Inspection on 09/03/09 for The Beeches

This inspection was carried out on 9th March 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Beeches 14/02/07

The Beeches 07/02/06

The Beeches 13/09/05

The Beeches 15/02/05

The Beeches 06/04/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Beeches 20b & 20c Parker Lane Mirfield West Yorkshire WF14 9PA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Brindle-Wills     Date: 0 9 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: The Beeches 20b & 20c Parker Lane Mirfield West Yorkshire WF14 9PA 01924491678 01924491678 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Holly Bank Trust care home 12 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 12 The Beeches is a care home providing personal care and accommodation for twelve younger adults with moderate to profound learning disabilities and associated physical disabilities. The care home is managed by the Hollybank Trust, a voluntary organisation that specialises in the area of learning disability and operates several facilities for this user group. The accommodation consists of an adapted house and a bungalow on the same site, each providing accommodation for six people. The accommodation is sited in a residential area of Mirfield, a small town midway between Dewsbury and Huddersfield. The bulk of the accommodation is on the ground floor. All service users have single rooms. The accommodation has large multi-level gardens. The central area between the two houses is used for parking. Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was positive and enjoyable. We spent some time having a look at the paperwork at the home, and we talked to people who live at the home, had a look round the home, sampled the meals, checked the medication and money, and talked to the staff. The paperwork we looked at included peoples care plans and assessments, some staff personnel and training files, the medication, health and safety records, the menus and kitchen records, and the daily records made by the staff about the activities people had been involved in during the day. We would like to take the opportunity to thank the people living at the home, the registered manager and the staff for their hospitality and patient co-operation throughout the inspection. Since we last inspected this service in 2007, we have not received any complaints about the service. Care Homes for Adults (18-65 years) Page 5 of 28 Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems in place to make sure that peoples needs are properly assessed before they move into The Beeches. Evidence: The registered manager showed us the pre-admission records of 4 people who live at the home. These were found to contain assessments and information about peoples life story and their health and personal care needs. Information was also found that gave details of how these needs should be met. The registered manager explained that if someone wanted to move into the home, then she or a member of staff with experience of assessments, would visit the person, and their family or representative, and undertake an assessment of their needs. Information contained within the care records confirmed that people with experience of assessments go to visit people to gather information about their on going health and personal care needs. The registered manager made clear that if people wanted to visit the home, and meet the people and staff, then they would be able to do this. The records show that once an assessment is made, then a decision based on that information is made as to whether Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: the service can meet that persons needs. The registered manager gave details of how a letter is sent to the person explaining the decision, and if the service can meet their needs, then arrangements are made for the person to move in. Information contained within the care records confirmed this. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information about how peoples needs should be met and how to minimize risks to people is available. Good support is given to help individuals make choices and decisions. The use of Person Centered Planning Tools, may enhanced the planning, care and support processes for people living at The Beeches. Evidence: The registered manager showed us the care plan files of 4 people living at the home. She was able to explain the care planning process in great detail, and which she said includes making sure that the staff learn what is important to the person in everyday life so that they can be supported to live a fulfilling life. She added that the staff involved in the care planning process, find out what the health and safety risks are to each person by talking to them and their families, and by undertaking a risk assessment, which is documented. Information contained within the care plan files confirmed what the registered manager had spoken about. She added that wherever possible, the person themselves, and or their family members (if appropriate) are Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: involved in the care planning process. Again this was supported by way of information contained within the care plans with peoples signatures being seen on various documents. People living at the home did not speak about the care planning process in detail, but did say that the staff ask them about what they like to do, about what their interests are and about how they like to be supported to undertake certain activities such as washing, dressing, shopping and socialising. Staff at the home confirmed that they are involved in care planning, and were able to speak about the process in a manner that indicated that they saw it as an important part of what they do, and not just a task to be completed. One staff said that talking to people and being creative in the things we do with people is central to supporting people to live a fulfilling life. We looked at the daily records which were found to contain information about what people had been doing during the day and night. The information was seen to be factual and non-judgemental, and when decisions had been made to participate in different activities, the reasons for this had been recorded. The registered manager explained that for some people, decision making can be difficult due to their level of cognitive ability, adding that when decisions are made on a persons behalf, to engage in a social activity for