Inspection on 11/11/08 for The Beeches

This inspection was carried out on 11th November 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Beeches 07/08/07

The Beeches 24/08/06

The Beeches 04/10/05

The Beeches 14/06/05

The Beeches 08/02/05

The Beeches 06/08/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Beeches Beech Road Armthorpe Doncaster South Yorkshire DN3 2DZ     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: Christine Rolt     Date: 1 1 1 1 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. that people have said are important to them: They reflect the things 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Beeches Beech Road Armthorpe Doncaster South Yorkshire DN3 2DZ 01302300312 01302835980 beechesdoncaster@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross Care Centres Limited Name of registered manager (if applicable) Mr Garren Painter Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Beeches is located in the village of Armthorpe and is surrounded by shops, pubs, churches and a library all within walking distance of the home. The home was purpose built in 1990 and provides residential care and accommodation for 32 older persons. It has pleasant gardens with seating. There is a car park to the rear of the home. All 32 bedrooms are single occupancy. There are nine bedrooms on the ground floor, three of which have patio doors to the garden. On the first floor, which can be accessed by passenger lift or stairs, there are twenty three bedrooms. Communal rooms comprise a lounge and dining room and a separate quiet lounge. People living in the home who smoke also have a smokers room. The homes fees were from 400 pounds and 14 pence to 475 pounds per week. A third party top up fee was charged for Executive Rooms. Additional charges were made for toiletries, hairdressing, chiropody and Care Homes for Older People Page 4 of 26 0 Over 65 32 care home 32 Brief description of the care home personal newspapers and magazines. The manager supplied this information during the site visit on 11th November 2008. Information about the home including the Statement of Purpose, the Service User Guide and inspection reports were available in the reception area of the home. Copies of the Service User Guide were available on request. Care Homes for Older People Page 5 of 26 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: The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The last key inspection of this service was on 7th August 2007. Care Homes for Older People Page 6 of 26 This was a key inspection and comprised information already received from or about the home and a site visit. The site visit was from 9:45 am to 4:45 pm. The manager completed an Annual Quality Assurance Assessment before the site visit. This document gave him the opportunity to tell us what the home did well, what had improved and what they were working on to improve. Various aspects of the service were then checked during the site visit. Care practices were observed, a sample of records was examined, a partial inspection of the building was carried out and service provision was discussed with the manager and the operations manager. The majority of people living in the home were seen throughout the day and several were chatted to. Questionnaires were sent to the home for distribution to people living in the home and their relatives and several visitors were asked to complete questionnaires on the day. The care provided for three people was checked against their records to determine if their individual needs were being met. All information, opinions and comments were considered for inclusion in this report. The inspector wishes to thank people living in the home, visitors, the staff, the operations manager and the manager for their assistance and co-operation throughout the day. What the care home does well: What has improved since the last inspection? The requirements from the last report had been met. People considered that the home had improved since the appointment of the new manager. This area (regarding communication and information) has improved since the new manager has been appointed. Since the new manager in place, staff have become more friendly and the home a better atmosphere. Care Homes for Older People Page 8 of 26 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 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 26 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 using this service had full assessments of their needs. Evidence: Assessments were carried out and copies were available on the three files that were checked. These contained good detailed information of each persons individual needs and wishes. This home does not provide intermediate care. Care Homes for Older People Page 11 of 26 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. Care and health needs were met and recordings of person centre care were almost met. Medication procedures were met. People were treated with respect. Evidence: People living in the home looked well cared for, clean and appropriately dressed. They said that they were happy living in this home. Staff were observed to treat people with respect and kindness and interactions were good. People said that they received the care and support they needed and were treated with respect and dignity. The home had a Dignity Champion who promoted respect and dignity. However, the manager could not confirm that all people had been given keys to their bedrooms. This was discussed. Three care plans were checked in details. They provided good details of each persons needs and wishes and information of how these were to be met. Daily records were only completed once per day therefore there was not sufficient information to determine how each person spent their day and