Inspection on 24/05/06 for The Beeches

This inspection was carried out on 24th May 2006.

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 09/10/07

The Beeches 01/11/05

The Beeches 05/07/05

The Beeches 09/12/04

The Beeches 28/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Beeches 45 Wordsworth Road Worthing West Sussex BN11 3JB Lead Inspector Mrs S Rodgers Unannounced Inspection 24th May 2006 09:30 X10015.doc Version 1.40 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 The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 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 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 DS0000024222.V291891.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Beeches Address 45 Wordsworth Road Worthing West Sussex BN11 3JB 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) 01903 239875 01903 217668 info@thebeechesnursinghome.co.uk Mrs Diana Jane Wyatt Mrs Christine Heffron Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43), Physical disability (1), Physical disability of places over 65 years of age (1) The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to 43 male and/or female service users in the category Old Age, not falling into any other category admitted/accommodated. One person in the category of Physical disability between the ages of 59 and 65 years may be accommodated. No more than a total of 43 service users may be accommodated. Date of last inspection 1st November 2005 Brief Description of the Service: The Beeches Nursing Home is a care home registered to accommodate up to thirty-nine service users in the category of old age with nursing. The establishment is a three storey converted and extended building located in a residential area of Worthing. Accommodation is provided in 33 single and 2 double rooms. There is a secluded well-maintained garden to the rear and side of the building. There is an area for private parking to the front of the property. The weekly fees range from £500 to £750. Extras include hairdressing and chiropody. A copy of the latest report is displayed in the hallway of home. The service is privately owned by Mrs D. J. Wyatt. The registered manager in charge of the day to day running of the establishment is Mrs C. Heffron. The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of 7 hours. Preparation for this inspection focused on reviewing the most recent inspection reports and general correspondence held on file. During the course of this inspection the inspector carried out a limited toured the premises and spoke with residents within the privacy of their own rooms. One person was visiting the home at the time of the visit. Comments from all people spoken with will be included in the main body of this report. The inspectors also undertook a review of records that are required to be kept by legislation. There has been one additional site visit to the home since the last visit to view the new extension to finalise the variation to increase numbers of resident admitted to the home from 39 to 43. What the service does well: What has improved since the last inspection? Since the last inspection the building work has been completed. The physical environment is of a good standard and well maintained. The laundry room has recently been refurbished and new trolley purchased so that laundry can be transported around the home easily. The gardens have been landscaped and handrails have been fitted to entrances where ramps have been fitted. The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 Page 6 Since the last inspection the management has introduced a quality assurances and quality monitoring system. This audit tool will enable the management to monitor systems and quality of service and enable them to identify areas of improvement 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 DS0000024222.V291891.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 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 the following standard(s): The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prior to moving into the home a pre admission assessment is undertaken on all prospective residents to ensure that the service can meet their needs. Intermediate care is not provided. EVIDENCE: The care plans of four residents were reviewed. For those residents who moved into the home after April 2002 pre admission documentation is kept on their individual care plans. The assessments take place in the prospective residents own home, hospital or in another care setting. One resident spoken with told the inspector that her assessment took place whilst she visited the home. The assessment follows the criteria set out in the National Minimum Standards for example, personal care, diet, weight, sight, hearing and communication, mobility, medication, hobbies and personal safety. Information gained at the pre admission assessment stage is used to form a basic care plan so that staff are aware of individual care needs on the day of The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 Page 9 admission. It was confirmed by Mrs Wyatt that intermediate care is not provided. The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 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 the following standard(s): The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans record the health and social care need of residents. Systems are in place to promote the health and social care need of residents. The homes policies and procedures for the management of medication promote safe practices. Residents feel they are treated in a respectful manner. EVIDENCE: Four care plans were reviewed in detail. The documents contained basic information required. The care plans set out the health, personal and social needs of residents and how they will be met i.e. any assistance required, manual handling assessment, bathing risk assessment, nutritional assessment. It was noted that care plans are reviewed monthly. The care plans clearly record their General Practitioners address and telephone number. Visits from the Doctor and other health professionals are recorded in the care plan. One resident confirmed that she is able to telephone her doctor The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 Page 11 to request a home visit. They only request from the manager is that she is informed of the visit and outcome so that they can plan care accordingly. Systems are in place for the receipt, recording, storage, handling, administration and disposal of medication. All medication is stored in a lockable cupboard. The home has a contract with a local pharmacy. The Monitored dosage system is used i.e. the medicine is pre dispensed by the pharmacist. The Medication Administration Record sheets record that medication is checked in. Trained staff administer all medication. Staff sign the Medication Administration Record sheet at the time of administration of medication. There was no evidence of stockpiling medication; the medicine cupboard was clean, tidy and orderly. The home has a contract with a wasted disposal company who dispose of medication no longer required. Records of all medication disposed of are kept. Residents spoken with confirmed that they feel that their privacy and dignity is maintained. One resident said ‘dignity and privacy is maintained, when personal care being given staff make sure doors and curtains are closed, if bed bathed only bit being washed exposed, they make sure your warm.’ And another ‘Staff knock on doors prior to entering and as they know I do myself they wait to be asked to enter. When staff assist me when I take a bath they are very good and maintain my privacy and dignity.’ The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 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 the following standard(s): The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a good range of planned programme of activities. Residents are encouraged to maintain contact with family and friends and are able to access the community as they wish. The meals provided are of a high standard. EVIDENCE: Residents spoken with confirmed that there is a wide range of social activities organised by the management of the home. Activities include music and movement, arts and crafts, board games such as scrabble, entertainment and monthly communion and weekly prayer services. The inspector was also told that following a recent residents meeting Mrs Wyatt the registered provider has brought a DVD player so that they can have weekly film afternoons. Sky T.V is also provided. Two residents spoken with confirmed that they are able to access the local community and regularly go into Worthing Town centre. One visitor was spoken with at this visit. The visitor told the inspector that ‘ Service very good here, the owner is in a lot and is very approachable.’ Residents generally receive their visitors in their own rooms. The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 Page 13 Residents spoken with confirmed that they are able to exercise personal choice. Those who were asked said that they felt they were able to develop and maintain and individual lifestyle with in the residential setting. As recorded above those who are able and wish can access the local community as they wish, residents can choose to take part in activities or pursue their own interests. One resident told the inspector ‘I am able to get up and go to bed when I want.’ Records seen at this inspection and confirmation form resident indicates that a varied and well balanced diet is offered. A four weekly rotating menu is followed. Residents are asked daily what they want from the menu. Service users confirmed that meals are unhurried and that they are able to choose where they eat their meals. All residents spoken with were complementary with regards meals provided. One resident said ‘the chef is so good, varied menu, will also get you something else if you do not like what’s on the menu. I was ill recently he sends up tempting titbits to encourage me to eat things like melon, you have proper napkins, fresh water every morning, everything is presented so well.’ Store cupboards were appropriately stocked and the kitchen was clean. The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 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 the following standard(s): The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and are managed within an appropriate manner. Systems are in place to promote the protection of vulnerable adults. EVIDENCE: A complaints procedure is in place. The procedure informs residents and their relative who they should address their concerns to in the first instance and timescales in which a response will be made. The procedure contains the address and telephone number of the Local office of the Commission for Social Care Inspection so that in the event that they are not satisfied with the outcome of the homes investigation they can contact Commission directly. A complaints folder was available. There have been two complaints since the last inspection. Both were dealt with within the allotted timescales. Training records evidence and staff confirmed that they receive training in adult protection procedures. Both care staff spoken with formally at this inspection are aware of the indicators of abuse. Both confirmed that they would report any suspected incidents of abuse to the manager. The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 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 the following standard(s): The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained. The home is clean, pleasant and hygienic. EVIDENCE: The home is located in a residential area of Worthing close to the town centre. The home is accessible and well maintained. One resident who has recently been admitted to a room in the new extension confirmed that ‘all doors wide enough for wheelchair. The en suite toilet is also wheelchair accessible, I was asked where I wanted things fitted before moving in.’ Mrs Wyatt proprietor, nothing is to much trouble for her, you just have to ask for something or mention something and it is done.’ The laundry room has recently been extended and refurbished. Appropriate systems are in place for the control of infection including the disposal of clinical waste. Protective clothing and hand washing facilities are provided. The standard of cleanliness throughout the home was of a high standard. The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 Page 16 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The skill mix of staff on duty is appropriate to the needs of the current residents. Appropriately qualified staff on duty to address the needs of residents. Staff are appropriately trained. EVIDENCE: Duty rotas seen indicated that there were sufficient staff on duty to meet the needs of the current residents. There are generally 7 staff on duty 2 trained nurses and 6 carers. In there afternoon this number is 2 trained nurses and 3 carers. At night there are 3 carers and 1 trained nurse. There is a suitable mix of trained nurses, senior carers and carers. Sufficient numbers of ancillary staff are employed in the home. The recruitment records were not reviewed at this inspection, as the person who has access to the files was not available. Recruitment records were seen at the previous visit they indicated that a formal recruitment process is followed. One of the trained nurses is has been designated at the training manager. 20 care staff are employed. 5 hold the National Vocational Qualification Level 3 and 12 have Level 2. 6 staff have been enrolled on a National Vocational The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 Page 17 Qualification Course level 3 five of whom already hold a Level 2 certificate. Training records seen indicate that staff receive mandatory training such as food hygiene, fire training, First Aid and Health and Safety training. Following a recent audit a copy of training certificates are held on individual staff files and information regarding course content is kept in order that the quality of information being given can be verified. There is a staff-training programme in place. The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager of the home is suitably experienced. The home is run in the best interests of residents. The health and safety of residents is promoted. EVIDENCE: Mrs Heffron is the registered manager in charge of the day-to-day running of the home. She is a Registered Nurse on Part 1 of the register. Residents and staff spoken with said that they feel the manager is approachable and listens to their views. A quality assurance and quality monitoring audit has been undertaken and a report has been produced that identifies areas of strengths, weaknesses and The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 Page 19 action that is going to be taken to improve services. The overall outcome regarding services was positive. Residents are also able to express their views via residents meetings, minutes of these meetings were available. Records of money held in safekeeping were not viewed at this inspection, as the administrator was not on duty at this visit. Records were reviewed at the previous visit and were in good order. Maintenance records indicate that regular servicing of boilers and equipment such as vertical lifts; boilers and electrical appliances are carried out. Systems are in place to ensure safe working practices. All new staff undergo induction training in line with the Skills for Care guidelines. Training records indicate that all staff have received fire safety instruction. It was confirmed that should any staff member miss the training session they complete a fire-training questionnaire that is kept on file. Risks assessments are carried out for safe working practices i.e. manual handling and risk assessments of the physical environment have been undertaken. The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 Page 20 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO 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 The Beeches DS0000024222.V291891.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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. 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