example, then the staff always ensure that good records are kept so that the reasons why and when decisions are made by others can be clearly demonstrated. Information contained within the daily records confirmed this. Staff working at the home explained that sometimes decisions are made to include a person in a social or recreational activity as it is seen to be of benefit to the person, and is perceived to enhance their quality of life. They added that the risks associated with an activity are always considered, and where appropriate recorded. The records confirmed this. A discussion took place with the management team about the use of specific Person Centered Planning Tools, and they explained that this something they would be very much interested in developing in order to improve the lifestyle opportunities and care planning systems for individuals at the home. Care Homes for Adults (18-65 years) Page 12 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home lead a reasonably active lifestyle, are supported to keep in touch with family and friends, have their rights respected and have a healthy and varied diet. Evidence: The registered explained that the people who live at The Beeches have differing interests and preferences as to how they spend their day. She said that some people go out to day centres and voluntary work placements, others prefer to stay at home, or do not access day time services. Information contained with peoples care plan files confirmed what the registered manager had said. One member of staff said that for those people who do not access a day placement, there are activities put on in the home, and that people do get the opportunity to go out and take part in recreational activities such as shopping, meals out, visits to the pub and visits to see family. This Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: was cofirmed by way of information contined within peoples files, and after alking to some of the people living at the home. The meuns were looked at, and were found to offer people a varied and nutitrious diet. One person said that there was always plenty to choose from, and that if they didnt like what was on the menu, then the staff would make them something different. One staff member said that some people are encouraged to make their own small meals, and this was confirmed when speaking to the manager who said that those who are capable of taking part in this kind of activity do so. People confirmed that they are supported to keep in touch with their families and friends, and the daily records show when family and friends visit. Care Homes for Adults (18-65 years) Page 14 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Greater attention needs to be paid to ongoing medicines management so that errors do not occur in the recording of the quantities of medications held at the home. People receive personal support in the way they prefer and require and, generally, peoples health care needs are met appropriately. Evidence: The registered manager explained personal supported is always provided to people in private, and that routines such as the times for going to bed, having baths, meals and other activities are flexible. She added that people are encouraged to choose their own clothes and hairstyle, and where possible peoples appearance reflects their personality. Discussions with people living at the home confirmed this. Observations made on the day of the visit confirmed that staff work with people in a sensitive manner, providing flexible personal support in ways that promote peoples privacy and dignity and where possible their independence. Information contained within peoples care files indicated that peoples health is monitored and any potential complications and problems are identified and dealt with at an early stage, including referral to the appropriate healthcare professional. The registered manager explained that people are Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: encouraged to and supported to attend yearly health checks, and visits to their GP as and when appropriate. Further to this, people with specific healthcare needs are supported to visit specialist, and if they are unable to make their own appointments, the staff do this on their behalf. This was supported by way of information contained peoples care plans showing when appointment had been made, the outcome, and any action that needs to be taken by the person, or the staff at the home to promote peoples health and wellbeing. Feedback from relatives indicated that they were satisfied with the way in which staff at the home support people with their healthcare needs. A sample of the medications held at the home were looked at. A number of problems in the recording of medications were odentified, however, these were qucikly resloved on the day of the site visit, and the registered manager put measures in place to ensure problems like this do not come up again. The registered manager was able to explain in detail the medication policies and procedures, and these were found to be satisfactory. She explained that records are kept of all medications that are received, administered and disposed of within the home, however, some of these systems were found to be unsatisfactory. The records should that staff have had training in the use and medication. Care Homes for Adults (18-65 years) Page 16 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems in place for dealing with complaints appropriately. The systems and procedures in place to protect people from abuse and neglect are appropriate and the systems for responding to suspected or witnessed abuse are robust. Evidence: The registered manager explained that the home has a complaints procedure, which is available for all to see as it is posted in the entrance hall of the home. The procedure was seen to be satisfactory, and is available in an alternative format for people who have difficulty reading. The records show that the service has not had any complaints within the last year, and the records held by CSCI show that we have not received any complaints about this service. People who responded to our survey indicated that they knew who to speak to if they had a concern or complaint, and that they felt confident that their concern of complaint would be dealt with quickly and appropriately. One person living at the home who was spoken with said that they would speak to a staff member if they were worried about anything, and