taking them out. Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 Page 17 The registered manager has progressed the home since the last inspection but the registered provider had not made regular regulation 26 visits to the home in the past year. This may be due to management reorganisation. Health and safety checks are completed regularly and fire extinguishers serviced within the past year. The home now monitors all visitors to the home and records confirmed these are kept up to date. The home has a quality assurance and monitoring system, which is completed by the registered provider but does not include a personalised action plan. Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X 4 X X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X 3 LIFESTYLE Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 3 X x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Beeches (The) Score X 3 4 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X X 2 DS0000047171.V265376.R01.S.doc Version 5.0 Page 19 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 YA43 Regulation 26 Requirement The registered provider should complete regulation 26 visits monthly. Timescale for action 01/04/06 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. 3 4 Refer to Standard YA32 YA39 YA43 YA32 Good Practice Recommendations Staff should undertake training in aspergers, epilepsy makaton and autism. Quality assurance and monitoring of the home should be personalised to The Beeches The home could improve communication for staff with the use of email and a fax machine. A suitably qualified deputy manager should be employed to cover in the absence of the registered manager. Beeches (The) DS0000047171.V265376.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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