Inspection on 15/11/05 for The Beeches

This inspection was carried out on 15th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 13/02/09

The Beeches 22/02/08

The Beeches 16/03/07

The Beeches 16/05/05

The Beeches 31/08/04

The Beeches 19/04/04

Similar services:

Insight - Eastchurch

Southfields

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33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Beeches 35 Ethelbert Road Canterbury Kent CT1 3NF Lead Inspector Tina Thomas Announced 15 & 16/11/05 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Beeches Address 35 Ethelbert Road, Canterbury, Kent, CT1 3NF 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) 01227 769654 Mr David Jogn Barzotelli Mrs Anne Cecilia Britnell Registered Care Home 18 Category(ies) of Care Home for Younger Adults with a Learning registration, with number Difficulty, 14, Service Users aged 65 with a of places Learning Difficulty,4 The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: LD(E) is restricted to those residents whose dates of birth are 26/07/1930, 02/04/1935, 16/11/1927 & 08/01/1931 Date of last inspection 16/05/05 Brief Description of the Service: Beeches is a care home for young adults. It provides personal care and accomodation to 18 people with learning disabilities. There is currently a variation to the registration because three of the people living in the Home are over 65. The Home is located in a residential part of Canterbury,not far from the city centre and close to public transport.The Home consists of a large detatched building with an extension to the rear. There are 16 single rooms and 1 shared. There is parking space at the front of the house and also some on road parking. At the rear of the house is a large garden area which is well maintained and accessible. The owner is Mr David John Barzotelli. Mr Barzotelli also owns another home in the area called Pilgrims Lodge. The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector conducted this inspection over a two-day period. The inspector was assisted by the Manager Mrs Anne Britnell. The inspector spoke with people who live at the home, the manager and members of staff. All standards assessed were met. The inspector received positive feedback from the comment cards filled in by the people that live at the home and also from relative and visitor comment cards. The inspection process identifies that the home is a happy environment, where people’s needs are met. People are encouraged to remain independent, and are supported to achieve their aspirations and goals. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 7 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 standard(s) 2 People’s aspirations and needs are assessed prior to their making a decision as to whether to live at the home. EVIDENCE: The Manager explained that a care manager would usually make referrals. The home conducts an in-depth and holistic pre- admission assessment with the help of the prospective service user and their supporters. The home invites people to visit the home four times prior to making a choice as to whether to live there. One of these visits would be an overnight or weekend stay, sometimes a second night visit is arranged to ensure that people make the right choice. Care managers usually give the home a lot of information, including a care needs assessment. There is always a multi disciplinary meeting prior to people choosing to live at the home to discuss needs. The home continues to assess needs at the initial visits and then weekly for six weeks after admission. Needs are then assessed on a monthly basis or less when necessary. The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 8 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 standard(s) 6,7,9 The care planning system is clear and consistent and provides staff with the information they need to meet Service Users needs. Service Users are involved, and understand as much as they are able, their care plans. EVIDENCE: The home uses the information gathered from the care manager’s assessment and their own pre-admission assessment to create a holistic care plan. Care plans clearly indicate each person’s individual needs and give clear instructions to staff as to how these needs can be met. Care plans are well documented and of good quality. The plans are reviewed monthly with the people who live in the home, who sign their agreement of the plan. Input from G.P’s, speech therapists and other health care professionals is clearly documented. A behaviours and strategies sheet gives staff instructions on how to deal with certain behaviours in a consistent manner, to enforce positive behaviour. Daily records reflect clearly the care plan. Staff were observed to offer people in the Home choices for example, ‘Would you like to join in this game’, ‘ how will you do that?’ ‘What will you wear if you go out?’ Care plans record the personal skills and household skills of those that live in the home. Several people discussed what they do in the home, which included The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 9 one person who tended the gardens. Suitable risk assessments are in place where necessary. The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 10 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 standard(s) 11,12,13,15 The people that live in the home have opportunity for personal development. People that live in the home take part in meaningful activities that are age, peer and culturally appropriate activities. People that live at the home are part of the local community. Staff support people in the home to maintain family links and friendships. EVIDENCE: Staff encourage the people in the home to continue to build on their skills. On the day of inspection, five people were attending a day centre. Some people go to Gateway club; others go to Club Connect, which is a day resource centre. One of the people that live in the home used to do voluntary work and this is something that the home would encourage and support, if appropriate, with other people. Two people have joined staff in completing a 1st aid course, and are now awaiting the fire safety training, two more want to join staff on the next occasion. The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 11 People that live in the home have a lot of community presence. Some of the local amenities the access are, the local swimming pool, shopping, pubs, theatre and cinema. Sometimes people go out as a group, but more usually key workers and the people in the home will go out together on a 1-1 basis. Staff hours are flexible so that activities can go on of a weekend and in the evenings. The home has its own mini bus. People that live in the home have the opportunity to go on a provided holiday once a year. People that live in the home are encouraged to take part if they wish in the voting process. 