Random inspection report
Care homes for older people
Name: Address: The Beeches West Harling Road East Harling Norwich Norfolk NR16 2NP two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Lella Hudson Date: 1 0 0 7 2 0 0 9 Information about the care home
Name of care home: Address: The Beeches West Harling Road East Harling Norwich Norfolk NR16 2NP 01953717584 01953717886 beeches03@aol.com www.beeches-residential.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Beeches (East Harling) Ltd care home 44 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 44 The maximum number of service users who can be accommodated is 44 The registered person may provide the following categories of service only: Care Home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Dementia - Code DE Date of last inspection Brief description of the care home The Beeches is a care home providing personal care and accommodation for 44 older people who have dementia. The home is owned by The Beeches (East Harling) Limited and is located in the village of East Harling and close to local amenities such as shops and pubs. 2 6 1 1 2 0 0 8 Care Homes for Older People Page 2 of 11 Brief description of the care home The home consists of a two-storey, converted house that is set in its own grounds. There are four shared rooms, the remainder being single rooms. All rooms have ensuite toilets, washbasins and showers or baths. The majority of rooms are on the ground floor. There are enclosed courtyards and a private garden to the rear and side of the Home. The fees are currently between £425 - £500 per week. Please contact the Home for more up to date information about fees. Care Homes for Older People Page 3 of 11 What we found:
This Random Inspection was carried out by two Inspectors on the 10th July 2009. The purpose was to check compliance against requirements that were made at the Key Inspection that took place on 2nd July 2009. The Responsible Individual and the Registered Manager were present for the majority of the Inspection and brief feedback was provided to them at the end of the visit to the Home. During the Inspection we spoke to the Responsible Individual, to the Manager and to four members of staff. We observed staff working with residents and we looked at a selection of records. We were shown the medication system and we also looked at some of the communal areas of the Home to check compliance with requirements that had been made about health and safety issues. This report does not list the requirements made at the Key Inspection as that report has not yet been finalised. What the care home does well: What they could do better:
Although there have been some improvements to the care plans there are still areas that are in need of further clarity to ensure that they provide detailed guidance for staff about how to meet residents needs. For example, a care plan has now been written for a resident who sometimes has behaviour that is aggressive towards other people. This does not include any suggestions to staff about how they may prevent the situations occuring or how they should support residents if it does. One of the residents care plans states that cream should be applied to the residents legs but in discussion with staff there was confusion as some staff said that the resident needs cream but one of the staff said that this is no longer used. There are still some discrepancies within the care plans for residents. For example, the Strengths Assessment states that the resident needs 1 member of staff to assist with mobility and the Manual Handling care plan states that 2 staff are needed to assist with
Care Homes for Older People Page 4 of 11 mobility. Both documents are dated the same day. We also found examples of information not being cross referenced appropriately. For example, a residents turn chart records that they had a fall but there is no record of this on the shift to shift handover or in the daily notes. We looked at the medication records relating to two of the residents. They both have medicines prescribed on an as required (PRN) basis. The guidance in place for the use of PRN medicines is very general and not specific for the resident. For example, the prescribers instructions on one of the medicines states to give 1-2 tablets but there are no details about when to give 1 tablet and when to give 2. The medication administration record shows that 2 tablets were given on one occasion and 1 tablet given on three occasions in the previous month. We looked at specific areas of the environment to check compliance with requirements made at the last Inspection. A requirement had been made for the call bells in the toilets to be available. We saw that the call bells do not have leads in the toilet next to the dining room and in the toilet opposite bedroom 9. If the call bells do not have leads then they cannot be reached if a resident has a fall. A requirement had been made about residents having their own toiletries. We looked in the bathroom and saw that there was still a large bowl of toiletries and dirty brushes, combs and razors. The Manager said that she had moved the previous bowl of communal toiletries but that staff had put them back. A requirement had been made for the raised cover in the corridor near to the