Inspection on 09/10/07 for The Beeches

This inspection was carried out on 9th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Beeches 24/05/06

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 David Bannier Unannounced Inspection 9th October 2007 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.V347580.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 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.V347580.R01.S.doc Version 5.2 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.V347580.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Up to 43 male and/or female service users in the category Old Age, not falling into any other category admitted/accomodated. One person in the category of Physical disability between the ages of 59 and 65 years may be accomodated. No more than a total of 43 service users may be accommodated. People under the age of 65 years may be admitted/accommodated. Date of last inspection 24th May 2006 Brief Description of the Service: The Beeches is a care home which is registered to accommodate up to thirtynine residents in the category (OP) old age, not falling within any other category. It provides personal care and nursing care. The Beeches is a three storey property which has been extended and adapted for its current us. It provides accommodation in shared and single bedrooms located on the ground and first floors. A vertical passenger lift provides access to all floors. A dining room and lounge are located on the ground floor. An attractive garden, located to the rear and side of the premises is available for residents to use. The property is located in a residential area of Worthing, near to the seafront. The fee levels range from £650 to £800 per week. Additional charges are made for hairdressing, chiropody and newspapers. The registered provider is Mrs D. J. Wyatt who also owns the service. Mrs C Heffron is the registered manager, who is responsible for the day to day running of the care home. The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection has followed the Inspecting for Better Lives methodology and is called a key inspection as it assesses those standards determined by the Commission as key standards. This inspection will also determine the frequency of inspections hereafter. The registered provider returned an Annual Quality Assessment Form (AQAA) prior to the inspection. Some residents and their relatives were sent surveys by the Commission entitled “Have Your Say.” Surveys were also sent to two social workers. These are designed to enable residents, relatives and other stakeholders to give their opinions about how the care home is being run. Four surveys completed by residents and four surveys completed by relatives were returned to the inspector. The information received from these documents will be referred to in this report. A visit to The Beeches was made on Tuesday 9th October 2007. As this was an unannounced inspection the care home had no notice of this visit. We met and spoke to four residents in order to form an opinion of how it is to live at the care home. We also met and spoke to four staff on duty in order to find what it is like to work at The Beeches. We viewed some of the accommodation and observed care practices. Some records were also examined. The visit lasted approximately seven hours. Mrs Wyatt and Mrs Heffron were present and kindly assisted us with our enquiries. What the service does well: The home continues to provide residents with the flexibility and opportunity to develop and maintain individual lifestyles within a residential setting, they are able to access in house social activities as they wish. A relative commented in a survey, “The Beeches is a far larger home than that which my relative lived previously, and they engage the residents in a far wider range of activities. Although my relative does not partake in many the extra stimulus seems to have been beneficial.” The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 6 The home’s training programme has enabled the management of the home to exceed the 50 of all care staff being appropriately qualified. All staff spoken with were knowledgeable with regards the needs of individual residents. The interaction between residents and staff was relaxed, confident and respectful. When asked what the home does well, a relative commented in a survey, “Providing care and support.” Another relative commented, “All staff are wonderfully helpful and friendly.” A third relative commented, “Good communication with relatives.” All residents spoken with were complimentary with regards meals provided. The confirmed a varied diet is offered and that they can have a choice of meals each day. A relative commented in a survey, “The food is perfect and always the right quantity.” The premise is well maintained and kept to a very good standard of hygiene. A relative commented that the Beeches is a, “Clean, well run and maintained home.” What has improved since the last inspection? What they could do better: Care plans and personal information about the needs of residents need to be kept in a confidential manner. This will mean only those people who need to have information about the personal care needs of residents have access to care records. Medication records must be kept up to date. This will ensure there is evidence which confirms that medication has been administered to residents in The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 7 accordance with prescribed times and doses. Where residents have not received medication, the reason for this should be clearly recorded. The registered provider must undertake a risk assessment of the premises. The purpose of the assessment should be to identify whether residents are at risk of scalding themselves where surface temperatures of radiators become excessively hot. Where a risk has been identified, appropriate action must be taken to ensure this is reduced. Whilst there are sufficient numbers of staff provided for each shift, there is evidence that residents wait a long time to receive attention when they ring their call bell. The registered manager needs to review this to ensure staff are clear about timescales within which call bells should be answered. The registered manager needs to ensure the Commission is notified of incidents and accidents, which affect the wellbeing of residents. This will ensure the Commission can monitor such incidents and the subsequent care and treatment provided. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care needs of all prospective residents have been assessed before moving into this care home. This care home does not provide intermediate care. EVIDENCE: The names of three residents, who had been admitted on a permanent basis, were identified for case tracking purposes. Records seen showed that residents’ care needs were assessed before admission. Information gathered from the assessment process has been The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 10 transferred into care plans. This means that staff have appropriate information about each resident with regard to the care they require. Care staff on duty were spoken to as a group. Following discussions about the needs of identified residents, the staff team were able to demonstrate they were fully briefed about the care residents required and what was expected of them to ensure their needs have been met. Information supplied by the registered provider confirmed that what this care home does well is, “Pre-admission assessments and comprehensive planning.” It was also confirmed the care home does not provide intermediate care. The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident’s health, personal and social care needs are set out in an individual plan of care. Residents’ health care needs have been met. Residents are protected by the home’s policies and procedures for dealing with medicines. Residents feel they are treated with respect and their right to privacy is upheld. EVIDENCE: The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 12 Care plans have been drawn up from the information gathered when residents’ needs were assessed. They have also been reviewed regularly. The care planning system includes risk assessments for manual handling, pressure area and nutritional assessments. It also records visits to each resident by doctors and other health care professionals together with any treatment prescribed. Care plans are kept in the main office. It was noted that, when no one was using the office, the door remained open. This meant that anyone, including residents, relatives or visitors had access to personal information about all residents accommodated. Additional information about the care needs of residents is recorded on postcard size cards. They are kept on a nursing station near to the lounge area. This means that staff can access information easily. However, it was concerning to note that this information, together with other information of a personal nature, could be easily read by anyone, including other residents, their relatives or other visitors, who were passing by the nursing station. When this was brought to the attention of the manager and the provider they immediately understood the need to ensure such information is kept confidentially and securely. Most surveys returned by residents and relatives confirmed they receive the care and medical support they need. One resident commented, “I couldn’t have better care and attention. Every member of staff is very friendly.” Another resident commented, “I get very good support from all concerned.” However, another resident commented, “Depending on what carers are on duty, the care I need is not always given unless I specifically ask for it”. Appropriate systems have been put in place for the recording, storing, handling, administration and disposal of medication. Medication is stored safely and securely. There was no evidence of medication being stock piled. Medication record sheets were seen. A picture of each resident is attached to their own medication record. Trained nurses administer all medication. Records of staff signatures and initials are kept. It was concerning to note that there were significant gaps in the medication records over several days. This means there is no evidence to confirm that all medication has been administered to residents in accordance with the instructions of the prescribing doctor. The manager agreed to take this up with staff who are responsible for administering medication to ensure they keep records up to date. Staff on duty were able to demonstrate they were aware of the individual needs of residents and the action to be taken in order to meet them. Staff were seen to provide care in a manner which respected the individual wishes of residents and also ensured their dignity and privacy has been maintained. Staff were courteous when speaking to residents and ensured doors were closed when personal care was being provided. The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 13 Information supplied by the registered provider confirmed that, what the care home does well is, “Maintain high standards of care. Support residents in decision-making, respecting dignity. The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 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 activities that satisfies their recreational interests and needs. Residents maintain contact with family and friends as they wish. Residents are helped to exercise choice and control over their lives. Residents receive a wholesome appealing balanced diet in pleasing surroundings. EVIDENCE: The care home organises activities regularly for residents to enjoy. Details of planned activities were displayed on a notice board in the front hallway. These included gentle exercise and “Music for Health” sessions, and prayer meetings. The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 15 A selection of greetings cards was on display and were for sale in the dining room. Residents who have attended art and craft sessions have made them. A small group of residents were sitting in the lounge enjoying a display of traditional dancing on the television. Sky TV has been provided in this lounge. A selection of books, including audio books and large print books were available to residents on bookshelves in the lounge. A visiting library visits regularly to ensure books can be ordered and exchanged. Residents’ assessment records also include details of recreational and social activities residents have enjoyed before moving into The Beeches. Surveys returned by residents confirmed that activities, that they can take part in, have been arranged by the home. One resident commented, “Some were attractive to me and some not, but I would always read. Ample books available.” A relative commented, “My relative, who is a devout Roman Catholic, receives a visit from a Special Minister every week and enjoys the prayer services arranged by the home with a local URC minister.” Surveys returned by relatives confirmed they are helped to keep in touch. They also confirmed they are kept up to date with important issues such if their relatives have been admitted to hospital or have had an accident. One relative commented, “I am sure they would, but the matter has never arisen.” Residents spoken to also said they are able to keep in touch with their families. They are made welcome and offered refreshments when they arrive. One resident said, “The home is handy for my daughter. It only takes her 5 minutes.” Staff on duty were seen to ask residents what they wanted. Whilst discussing the needs of residents, staff on duty made it clear the importance of ensuring residents take control wherever possible. They ensure residents choose what they wish to wear and what they wish to do during the day. Some surveys returned by residents confirmed that staff do listen to them and act on what they say. One resident confirmed, “They never forget a thing.” However, another resident stated this is only sometimes. The main meal of the day consisted of sweet and sour pork with rice and peas followed by bakewell tart and custard. There was also an alternative meal of tuna salad with potato. These meals were presented in an appealing manner to encourage and stimulate residents’ appetite. Those residents who wanted this