that they felt sure the staff would support them and deal with their worries properly. The registered manager explained that staff have had adult safeguarding training, and added that the service has a adult safeguarding policy and procedure, which is displayed within the home, given to staff, and used as a basis for staff training. She added that the organisation also has a whistle blowing procedure. These policies and procedures were looked at the found to Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: be in good order and in line with the local authority safeguarding procedures. One member of staff who was spoken with was able to talk about what they would do if they suspected or witness abuse, and their explanation was found to be in line with the policies and procedures operated by the service. The personnel records held at the home show that the Protection of Vulnerable Adults register is checked before staff are appointed to work in the home. The registered manager explained that is a good way to ensure that those people unsuitable to work with vulnerable people are given the opportunity to do so. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable home with plenty of space. All parts of the home are kept clean and tidy, and fire doors are not wedged open and therefore peoples safety is not compromised. Evidence: The registered manager explained that the comments she regularly gets back from people living at the home, their relatives and visitors, state that people see the home as being comfortable, roomy, bright, cheerful and clean. On the day of the visit, the home was found to clean and tidy, with the furnishings and fittings being seen to be of a good quality and in good working order. Staff at the home said that the location of the home offers people access to the local amenities, and access to the local towns and facilities is gained either being way of public transport or the homes own transport. People living at the home said that they think it is kept clean and tidy, but added that they can keep their bedrooms as they like. This was confirmed on having a look around the building. Hand washing facilities were found to be located appropriately throughout the building, and the registered manager explained that laundry facilities are sited so that soiled articles and clothing are not carried through areas where food is stored and prepared. This was confirmed on having a look around the building. Care Homes for Adults (18-65 years) Page 19 of 28 Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A skilled staff team supports the people living at The Beeches and the recruitment practices are good, with robust procedures. Evidence: The registered manager explained that the comments she regularly gets back from people living at the home, their relatives and visitors state that people believe the staff team to be approachable, reliable, honest and motivated to make sure people are cared for properly. Observations made on the day supported this, with staff being seen to work sensitively with people, communicating with people effectively and showing an interest in individuals. Feedback from people who completed our survey showed that they too believed the staff to be good at what they do, friendly and enthusiastic about the work they undertake. The personnel and employment records that were looked at contained good levels of information Information contained within the records show that new starters are only confirmed into post once a satisfactory Criminal records Bureau check has been undertaken, and a check against the Protection of Vulnerable Adults register is made. The staff training records show that staff receive good levels of training in all aspects of work within a care setting. Feedback from people who completed our survey indicated that they believed the staff to be well trained. Staff working at the home spoke about the training they had received, giving details of Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: scenarios that come up from time to time, and details of what they would do, how they would deal with issues, and how they could do things differently if needs be. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory quality assurance systems are in place, however, the management team must ensure that the regular audits and monitoring systems relating to medication are robust to ensure people health and welfare are promoted and protected. Evidence: The records held by CSCI show that the manager is registered with us. The registered manager explained that she obtains feedback from people using the service, their relatives, and other relevant parties about the services provided by way of user satisfaction questionnaires. The records of these were seen, and the feedback supplied by people was seen to be positive. She added that she has in place audit and monitoring systems for various practices within the home such as medication, money, accidents and incidents. Again, the records of these were seen, and there were found to be satisfactory. |however, in relation tot he medication system, the audits had not picked up on some of the problems relating to recording the qualities of medication held at the home. The records relating to the health and welfare of people living and working in the home were seen, and were found to be satisfactory. These included Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: records relating to weekly alarm system tests, food hygiene control measures, infection control systems, the regulation of water temperatures and the maintenance of equipment. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The registered person must ensure that a safe system for recording medication held at the home is in operation at all times. This is to ensure that peoples health and welfare is maintained, protected and promoted at all times. 21/05/2009 2 38 13 This is to ensure that 21/05/2009 peoples health and welfare is maintained, protected and promoted at all times. To ensure peoples health and welfare is promoted and protected at all times Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The use of Person Centered Planning Tools such as PATHs, MAPs, and Essential Lifestyle Plans, may enhanced the planning, care and support processes for people living at Page 26 of 28 Care Homes for Adults (18-65 years) The Beeches. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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