7 voted in the last election. Staff talk through the political process, and people living in the home read leaflets from the differing political parties. The visitor’s book indicates that the home has lots of visitors. The Manager told the inspector that visitors are very involved in the home and the Commissions relative surveys supported this. Some people that live at the home continue to visit their previous placement, and their friends visit them in return. The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 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 standard(s) 18,20 People that live in the home are encouraged to maintain their independence. Personal care is given in such a manner as to maintain privacy and dignity. People that live at the home are protected by the homes policies and procedures for dealing with medication. EVIDENCE: People’s personal care is identified in their care plans, which they sign agreement of. Care plans clearly identify people’s preferences for their care. All the people living in the home have a named key worker. All personal care occurs in either the bathroom or peoples own rooms. People choose if they want to have a lie in, in the mornings, although because of college etc. this usually happens at the weekend. People have their own clothes that are of their own choice and reflect their personalities. The home has aids and adaptations to promote independence for example raised toilet seat, raised commode, eating aids, and handrails. Specialist support is given by speech therapist, physiotherapist, chiropodist, dentist, epileptic nurse, diabetic nurse and one person has a massage therapist. The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 13 The home has a number of good quality policies pertaining to medication issues. The home has its medication delivered in monitored dosage systems this means that the majority of medication is pre-packed by a pharmacist. When they are delivered two staff check in these systems. Records of all medications ordered and returned are kept by the home. No one living at the home is currently able, or chooses to self-medicate. The home does not have any service users that require controlled drugs. All Staff that give medication have medication training. They are also observed administering medication on three occasions before being able to administer medication alone. The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 14 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 standard(s) 22,23 Service users feel their views are listened to and acted on. Service Users are protected from abuse, neglect and self-harm. EVIDENCE: The home has a robust complaints procedure. One person who lived at the home had made a complaint, which was thoroughly investigated. The person was told of the outcome and had signed the investigation form to say that they agreed and were happy with the outcome. The inspector spoke at length to one person who confirmed that they felt able to speak openly with all the staff and the manager, and was confident that they would do all they could to sort out any problems. The home has suitable policies in place to protect people who live at the home from abuse. Staff are aware of adult protection protocols and the homes own whistle blowing policy. All staff are have CRB checks prior to being employed. The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 15 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 standard(s) 24,26,27,28,30 EVIDENCE: The Home is clean and free from offensive odour. Furnishings, fittings, adaptations and equipment are of good quality and domestic in nature. Bedrooms are very personalised; some people have chosen how their room is decorated and furnished. People that live in the home have added their own effects to reflect their own personality. Furniture and fittings provided by the home is of good quality. Bedroom doors are lockable and some people that live at the home choose to use their keys. The Home has 4 baths and 7 toilets. Toilets and bathrooms are clean and have suitable aids to assist the people that live at the home. One bathroom has a hoist. Toilets and bathrooms are lockable. The home has two lounges and a dinning area, which can be used for a variety of activities. The Home has a selection of garden space, which has suitable garden furniture. The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35 People that live at the home benefit from staff having defined job descriptions. Staff have the competencies to meet the needs of the people living in the home. Staff fulfil the aims of the home and meet the needs of those people that live there. EVIDENCE: Staff understand their roles fully and this is demonstrated in their relationships with people that live in the home. On observation the staff’s relationship is very inclusive with the people that live in the home. For example, people where they are able help in the kitchen or garden, conversation is inclusive and not exclusive to staff. Staff under go induction training, which is in line with Skills for Care. The manager has a training budget; training is booked in January and added to throughout the year. Each member of staff has an individual training plan. Eight out of eighteen staff are qualified in N.V.Q Level 2 or above. All staff have mandatory training. Some have training in epilepsy awareness, diabetes awareness, Maketon, sexuality and learning disability, NAPPI, bereavement, incontinence, infection control, effective personal development and visual impairment. (This list is not comprehensive) The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39 The home is a well run home. The home has effective quality assurance and quality monitoring systems, based on seeking the views of service users. EVIDENCE: The Manager is qualified, competent and experienced to run the home. She has a N.V.Q. 4 in care and management, and has attended other courses in both management skills and care skills. The Home has a quality assurance process in place and continually strives to improve the home. People that live at the home are very involved with the decisions made in the home and about their own lives. They expressed that they felt comfortable in expressing their views and could do this either to their key worker, the manager, or more formally at a meeting. The home has an annual development plan which looks on a monthly basis at amongst other things, training, and decorating. Staff, visitors, and health care professionals, as well as the people that live at the home, are given quality assurance questionnaires. A report is made from the results, together with an The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 18 action plan. The home has team meetings for staff once a month, and the people that live in the home also have a formal meeting once a month. The Registered manager ensures the health, safety and welfare of the people that live in the home and the staff by ensuring suitable risk assessment, staff training including manual handling and COSHH . Risk assessments are in place so as to ensure the health safety and welfare of Service Users. Manual handling risk assessments should be more descriptive, for example; A good practice recommendation was made regarding this matter.(Recommendation 1 Part A). The Beeches H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 x x x x Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Beeches Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x H56-H05 S23597 The Beeches V248453 151105 Stage 4.doc Version 1.40 Page 20 NO 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 42 Good Practice Recommendations Manaual handling assessments should be more discriptive ie which hoist to use, and which sling to use with it. 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