Inspection on 19/10/07 for The Beeches

This inspection was carried out on 19th October 2007.

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 26/02/10

The Beeches 06/07/06

The Beeches 28/02/06

The Beeches 27/04/05

The Beeches 21/12/04

The Beeches 19/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Beeches (The) Fairfield Bungalows Blandford Dorset DT11 7HX Lead Inspector Andrea East Key Unannounced Inspection 19th October 2007 13:00 Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beeches (The) Address Fairfield Bungalows Blandford Dorset DT11 7HX 01258 453436 01258 451540 s.j.tuck@dorsetcc.gov.uk www.dorsetforyou.com Dorset County Council Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Susan Joy Tuck Care Home 25 Category(ies) of Learning disability (25) registration, with number of places Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Staffing levels must be those determined in accordance with guidance recommended by the Department of Health. The home can accommodate one named service user, who has a sensory impairment in the bungalow at The Beeches. The home must meet the staffing levels as agreed in their action plan to the commission dated 12th November 2003. To accommodate up to a maximum of 6 service users in the category of LD (E) at any one time. 6th July 2006 3. Date of last inspection Brief Description of the Service: The Beeches provides accommodation for adults who have a learning disability, providing long-term and short-term care. The home was purpose built in the 1970’s. Accommodation is arranged over two floors, with the lounges, dining room and domestic kitchen being on the ground floor. There is a large garden to the rear of the property. The home has good access to the local community and is within walking distance of the town centre. The Beeches has a bungalow attached to the main home that currently accommodates three service users. The people who live in the bungalow, are supported by two members of staff during the waking day, and one waking night staff. The bungalow has its own kitchen, dining room, lounge and bathroom. The home’s service users guide and a copy of the last inspection report could be found in the home’s office and is available on request. Details of charges are not detailed in this report, as they do not fully reflect the cost to the individual. Unit costs are available for each person on request. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection site visit was carried out over a day. A range of documents including staff and individuals’ files, policies and procedures were examined. People were spoken to in the home’s lounge and in private rooms and members of staff were also spoken with. The home’s manager was present throughout the inspection. Feedback about the home was also received by post in survey questionnaires, in the home’s Annual Quality Assurance Audit, provided by the Commission and by the home’s own quality assurance system. What the service does well: The service had good procedures for welcoming people into the home and ensuring that people’s assessed needs were discussed and agreed before coming into the home. The service promoted an independent lifestyle in which people were well supported to make choices, achieve personal goals and take risks. Good record keeping including assessments and care plans ensured that all staff were aware of people’s changing needs and how best to support people to meet those needs. The home provided people with the opportunity for personal development, through a range of appropriate activities, in the home and local community. For example attending activities offered by day services, horse riding, swimming, drama, attending college, local church, sport centres, cafes and shops. This meant that people were also supported to attend leisure activities and maintain positive relationships. The home had an excellent meal service that meant people enjoyed their meals and meal times, with well prepared varied meals, served in a variety of ways and supported by staff when necessary. Members of staff were well trained and competent, so that people received from staff good personal support, which met people’s physical and emotional needs. This included supporting people to understand their medication needs. Good policies and procedures on the safe administration of medications, helped to keep people safe from harm. The service had a good recruitment system so that people were protected from those who may be unsuitable to work with vulnerable adults. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 6 The home and grounds presented as a homely, comfortable and safe environment, which was well maintained, clean and hygienic. The Beeches was a well managed home, that took into consideration people’s views on how to improve the service and protected people from harm by good health and safety practices. 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 summary of this inspection report can be made available in other formats on request. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People’s individual needs and aspirations were assessed and discussed with the person coming into the home or their advocate. EVIDENCE: The manager said that during the pre-admission stages of someone coming into the home a member of staff was identified as a ‘link worker’. The link worker would then be responsible for forming and maintaining a relationship with the new person coming into the home. A written policy on the ‘link worker’ system described how this system worked. The policy detailed how the link worker should “become familiar with the strengths and limitations of the individual and the areas of assessment needed to ensure that people’s needs were met”. Staff had compiled two large files for each person living at the home. These files contained assessment information from a range of health and social care professionals, which had been considered before the person moved into the home. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 9 Staff had discussed with the person moving into the home and their relatives or advocates the information in assessments. Assessment records also included how people’s strengths would be built upon to reach planned goals safely, with support from staff, family, friends and other professionals. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People were supported to make choices, achieve personal goals and take risks as part of an independent lifestyle. This was recorded in detail in individual plans. EVIDENCE: Care plans and assessments related to two of the people living at the home were examined. Care plans were very detailed, reflecting the ongoing assessment of people’s needs, changes in care and how people were supported in making decisions. Risk assessments were completed showing input from the person choosing to live at the home, their advocates and social care professionals. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 11 Assessments and care plans were provided in different formats such as pictures and simple words to help people understand their care needs. The staff ‘handover’, where staff communicated about people’s needs, showed that staff had a detailed knowledge of individuals’ needs and how best to support people to make choices and make decisions. Surveys returned to the Commission, from people who used the service (some were completed on their behalf) said that they made decisions about what they did throughout the day and night. Surveys from relatives, carers and advocates said that the service “supported people to live the life they chose”. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16 & 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People had the opportunity for personal development, through a range of appropriate activities, in the home and local community. People were supported to attend leisure activities and maintain positive relationships. People enjoyed their meals and meal times, with well prepared varied meals, served in a variety of ways and supported by staff. EVIDENCE: The manager and staff spoken with said that each person living at the home had lots of opportunities to attend a range of activities in the home and local community. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 13 Files held written records for each person on the kind of activities people enjoyed and attended. These activities were also detailed in the home’s annual quality assessment audit and included “social, domestic and therapeutic activities”. Such as attending activities offered by day services, horse riding, swimming, drama, attending college, local church, sport centres, cafes and shops. All activities were based on individuals’ strengths and development needs and were monitored and recorded in care plans, reviews and assessments. Surveys from the relatives and carers of the people using the service said that one of the things the home did well was too “keep up with interests and hobbies”. They also said “activity days are arranged when possible and in conjunction with the day centre, there are also other interests to be pursued if they wish”. The cook described the working practices in the kitchen, which complied with health and safety and environmental health guidance. All foods, menus and people’s choices were well recorded and passed on to all staff to ensure that people ate the food they liked and chose. The staff team working with the cook and catering staff were developing menus that were described in pictures. Pictures were also used to help people make a choice in the foods bought and served. The dining room had a self-service area for people to be as independent as possible and serve themselves. For those people who needed more support, members of staff were available and were observed discussing what was on the menu with people choosing what to eat. Surveys from relatives and carers of the people using the service said that the home had “good meals and happy environment in the dining areas”. A survey from a specialist nutritionist praised the home for the support given to people with complex diet and fluid needs. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 & 21 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People received from staff good personal support, so that their physical and emotional needs were fully met. People were supported to understand their medication needs. The home had good policies and procedures in place on the safe administration of medications, which helped to keep people safe from harm. EVIDENCE: Information held on people’s individual files included the ongoing assessment of people’s personal and health care needs. These files included assessments from health professionals such as speech and language therapists, psychologists, physiotherapists and occupational therapists. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 15 The files also held information on care needs consent forms, for the dentist, audiologist and chiropody. Health care ‘tracking records’ included weight charts and a record of specific personal care needs. Surveys from health professionals said what the home did well was “an awareness of small changes in physical and mental conditions and contacted the professionals in a very prompt manner”. Surveys said that individual health needs were always met by the service. The home had an excellent system for recording, administering and supporting people in understanding and taking medication. The manager said that since the last inspection, new procedures had been consolidated and more time had been spent working with people (using various types of communication aids) to help people understand the medicines they were taking. This approach was clearer recorded in people’s files. Medication records showed the administration and review of medicines and that staff were recording when medication was administered. The storage area for medication was clean, tidy and organised and the members of staff spoken too were well aware of people’s medication needs. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A robust complaints procedure ensured that People views were listened to and acted upon. People were protected from abuse, neglect and self-harm. EVIDENCE: The home’s annual quality assessment audit described the home’s policies and procedures in dealing with concerns and complaints. This included a minor complaints or “grumbles book” where their concerns were discussed with the manager and recorded. There was also a record made of when the issue was resolved. This process was observed as one of the people living at the home wanted to raise concerns about something that had happened earlier in the day. The manager spoke with the person at length and discussed the process and possible outcomes with the person raising the concern. A complaints procedure with the Commission’s contact details was made available to the people using the service, relatives and staff. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 17 Staff received regular training and updates on safeguarding/adult protection. Staff spoken with knew how to raise concerns and felt comfortable in addressing issues raised by the people living at the home. Surveys from people using the service said that they felt able to talk to their link worker or the manager if they were not happy. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service provided a homely, comfortable and safe environment, which was clean and hygienic and people enjoyed. EVIDENCE: On touring the premises the home appeared to be clean, tidy and comfortable. People’s individual rooms were personalised with ornaments, photographs and furnishings, which people had been supported to bring into the home and choose. Since the last inspection the home had completed the changes to improve the downstairs bathroom and had continued with ongoing maintenance and repair. Also addressed since the last inspection were concerns about food labelling and access to the kitchen from the adjoining bungalow. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 19 All foods were clearly labelled and the manager confirmed that action had been taken, in conjunction with the fire authority, to ensure that the door from the bungalow to the kitchen was secure, limiting the access to the kitchen. The manager demonstrated how this door now operated. The home had a range of policies and procedures in place related to the environment and health and safety, including risk assessments, fire safety procedures and infection control guidance. Staff said that they aware of health and safety issues in the environment and had received training in this area. Alternative accommodation that is more suitable to meet the needs of the people who lived at the home, was planned for the future. These plans would also address concerns about the lack of communal space for those people staying at the home for short-term care. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People’s individual and joint needs were met by well trained, competent staff. Staff had been subject to rigorous recruitment policies and procedures, so that people were protected from those who may be unsuitable to work with vulnerable adults. EVIDENCE: Staff said that they received opportunities to attend a range of training. A training spread-sheet detailing all the staff training and when training needed updating were regularly completed. This enabled the manager to plan for staff to attend training when they needed it. The manager and staff described ‘core training’ such as first aid, health and safety and safeguarding adults and ‘enhanced training’ that looked at more specialist topics such as epilepsy and dealing with aggression. Staff also received induction, training workbooks when starting employment in the home. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 21 Staff files held clear details of staff roles and responsibilities in job descriptions and procedure documents such as the role of the ‘link worker’. The home had a good recruitment process that included interview checklists and questions, references and police checks, identity checks and photographs of staff. Surveys from health professionals said that staff usually had the right skills and experience to support individual social and health care needs. One survey said “I feel that staff are motivated, caring and do the best of their abilities to help residents lead a fulfilled and happy life”. The number of staff with a National Vocational Award at level 2 in Care was over fifty per cent of the employed staff. This was an improvement in the previous numbers of staff with this qualification, from the last inspection. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People received services through a well managed home, which takes into consideration people’s views on how to improve the service. People were protected from harm by good health and safety practices. EVIDENCE: The manager was supported in the home by a senior management group, personnel departments, senior support workers, care, catering and domestic staff. Care staff also did domestic tasks with the people living at the home. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 23 The manager had years of experience in care and had completed a National Vocational Award level 4 award in care management. Staff said that they felt confident that the home was well managed. The manager said that feedback about the quality and development of the home was actively sought from the people living at the home and their advocates. People were consulted formally and informally; formally through a quality assurance system that asked people’s views through questionnaires. The results of the questionnaires were then published and made available on request. The questionnaires were very positive about the services provided by the home. People’s views were also sought through meetings, one to one discussion with link workers and regular reviews of people’s care. Surveys from relatives and carers said that they were kept well informed about the home and developments in care. The home had a range of policies and procedures on health and safety. The manager and staff team had implemented a range of systems to protect people such as good recruitment and training of staff, audit checks and effective communication systems. Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 x 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 3 3 x 3 x x 3 x Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 25 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. 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. Refer to Standard Good Practice Recommendations Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Beeches (The) DS0000032198.V351008.R01.S.doc Version 5.2 Page 27 - 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!