whether all aspects of their needs had Care Homes for Older People Page 12 of 26 Evidence: been met throughout the day. There were activities sheets in the files but these were blank. More frequent recording covering physical, health, emotional and social needs was discussed with the manager. The care plans were reviewed as peoples needs changed and detailed review meetings were held every six months. It was recommended that care plans be reviewed at least once per month as a sign of good practice. Files contained risk assessments with details of the identified and associated risks and the action taken to minimise the risks. Accidents were recorded and 24-hour monitoring charts were used for the close monitoring of people who had had an accident or fall where there was no apparent injury at the time of the incident. This is good practice. People said that their health needs were met and relatives were kept informed. Comments were, They would inform me if something was wrong. I am always informed immediately if there are any problems. ...they ring straight away to let me know whats happening. They are ready with any help you need.The manager said that people who were able were encouraged to visit their GP as this encouraged their involvement in the community and promoted their independence. This is good practice. Peoples files contained records of how their health needs were monitored and reviewed. A medication round was observed and the correct procedures were followed. The person dealing with the medication wore a tabard that stated that she was not to be disturbed whilst dealing with medication. This is good practice. The Medication Administration Record (MAR) sheets were checked and each medication was signed and dated on receipt and quantities were recorded. Staff competency for dealing with medication was checked regularly and records were available. This is good practice. Controlled drugs were stored in a controlled drugs cupboard. The controlled drug register was checked. Medication was recorded properly with two signatures and a diminishing total. Medication that needed to be kept cool was kept in a medication refrigerator. The temperature was recorded daily. Care Homes for Older People Page 13 of 26 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 were generally satisfied with their lifestyles in the home. Evidence: The home had an activities coordinator. Weekly activities were displayed on the notice board and the home also had notices advertising monthly activities. Some relatives considered that more could be done on an individual basis. Comments were, The activities seem to have improved but I would like to see more interaction between staff and residents, I do feel that more could be done to stimulate the residents....I have asked them to walk her around the home or better still take her for some fresh air in a wheelchair (not happening). Activities were discussed with the manager during the site visit and the necessity of recording all group and individual activities and interactions. See previous section Health and Personal Care. Relatives and friends could visit the home when they wished and several were seen visiting the home throughout the day. Care Homes for Older People Page 14 of 26 Evidence: People living in the home could choose how to spend the day. Several chose to spend their time and eat their meals in their rooms. Information on peoples preferences were recorded in their files. The dining room was clean and tidy. People had a choice of meals. The home used a recognised system called Nutmeg which determined whether meals were nutritionally balanced. Graphs of this together with a full menu was displayed in the entrance hall. The menu contained the full list of all meals and was in small print. On the day of this site visit, people had a choice of cottage pie or omelet with salad. Both meals were well presented and looked appetising. People living in the home said that they always or usually enjoyed the meals. The manager said that staff went round and asked people for their choice. However, there was no menu board to inform and remind people of the choice of meals. One person considered that breakfasts could be more varied. At times breakfast could be more varied. While I appreciate cooked breakfasts are a problem, maybe eggs in some form could be offered. The availability of cooked breakfasts was discussed with the manager who said that they were available and people only needed to ask. The use of a menu board in the dining room would ensure that people knew what was on offer and had a positive choice at all meals. Care Homes for Older People Page 15 of 26 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. People felt they were listened to and protected. Evidence: The complaints procedure was seen and the complaints book was checked. People said that they knew how to complain and who to tell if they werent happy. All staff had undertaken adult safeguarding training and this was updated at regular intervals. There had been one adult safeguarding issue but this did not involve anyone working in the home. Care Homes for Older People Page 16 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in a clean and pleasant environment but some aspects of safety need improvement. Evidence: The home was clean and there were no offensive odours on the day of this site visit. Bathrooms and lavatories were clean, tidy and fit for purpose. Liquid soap and paper towels were available to prevent cross contamination. Bedrooms were attractive and had been personalised by their occupants. Some had been newly redecorated. Some bedrooms had beds against the wall and some wardrobes were not stable. Denture cleaning tablets were on view in one unlocked bedroom. Risk assessments need to be carried out to ensure