Inspection on 23/08/05 for The Beeches

This inspection was carried out on 23rd August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Beeches 12/02/07

The Beeches 07/02/06

The Beeches 25/11/04

The Beeches 13/08/04

The Beeches 11/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Beeches Yew Tree Lane, Dukinfield SK16 5BJ Lead Inspector Janet Ranson Announced 23 & 24 August 2005 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 F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Beeches Address Yew Trees Lane, Dukinfield, SK16 5B 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) 0161 338 4922 0161 303 8742 Tameside Care Limited Marie Mcpherson CRH Care Home 32 Category(ies) of OP Old Age (32) registration, with number PD Physical Disability (1) of places PD(E) Physical Disability - over 65 (32) The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: No service user under the age of 63 may be admitted into the establishment. Date of last inspection 25th November 2005 Brief Description of the Service: The Beeches is a purpose built establishment, situated to the rear of Yew Trees, both homes being owned and managed by Tameside Care Limited. The home is registered to provide accommodation for 32 older people, some of whom may have a physical disability. All the accommodation has en-suite facilities and is above the minimum standard size. The doors are lockable and there is a lockable facility in each room. Bedrooms are located over two floors. Each floor has a sitting and dining area with small kitchens. All areas are equipped to a good standard. An additional small lounge is provided on the first floor for those service users who smoke. Kitchen and laundry facilities are provided by the adjacent home (Yew Trees) and a landscaped secure garden (to the rear) is also shared by both homes. A small external sitting area is also available to the front of The Beeches. Car parking is provided at the front of the building. The home is located within a residential area of Dukinfield, close to shops and on a bus route. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out over two days, a total of 11 hours. The Beeches is registered by the Commission for Social Care Inspection (CSCI) to provide personal care for up to 32 people over 65 years of age. It is owned and managed by Tameside Care Limited, a not for profit organisation. The manager who was present throughout the inspection is registered with CSCI. In addition to teams of carers, the organisation employs domestic, catering, laundry and maintenance personnel. Individual case files and care plans of five residents were examined as part of the inspection process. They concerned people who had lived at the home for a long time, were newly admitted and whose needs were changing. Wherever possible, the residents were invited to talk to the inspector of their experiences and expectations. Two key workers were interviewed and one resident’s visitor assisted the inspector with her comments. The inspector also spoke with the senior staff and a housekeeper. Observations of staff practice were also made during the first day. Ten service user comment cards were distributed prior to the inspection and seven were returned. Responses concerning the food were mixed, however those regarding suitable activities were all positive. One person commented: “I really like it here. Everyone is so nice.” One resident indicated she would like to speak with the inspector. comments were, in general, very positive. Her Ten relative/visitor cards were made available and five returned to the inspector. All the respondents indicated they had not made a complaint and all were satisfied with the overall care provided. Written comments confirmed this to be the case: “… is treated with dignity and respect. The family have nothing but good things to say about The Beeches.” “Excellent home. … is really happy here. Staff are all great and good fun.” “… is very happy and contented here and the staff are very helpful and really understanding.” The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 6 One resident commented to the inspector that the best thing about living at The Beeches was that she felt safe, particularly at night. Two comment cards were also received from visiting general practitioners. They contained no adverse comments. The home has been operating for three years and it is understood that a programme of redecoration has been planned. What the service does well: What has improved since the last inspection? What they could do better: The care planning process would be improved with the addition of individual social histories. At present, the staff have knowledge of certain details that could affect the resident or their welfare, this is not documented in the care plan. The Beeches shares kitchen and laundry facilities with the adjacent residential care home (Yew Trees). There has been a history of problems concerning this situation and although there were no complaints made to the inspector at this time, it is considered to be unacceptable. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 7 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 F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 8 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 F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 9 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) 3 & 5 Systems are in place to ensure the residents’ needs can be fully identified and met by the home. Prospective residents have the opportunity to visit the home and have a meal before making a decision to move in. EVIDENCE: Care needs assessments were contained within the five care files examined as part of the inspection. The home also has a process of assessing potential residents’ needs carried out by a senior member of staff. By completing such an assessment, the home can ascertain individual needs and ensure they can be met. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 10 A resident who spoke with the inspector confirmed they had visited the home whilst they were still in hospital, and was pleased to be invited to share a meal with the other residents. She had also had the opportunity to visit other establishments but felt that The Beeches would be more suitable. Her family had also visited the home at another occasion. The manager confirmed that, wherever possible, prospective residents and their representatives are offered the opportunity to look around the home. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 11 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, 9, 10 & 11 The residents’ personal care health and welfare needs are fully documented, met and reviewed, including at the final stages of life. The residents are enabled to self medicate wherever possible. The residents are treated with respect and their privacy is maintained at all times. EVIDENCE: Five care plans were examined as part of the inspection process. They clearly set out the residents’ individual care needs. The care plans document the action to be taken by the carers to ensure all aspects of health, personal and social care are met and reviewed. The residents who spoke with the inspector were aware of the care planning process and their involvement with it. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 12 Where identified, the resident’s health is monitored and addressed by the appropriate health care professionals. The district nurses are involved on a regular basis, as are the chiropodist, audiologist and optician. The community dentist was in attendance during the inspection. Specialist equipment to prevent pressure sores was in evidence; this is provided after an assessment of need, by the district nurse. An external trainer provides regular sessions of armchair aerobics to maintain or improve the residents’ mobility. Five medication administration records were examined and found to be completed in the approved manner. All senior staff responsible for the administration of medication have received the appropriate training. Records are retained to show changes to medications. There is a policy and procedure in place to enable the residents to self medicate where this is considered to be appropriate and subject to an assessment of risk. The inspector observed the staff respecting the residents’ privacy by knocking and waiting before entering the room. At interview the staff clearly demonstrated their understanding of privacy and dignity. It was apparent that the residents come and go to their rooms and visit other residents throughout the day. This created a relaxed and informal “buzz” about the home, particularly during the morning. A relative wrote to the inspector about the experiences and support the whole family had received during the final stages of the resident’s life. “care received as she deteriorated was excellent. … were also supported through that sad and difficult time. An application to care which I feel was over and above the call of duty, but very much appreciated.” The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 13 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, 14 & 15 Residents are offered choices about lifestyle and meals and their visitors are made welcome. Previous lifestyles and histories are not documented. EVIDENCE: The individual care plans do not document the resident’s previous lifestyle and social history. At interview the carers clearly demonstrated their knowledge of the residents’ previous experiences and fully understood the importance of this in providing the care package. Such information is dependant upon the carer’s memory and, as such, must be documented by the key worker. The opportunity for the residents to attend the various activities has greatly improved since the previous inspection. The activities are programmed for afternoons and take place in the ground floor lounge. Carers and an activities person are involved. It was apparent that the programme is not set in tablets of stone, as it was changed at the residents’ request whilst the inspector was present. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 14 A newly admitted resident who had not left her house for many months was looking forward to a canal trip and had enjoyed the recent trip to the local theatre. It was observed that the staff greeted visitors in a warm and informal manner. The residents confirmed that they received visitors either in the lounge or in their own rooms. The main meal of the day at The Beeches is served at 1.00pm; breakfast is flexible, as and when the residents get up. The evening meal is provided at 5pm with supper from 7.30pm. The meal choices for the day were displayed. The residents who spoke with the inspector were unable to remember what they had chosen for their next meal but were able to refer to the board that also shows the staff on duty and the activity for the day. Each dining area is equipped with domestic appliances in order that snacks and drinks can be made. The menu was submitted as part of the pre-inspection process. The content appeared nutritious and well balanced. The residents at The Beeches are involved in changing the content. The meals are cooked at the adjacent home and transported in two heated trolleys. There has been a history of problems with this system. No complaints regarding the meals were received during this inspection. The inspector is aware that, periodically, difficulties do arise, mainly due to staffing problems at Yew Trees. This also applies to the laundry facilities, which are also shared. It is considered that the management of the organisation should review this situation. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 15 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 The residents and staff were confident their complaints would be treated with respect and acted upon. The policies, procedures and staff training protect the residents from abuse. EVIDENCE: The home has a complaints policy and system available to the residents and their representatives. It was displayed in the home, in addition to the residents’ bedrooms. In discussion, the residents stated they would speak to their family or manager if they had a complaint or concern. They felt sure that this would be addressed but had not had occasion to make a complaint. Records concerning complaints are retained at the home. The staff demonstrated their understanding and expectations in the event of a complaint made to them. The staff have undergone training in the protection of vulnerable adults. This has now been incorporated into the induction training. Systems and policies are also in place concerning this issue. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 16 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, 24 & 26 The Beeches provides a warm, clean, and well-maintained environment with a high standard of furnishings and fittings, which meets residents’ needs. EVIDENCE: The residents and their representatives who spoke with the inspector voiced their satisfaction with their accommodation. The home is purpose built and each bedroom has an en-suite (toilet and wash hand basin) facility. Personal effects were in evidence. The main entrance into the home is accessible to the general public. The main doors being secured at 8pm. It is understood that a programme of redecoration is to be undertaken in the near future. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 17 The rear garden is shared with the adjacent home, it is a pleasant area complete with garden furniture. Some bedrooms overlook the garden. It can however only be accessed via a locked gate. Some residents choose to sit in a small area the front of the home. The Beeches is maintained in a clean and hygienic state there were no offensive smells noted. The residents commented that this was the usual state in the home. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 18 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) 27, 28, 29 & 30 Staff are safely recruited and provided with training and development opportunities. EVIDENCE: From observation, the staff (with one exception) were attentive and responded to the residents and their visitors in a respectful manner. Additional information contained in residents’ comment cards noted: “Staff are all great and good fun.” “Staff are really helpful and really understanding.” The registered manager stated the staffing met with the current residents’ dependency levels. Recruitment is carried out according to the organisation’s policies. The staff who spoke with the inspector confirmed they had provided referees and had CRB clearance, and examined files confirmed this to be the case. Mandatory training is provided to all staff and there is a system to ensure such training is kept up to date. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 19 The organisation continues to support carers to complete the National Vocational Qualification at level 2. According to the pre-inspection questionnaire the number of carers with a level 2 or above currently stands at 60 (12 out of 20 carers). The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 20 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) 31, 32, 33, 35, 36 & 38 The home is well managed and staff, residents and relatives are involved in care delivery. EVIDENCE: The manager has the appropriate experience and qualifications to manage the home. The staff confirmed that she was approachable and they could trust her with any personal issues. She has adopted a calm and open management style. All care plans are reviewed at regular intervals and a resident confirmed their understanding of the reviewing process. A representative of the organisation also carries out regular spot checks on records, health and safety issues, in addition to seeking the residents’ views of the service wherever possible. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 21 The residents’ meetings are carried out at regular intervals; minutes are retained for those residents who were unable to attend. It was noted issues such as menus and activities are regularly discussed. When questioned, two staff informed the inspector that they felt fulfilled, derived job satisfaction and were supported in their work. They were proud to work at The Beeches, stating that they had a good team. The manager confirmed this to be the case. A well-established system of formal supervision and team meetings is in place. This provides the staff with support and guidance and, with the addition of good training opportunities, can only serve to benefit the residents. There are procedures to enable residents to maintain their own financial affairs. The home handles small amounts of money on behalf of the residents. Records are retained to account for expenditure. The staff confirmed they had received all the mandatory training concerning the health and safety of the residents. The organisation also has a system to ensure the training is current. The maintenance of all appliances and equipment is carried out under contract. The health, safety and welfare is further ensured by the systems in place to report accident and incidents. The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 22 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 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x 3 x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x 3 3 x 3 The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 12 Regulation 15(1) Requirement The registered person must ensure that the residents life and social histories are documented. Timescale for action 01/12/05 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 Good Practice Recommendations The Beeches F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton under Lyne OL7 0QD 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 F54 F04 the beeches A s28452 v240851 230805 Stage 4.doc Version 1.40 Page 25 - 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!