Inspection on 26/09/06 for The Beeches

This inspection was carried out on 26th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 26/08/08

The Beeches 05/01/06

The Beeches 12/09/05

The Beeches 09/12/04

The Beeches 26/02/04

The Beeches 20/01/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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Seabourne House

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 Lympne Place Aldington Road Lympne Hythe Kent CT21 4PA Lead Inspector Mrs Sue Gaskell Unannounced Inspection 26 September 2006 09:30 th The Beeches DS0000023478.V303641.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 The Beeches DS0000023478.V303641.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. The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Beeches Address 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) Lympne Place Aldington Road Lympne Hythe Kent CT21 4PA 01303 260453 www.hft.org.uk Home Farm Trust Mr Clifford Andrew Neve Care Home 8 Category(ies) of Learning disability (8) registration, with number of places The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th January 2006 Brief Description of the Service: The Beeches is a care home registered to accommodate up to eight people with a learning disability. The fees are in the range of £1032 - £1474 per week. The Registered Provider is The Home Farm Trust and the home is currently managed by Mr C. Neve. The home is one of several units operated on the Lympne Place site by the Trust and the area service manager is also based on this site. The home has its own usable garden, with garden furniture and residents also have access to the general grounds and a club house. The home is situated in a rural setting but within easy travelling distance of the towns of Hythe, Ashford and Canterbury. The home has its own transport. The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 26th September 2006 between 10.30am and 4.00pm. There are currently 7 people living at the home. The inspector spoke to 5 of the residents, 3 members of staff and by telephone to one resident’s care manager. Some of the residents have limited communication and therefore the inspector joined them for a while whilst they were waiting to go out in order to see whether they appeared relaxed and comfortable. The inspection process consisted of information collected before and during the visit to the home, and care management feedback after the site visit finished. Other information seen included incident report forms, assessment and care plans, medication records, duty rota and staff employment and induction paperwork. 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 DS0000023478.V303641.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 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 the following standard(s): 2&5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose, service user guide and individual statement of terms and conditions, clearly says what service will be offered. Prospective residents can be confident that their needs will be assessed and can be met. EVIDENCE: There have been no admissions to the home since the last inspection visit and there have been no changes to the previously reported admission process. All prospective service user contact is initiated via the HFT Social Worker who, together with staff from the home, undertakes a pre placement assessment in the prospective resident’s home or current placement, and compiles a profile of needs. Prospective residents and their families or advocates are encouraged to participate in the decision making process. Trial visits are arranged but are only offered if appropriate. The home does not take emergency admissions. All staff have experience in working with adults with a learning disability and further training is offered for any specific conditions. All residents have now been issued with a copy of their terms and conditions of residence and a service user guide, both of which are in a pictorial format. The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 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 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. The service user plans are easy to use and descriptive. Residents’ choices are respected and their decision-making is well supported. Residents are supported in taking risks in the daily and social activities that form part of an independent lifestyle. EVIDENCE: Person centred care plans are in place for each resident. They include personal profiles, assessments, likes and dislikes, and guidelines on how the home will assist residents in achieving their short and longer term goals. Residents have key workers who monitor their individual needs and activities and help them understand, and contribute as much as possible to, the contents of their care plans. Comprehensive risk assessments have been prepared for each resident’s needs or activities, and include specific guidelines on how to minimise any risk. The records showed that staff sign to acknowledge having read these guidelines. The inspector was informed that the home maintains a level of The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 9 three staff per shift plus the manager or team leader during the day. Staff said that extra staffing is always provided if there is a necessity. Issues relating to confidentiality are addressed during the induction period. All records are stored in a lockable office and there was no public display of confidential or personal information. The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 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 the following standard(s): 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. Daily life generally meets the residents’ lifestyle preferences and expectations. Residents’ ability to engage in appropriate leisure activities could be compromised occasionally by lack of staff. Residents have regular contact with their families and friends and receive a nourishing and balanced diet. EVIDENCE: The residents are supported by the staff and management to help them participate in a range of activities and events for educational, recreational and therapeutic purposes. There is a weekly programme of activities but the home has to be flexible if residents’ needs change or if they would rather do something else. The care plans contain a list of residents’ needs, likes and dislikes and preferences in pictorial form or a format that they can understand. Residents may come and go as they please in the communal areas and The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 11 grounds, subject to risk assessments. However this should be risk assessed on a continuous basis as residents’ needs change. There was evidence in the residents’ daily records to show that families, and other visitors are encouraged and welcomed, and some residents have independent advocates. Meals are provided mainly based on residents’ choices, but also taking into account the need for a reasonably balanced diet. One resident has a particular need which requires special consideration and the records showed that she has been referred to the dietician. The store cupboard contained a wide range of good quality food including fresh fruit and vegetables. Residents said that they enjoy accompanying staff in shopping for provisions. Residents also have the opportunity to prepare under supervision, or assist staff to prepare meals that they have chosen. The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 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 the following standard(s): 18,19 & 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ choices over their care are respected. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication. EVIDENCE: All of the five residents who were either spoken to or around during the inspection were seen to be relaxed and comfortable interacting with staff. Staff explained how residents are supported in as their needs change and referred to the importance of being sensitive to the needs of each individual. Residents care plans and daily records referred to clear guidelines on providing support and monitoring health care and social care needs. There was evidence in residents’ files to show that residents’ needs have been closely monitored and that they have been referred for specialist help whenever necessary. The three members of staff spoken to showed a high level of awareness of residents’ needs and referred to various issues, such as medical, nutritional or communication assessments, being included in the care plans. There was The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 13 evidence of staff involvement in the daily recording, care plans and referrals for specialist help. The team leader said that new members of staff are referred to care plans as a matter of priority and staff have to sign to acknowledge having read any important guidelines. The home has sound medication procedures. Staff confirmed that only trained staff who have been “signed off” would administer medication and that all staff have to read the procedures stored in the medication file. Medication was stored securely and appropriately and there are procedures for its receipt and disposal. The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 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 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. Residents can be confident complaints will be listened to and dealt with appropriately and they will be protected from abuse. EVIDENCE: Although it was difficult to obtain from some of the residents due to their communication needs, one resident said that she would feel comfortable telling staff about anything she was not happy with. Two residents have independent advocates. Staff said that every effort is made to ensure that residents can communicate their feelings if they are not happy with something. The home uses complaints forms that have been produced in a pictorial format and there was evidence to show that these have previously been used by residents. The home has adult abuse procedures in place and staff confirmed that they have received training on adult protection and when and how to intervene in order to safeguard and assist residents. Staff confirmed that new staff are issued with a handbook on joining the Trust which refers to policies and procedures concerning appropriate behaviour when assisting with personal care, the use of appropriate intervention techniques, and “whistle blowing”. The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 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 the following standard(s): 24, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely,comfortable and safe environment. The home is hygienic and clean. EVIDENCE: All bedrooms and living areas are furnished and decorated to a good standard, and contained the type of furniture and equipment necessary to provide a homely environment. 2 residents indicated that they are pleased with their bedrooms and that they had helped to chose colours, furniture etc. One bedroom was being re-furbished and decorated at the time of the inspection, prior to a new resident being admitted. Staff said that it was likely that he would select the colour of the wall paint. All areas were seen to be clean and hygienic but there are several areas requiring minor maintenance or attention, eg some areas of plaster in the hall and the ground floor bathroom. Windows are fitted with restrictors and access to the first floor is by the use of a number keypad. There is one resident who has a bedroom on the first floor. There is an alarm call in this bedroom but staff were unsure of whether it was working. However there is a sleeping in room close to the resident’s bedroom and there The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 16 is also an awake member of staff on night duty. One resident’s window faces steps to one of the other buildings on the campus and the inspector asked staff whether they had ever considered that net curtains might add to the resident’s privacy. There is a well maintained garden with garden furniture which is used by the residents. Staff showed a good awareness of health and safety issues. Maintenance certificates were current and there are no outstanding health and safety requirements. The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a team with a wide range of skills. Staffing numbers are appropriate to meet the service users’ needs and wishes. Recruitment practices are sound. Training provision and staff support is good. EVIDENCE: The Team leader said that the current staff rota includes the manager or a shift leader and generally 3 support staff. Another member of staff said that this is adequate to ensure that residents are safe and can participate in their chosen activities. Night staffing also appears adequate and there are emergency on call systems, as well as methods of internal communication systems. Staff confirmed that there are sound recruitment practices and that all staff have to be CRB checked and have verbal references prior to their employment, with subsequent written references. Staff confirmed that induction training takes place with core training and further on-going training. Recent training has included dementia awareness and how to prepare and The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 18 make use of risk assessments. Staff confirmed that they receive regular supervision and there were records of this in staff’s files. Staff also referred to the high level of on-going support from the Manager for work and personal issues affecting their work. The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. 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. Residents are supported and protected by the effective management of the home. The company encourages input from residents and regularly reviews its procedures, thus benefiting the residents lifestyle and safety. Health and safety in the home is promoted. EVIDENCE: Staff said that residents’ views and feelings are regularly questioned and monitored, either through talking to them or through observing them to see whether or not they appear happy. This is particularly important where some residents’ needs have changed. Staff said that quality assurance is given a high priority and any feedback from residents and/or their families or advocates is acted upon. One resident’s parents and another resident’s The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 20 advocate confirmed this. The general management of the home and completion of records are of generally of a good standard. Staff said that the manager is supportive and that they can approach him for advice and support on any issue. There were no obvious safety hazards around the home and there was evidence to show that health and safety issues are taken seriously eg staff ensuring that the laundry is locked and that cleaning chemicals are locked away. The maintenance file also contained current certificates to show that regular checks eg gas, electricity, are carried out. The manager ensures that staff are aware of any updated policies and procedures on health and safety and staff recently attended training on preparing and using risk assessments. The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 21 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 3 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 3 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 4 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 X 12 X 13 4 14 4 15 4 16 X 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 4 X 3 X 3 X X 3 X The Beeches DS0000023478.V303641.R01.S.doc Version 5.2 Page 22 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 DS0000023478.V303641.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 DS0000023478.V303641.R01.S.doc Version 5.2 Page 24 - 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!