that people living or working in the home are not put at unnecessary risks. Some bedrooms did not have shelves for toiletries, therefore toiletries were on the edge of the sink. The provision of shelving was discussed with the manager during the site visit. Aids and adaptations were fitted throughout the home to maintain peoples independence. The gardens were neat and tidy and the manager said that the Care Home Liaison Team in Doncaster had awarded the home a prize for their raised vegetable bed, which Care Homes for Older People Page 17 of 26 Evidence: people living in the home had planned and planted. A relative commented. The new manager has ensured the outside areas are now user friendly and has encouraged residents to help make the garden a lovely haven. Care Homes for Older People Page 18 of 26 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. People were cared for by a well trained and dedicated staff team. Evidence: There were sufficient staff on duty at the time of this site visit. The manager said that the home had sufficient bank staff to cover holidays and sickness therefore agency staff were not used. This meant that there was continuity of care for people living in the home. People considered that the staff were good and treated people living in the home with respect and dignity. The home had a Dignity Champion who promoted respect and dignity. Information of files showed that staff undertook induction training. The Annual Quality Assurance Assessment stated that over 80 per cent of all staff had achieved or were working towards the National Vocational Qualification in care. The manager said that staff undertook skills training including pressure care, customer care, dementia awareness, care planning and dealing with challenging behaviour. A copy of the staff training graph verified this. The recruitment files for four members of staff were checked. All contained the Care Homes for Older People Page 19 of 26 Evidence: relevant checks and information including evidence of Criminal Records Bureau disclosures. Correspondence was also available to show that the system was robust. Care Homes for Older People Page 20 of 26 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 manager promoted and managed the home in the best interests of people living in the home. Evidence: The manager had applied for registration with the Commission for Social Care Inspection. People liked him and there were positive comments about the improvements he had made to the home. Every Thursday afternoon he held a surgery for anyone who wished to see him but he also stressed that he had an open door policy for anyone who wished to see him. The home had a quality assurance monitoring system that included audits of systems and records within the home and checks of the environment. Residents meetings were held every two months and relatives meetings were held every six weeks. Questionnaires were given out to people living in the home and their relatives. The manager had made the questionnaires more appealing for people living in the home by Care Homes for Older People Page 21 of 26 Evidence: increasing the size of text and incorporating pictures and symbols. The results from questionnaires were collated. The manager said that to demonstrate this he produced bar charts showing the results. As areas improved, the results were compared on new bar charts. These were all discussed at the meetings. The manager informed the CSCI of any incidents that affected people living in the home and the responsible individual carried out visits to the home and produced reports as required by regulation. A relative commented, We do have regular meetings with the management, and discuss our views at length. Money held on behalf of people living in the home was banked in each persons name with their own account and gaining their own interest. The home kept accounts of all transactions and receipts were available. Mandatory health and safety training was ongoing and a training matrix was available with dates of training undertaken. The matrix also highlighted when staff were due to undertake refresher training in line with the organisations policies. Records and certificates were available to verify that service and maintenance checks were carried out within the regulated timescales. Care Homes for Older People Page 22 of 26 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 26 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 1 7 12 Daily records must be 06/01/2009 completed more frequently to ensure that each persons needs and wishes are met and provide a more holistic view of each person. To ensure that peoples needs and wishes as per their care plan have been met. 2 19 13 The risks associated with 06/01/2009 unstable furniture, beds against walls and display of caustic substances i.e. denture cleaning tablets, must all be assessed and action taken to minimise the risks. To ensure that there are no unnecessary risks to people living or working in the home. Recommendations These recommendations are taken from the best practice described in the National Care Homes for Older People Page 24 of 26 Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 7 10 As a sign of good practice care plans should be reviewed monthly. People should be given a keys to their bedroom unless there is an identified reason for not doing so which should be noted on their care plan. Consider providing a menu board in the dining room to inform and remind people of the choice of meals on offer. Some bedrooms would benefit from having shelves fitted near to wash basins for the storage of toiletries. 3 4 15 19 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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 26 of 26 - 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!