dining room to receive attention to make it safe. The cover is still raised and we saw that there are also raised covers in the corridors near to the bedrooms. The Responsible Individual said that the member of staff who deals with maintenance cannot solve the problem and so she will need to speak to an expert but had not done this yet. She also said that she had recently replaced the carpet in these areas which may have caused the problem as it was not as thick as the previous carpet. A requirement was made for the stair lift to have a safety certificate. The Manager said that there is no safety certificate as the company who provided the chair lift have recommended that it is replaced as it is obsolete. The Manager said that she could not find any of the previous safety certificates. The Manager provided us with copies of letters dated 2006 and 2008 from the chair lift company which state that the chair lift is obsolete. 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 2. Care Homes for Older People Page 5 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 3 14 It is required that effective pre admission assessments are undertaken To ensure that the Home can meet the needs of the residents 30/06/2009 2 4 14 It is required that the Home only admits residents whose needs can be met there To ensure that the residents needs are met in a consistent way 30/06/2009 3 7 15 It is required that the care 30/06/2009 plans contain detailed guidance about how to meet the residents needs To ensure that the residents needs are met in a consistent manner 4 8 13 It is required that the residents are referred to health care professionals as required To ensure that residents receive appropriate healthcare 30/06/2009 5 9 13 It is required that accurate records are kept of the administration of medicines 30/06/2009 Care Homes for Older People Page 6 of 11 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Ti ensure that the medication system is safe and ensures that residents receive their medicines at appropriate times 6 9 13 It is required that medicines 30/06/2009 are administered in line with the prescribers instructions To ensure that the residents get their medicines at appropriate times 7 10 12 It is required that the privacy 30/06/2009 and dignity of the residents is respected To ensure that the residents are cared for respectfully 8 12 16 It is required that the residents are able to take part in meaningful activities To ensure that residents have a choice about taking part in meaningful occupation 9 15 12 It is required that the dignity 30/06/2009 of residents is respected at mealtimes To ensure that the needs of the residents are met in a respectful and dignified manner 10 18 13 It is required that the Safeguarding procedure is updated to reflect the local procedures 30/06/2009 30/09/2009 Care Homes for Older People Page 7 of 11 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action To ensure that staff have clear guidance in the event of a concern being raised. 11 18 13 It is required that all staff have received updated Safeguarding training To ensure that residents are protected from abuse 12 19 13 It is required that the raised 30/06/2009 cover in the corridor receives attention to make it safe To prevent residents and staff from trips and falls 13 21 23 It is required that the second 30/09/2009 bathroom is upgraded so that it can be used To ensure that the residents have access to an adequate number of bathrooms 14 21 23 It is required that the toilet areas are decorated and upgraded as necessary To ensure that the residents have access to toilets that meet their needs and that are nicely decorated 15 27 18 It is required that staff are 31/07/2009 provided in adequate numbers and with the right skills and experience to meet the needs of the residents To ensure that the needs of the residents are met
Care Homes for Older People Page 8 of 11 30/09/2009 31/07/2009 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 16 30 18 It is required that staff receive appropriate training in both mandatory subjects and areas relevant to the residents needs To ensure that staff have appropriate training to enable them to carry out their roles effectively 31/12/2009 17 32 12 It is required that the 30/06/2009 management of the Home is consistent and that the Managers work well together and with the staff team. To ensure that the residents needs are met in a consistent way and that the Home is well managed 18 33 24 It is required that an effective quality assurance system is in place To ensure that issues are identified and action taken to make improvements 30/09/2009 19 38 13 It is required that the health and safety of the residents and staff is promoted To ensure that the residents are safe 30/06/2009 Care Homes for Older People Page 9 of 11 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, 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 1 9 13 It is required that there is 31/08/2009 clear guidance about the use of PRN (as required) medication To ensure that residents receive medication at appropriate times and in a consistent way 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 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 11 of 11 - 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!
