Inspection on 12/07/05 for The Beeches

This inspection was carried out on 12th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

The Beeches 03/08/09

The Beeches 28/05/08

The Beeches 29/05/07

The Beeches 31/05/06

The Beeches 05/12/05

The Beeches 25/10/04

The Beeches 22/07/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE The Beeches Green Lane Newtown Stockton-on-Tees TS19 0DW Lead Inspector Jackie Herring Unannounced 12 July 2005 10:00 am 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. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Beeches Address Green Lane Newtown Stockton-on-Tees TS19 0DW 01642 618818 01642 618818 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) TL Care Ltd Mrs Julie Hickey Care Home 64 Category(ies) of DE(E) Dementia - over 65 (32) registration, with number OP Old age (32) of places The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24/10/04 Brief Description of the Service: The Beeches is a two storey 64 bedded purpose built care home providing personal care for older people and for individuals suffering from dementia within two specific units. Personal Care for older people is provided on the ground floor whilst care for people suffering from dementia is provided on the first floor. There is a patio and garden area available for use.The home has been operating since January 2002. It is situated within an urban setting with close access to the town centre and public transport.The vast majority of the bedrooms are single rooms with ensuite facilities. There are two double rooms available within the home also with ensuite facilities. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place over one inspection day, six inspection hours in total. Three residents were interviewed individually and a group discussion took place as well as informal chats with residents. Two relatives were involved in discussions about the home and there was also detailed discussion with the manager. A number of records were also examined such as residents records, personal allowance records and staff files. What the service does well: What has improved since the last inspection? What they could do better: The actual template for the residents assessment and care needs records are comprehensive, however they are not being completing in sufficient detail and do not contain sufficient information about care needs. There is also the need to include details of individual preferences, decision-making and lifestyle habits. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 6 The two-lounge/dining rooms on the upstairs unit are in need of further development to establish exactly what the use and purpose of the areas are and to create a more homely environment. The upstairs corridor carpets are also in need of cleaning or replacement as they are showing signs of wear. Some concern has been raised in regard to data protection and confidentiality around the “nurse station” areas and the potential for telephone conversations to be overheard due to this area being open and public. It is again recommended that consideration be given to increasing the privacy of these areas. 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. The Beeches B51-B01 S53 The Beeches V232559 120705 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 The Beeches B51-B01 S53 The Beeches V232559 120705 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) 1, 3 The statement of purpose continues to need further development, in a format that offers prospective residents information about the home. The assessment of prospective service users must be more detailed to ensure that individual needs will be met. EVIDENCE: The statement of purpose is in the process of being reviewed and updated and developed into a more useable format with a clearer flow of information. Assessments are carried out prior to any new service users being admitted into the Beeches by the relevant professional such as Social Worker or Community Nurse; copies of these assessments are contained within resident’s files. The Beeches provides care for two categories of clients each within their own specific units. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 9 Work continues to be underway to introduce new assessment and care plan documentation, this was evidenced within three of the four files examined and developments had been made, however they were still in need of further detailed information about individual assessed needs and also to include lifestyle preferences. The fourth files contained very little information and could not demonstrate what the residents needs were or how the resident was being cared for. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 10 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) 7, 8, 10 The assessment and care plans did not contain sufficient detail to ensure that health, personal and social care needs are fully met. EVIDENCE: Four sets of resident’s records were examined during the inspection, two from each of the units. Through an examination of the records and discussion with the manager and staff, it was acknowledged that some progress had been made in regard to the assessment of individual needs and care planning, however further development was needed. There is also the need to ensure that the assessment of need and plans of care are current and reflect the actual needs of the residents. The assessment of needs was being evaluated monthly, rather than care plans being developed and these being evaluated. There was the need to include more detailed information and more direction of care for staff to follow, as well as plans of care for moving and handling and other risk assessed areas. The flow of information for GP involvement such as blood samples and urine samples needed to be improved to ensure that the results were obtained and any treatment commenced. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 11 Residents who were interviewed said, “It’s lovely here they look after me well”, “It’s a good home, I am quite satisfied”, “Staff are very friendly, treated properly, with the correct tone and manner”, “Very much treated with dignity and respect, certainly as an individual”. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 12 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) 12, 13, 15 Residents are able to maintain relationships with their friends and families and are able to take where possible certain levels of control over their lives. Residents are generally happy with the meal provision. EVIDENCE: During discussion with residents on the ground floor they described a flexible life at The Beeches and one in which they were able to make decisions and take control over their lives. One gentleman said, “I look forward to my cup of tea in bed on a morning, I like to bathe myself and I keep myself occupied with my TV, video, Sony Walkman and I can dip in and out of activities as I want to”. Residents spoke enthusiastically about the recent summer fair and barbecue and they also described activities such as entertainers and outings. Residents spoke of being able to follow their religious beliefs and one resident’s talked about attending the local Kingdom Hall. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 13 It was confirmed through staff and service user interviews that family members and visitors are welcomed into the home and that they are able to visit freely. During the inspection several visitors were observed within the home. Opportunities for visiting were also discussed with relatives who confirmed that they could visit at any time. Meals were discussed with the residents and they confirmed there was a choice of meals, in the main the meals were described as, “alright”, “on the whole very good”, “passable, I am realistic, cooking for 60 people”. One resident has made a request that meals are served on hot plates, which the manager in addressing. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 14 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) 16, 18 Residents are confident that any complaint would be acted upon appropriately. Robust procedures are in place, which ensure that residents are protected from abuse. EVIDENCE: A complaints procedure is in place and was observed to be on display on notice boards within the home. Staff confirmed that they were aware of the procedure and would be able to offer residents/relatives advise about making a complaint should this be required, or indeed handle it in the first instance. Residents said that they would be confident about raising any concerns should the need arise. Staff were aware of the components of abuse and confirmed that they had received training on reporting abuse. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 15 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) 19, 20, 26 The environment at The Beeches is generally safe, clean and well maintained, although the corridor carpets on the first floor need to be cleaned. Further development is needed to the upstairs unit to provide a more conducive and homely environment. EVIDENCE: Whilst walking around the home on the day of the inspection, it was observed to be clean, well maintained and odour free. Residents and relatives who were interviewed said that the home was always kept very clean and that it was a very pleasing environment. The two-lounge/dining rooms on the upstairs unit are in need of further development to establish exactly what the use and purpose of the areas are and to create a more homely environment. Currently, they are looking somewhat cluttered, with tables being up against the walls and equipment inappropriately stored. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 16 One of the shower room doors on the ground floor needed attention, as it would not close. The hot water in the hairdressing salon was tested and exceeds the required temperature, immediate action was taken to address this. A number of carpets were in need of cleaning or renewal, the manager did say that they were regularly cleaned, however this had little positive effect on improving their appearance. The garden area and patio was very pleasing to residents who stated they enjoyed being out in the garden. The ramp leading from the lounge into the garden had been improved and now had railings in place for additional safety for residents. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 17 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) 28, 30 The home provides staff with opportunities to complete the appropriate qualifications for their job role; the training programme needs to be more structured to ensure that all staff are fully up to date ensuring competence to do their jobs. EVIDENCE: The manager confirmed that 26 care workers had achieved NVQ Level 2 in care; with a further 14 care workers underway with it. Three care workers have NVQ Level 3 and a further 6 are underway. Currently, 58 of care workers have the required qualification. The manager confirmed that training was taking place and there had been dementia care training as well as mandatory such as moving and handling. Although training is taking place there is no actual plan or checklist, which the manager said, would be developed. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 18 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) 33, 37 Confidentiality of resident’s information is not as robust as it could be and does not fully safeguard personal information. Quality assurance systems have not been fully implemented and do not demonstrated that the home is run is the best interest of the residents. EVIDENCE: During discussion with the manager, it was confirmed that quality assurance systems continue to be in need of development and introduction, this includes obtaining the views of residents and relatives about the service being provided. Records are being stored appropriately however there continues to be some concern in regard to data protection and confidentiality around the “nurse station” areas and the potential for telephone conversations to be overheard due to this area being open and public. It is again recommended that consideration be given to increasing the privacy of these areas. The Beeches B51-B01 S53 The Beeches V232559 120705 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 2 x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 2 2 x x x x x 3 STAFFING Standard No Score 27 x 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x x x 2 x The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 20 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. 2. Standard OP1 OP3 Regulation 4 14 Requirement The statement of purpose must be updated and must be available within the home. The preadmission assessment of need must contain more detail of individual needs and must demonstrate that needs can be met. Further development must be completed in regard to residents assessments of need and must include lifesyle preferences. Further development must take place to ensure that residents have detailed individual plans, risk assessments and health records. Corridor carpets on the first floor must be cleaned or replaced. Timescale for action 1 October 2005 1 November 2005 1 November 2005 1 November 2005 1 September 2005 1 November 2005 3. OP7 14 4. OP8 14 5. 6. OP19 OP20 23 23 7. OP33 24 The two lounge/dining rooms on the first floor unit must be developed further to ensure they are homely and conducive for purpose. Quality assurance systems must 1 be developed and introduced and December include information about 2005 residents and relative views of the service. B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 21 The Beeches 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. Refer to Standard OP15 OP30 OP37 Good Practice Recommendations The meal provision should be reviewed further and residents should be consulted and their views taken account of. The training programme should be developed further to identify all of the training and that all staff are up to date the required training. Further considertation should be given to incresing the level of confidentiality around the nurses stations. The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit B, Advance St Marks Court Teesdale, Stockton-on-Tees TS17 6QX 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 The Beeches B51-B01 S53 The Beeches V232559 120705 Stage 4.doc Version 1.30 Page 23 - 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. 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