were served their meal in the dining room. The surroundings were very comfortable. Tables were attractively laid with fresh, clean linen napkins. Some residents required assistance with eating. Residents who require assistance with eating are served first. After this residents who will be eating their meals in their own rooms have their meals taken to them on trays. Then residents who want to have their meals in the The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 16 dining room are served. This system has been designed to ensure residents have enough staff support during their meal. Menus and records of food provided confirmed that residents have been provided with a varied, wholesome and nutritious diet. Surveys completed by residents confirmed they generally liked the food provided. One resident commented, “When a spiced dish or similar is one the menu, an alternative is available.” Another resident commented, “Ample portions for me personally and well presented.” A third resident commented, “The lunches are excellent. We have a fantastic chef who provides nourishing, wholesome and tasty lunches, together with delicious birthday cakes and cake for afternoon tea.. One resident commented about the evening meal “ …portions are small, unappetising and the same all year round.” The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered provider has taken appropriate steps to ensure any complaints made by residents, their relatives or friends will be listened to, taken seriously and acted upon. The registered provider has taken appropriate steps to ensure residents are protected from abuse or neglect. EVIDENCE: There is a written complaints procedure, which is displayed on a notice board near to the front door. It includes details of the person to whom the complaint should be made and indicates the timescales by which the complainant will receive a response. The address of the Commission was not correct. When this was pointed out to Mrs Heffron, arrangements were made to amend the procedure before the completion of this visit. Surveys returned by residents and their relatives confirmed they knew who they should speak to if they wished to complain about the care and services provided. It was also confirmed that the care home has responded appropriately when concerns have been raised about the care provided. The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 18 The manager has maintained a record of complaints she has received. This includes the details of the complaint and action taken to resolve any shortfalls identified. Following discussion, it was recommended that details of any investigations that have taken place should also be recorded. One complaint has been recorded since the date of the last inspection. This has been resolved to the satisfaction of the person making the complaint. Information supplied by the registered provider confirmed that, “All service users are informed of concerns/complaints procedures and would be fully supported by the staff.” The registered provider has drawn up a staff development and training programme. This also includes induction training for newly appointed staff. This indicated that all staff have been provided with appropriate training in identifying all forms of abuse and reporting any allegations made. It was also noted that the registered provider has a copy of the Adult Protection procedures published by West Sussex Local Authority. Staff on duty were able to tell the inspector about different types of abuse and to whom they should report any instance they may find. Information supplied by the registered provider confirmed that, “We have achieved training of all our appropriate employees with regard to the protection of vulnerable adults.” The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, and 26 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 safe, well-maintained environment. The home is exceptionally clean and hygienic. EVIDENCE: The private accommodation of several residents was viewed along with the communal areas, including the dining room and the lounge. These areas were tastefully decorated and furnished in a comfortable manner meeting the needs of the residents accommodated. Bedrooms have also been appropriately decorated. Residents have been encouraged to bring personal effects and small items of furniture in order to make bedrooms as individual as possible. The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 20 Individual aides and adaptations have also been provided as required. For example there was evidence of hoists, specialist beds and mattresses and wheelchairs. Bathrooms and toilets have also been fitted with appropriate equipment such as raised seats, grab rails and specialist bathing aids. A number of radiators in corridors were not fitted with covers. Weather conditions dictated that it was not necessary to have heating in the care home turned on during this visit. However, one radiator near to the main office had been turned on. The surface temperature was hot to the touch; it was not possible to leave a hand on the radiator after a minute or two. Following discussion, Mrs Wyatt confirmed she was not aware that there was a risk, and therefore had not taken any action, such as fitting radiator covers, to address the matter. Mrs Wyatt was advised to undertake a risk assessment of those areas of the care home where such radiators are present. The purpose of the assessment is to identify if residents are at risk of scalding themselves from excessively high surface temperatures. Mrs Wyatt agreed to carry out such assessments and any work necessary to reduce risks to residents without delay. Information supplied by the registered provider prior to the visit indicated that the premises has been visited by the Fire Officer and Environmental Health officer to ensure it is safe and meets requirements in terms of fire safety and health and safety regulations. The registered provider has also confirmed that any shortfalls identified have been rectified. Equipment such as gas installations, electrical wiring and equipment have been regularly checked and maintained to ensure they are safe to use. It was also confirmed that, “We ensure that the environment is well maintained and offers residents a homely place in which to live.” All areas of the premises have been maintained to a very good state of cleanliness. This included the laundry and sluice areas. Policies and procedures are in place for control of infection. The home has a contract with a waste disposal company for the collection and disposal of clinical waste. Surveys returned by residents confirmed the home is always fresh and clean. One resident commented, “No smell of urine, as is usual, even in the most expensive homes. So The Beeches proves that it is not necessary to experience that. Every home should be run on the same basis as The Beeches.” Another resident commented, “The housekeepers are excellent and they take great pride in keeping The Beeches spotless and smelling fresh and clean.” The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered provider has ensured there is sufficient staff on duty with the appropriate mix of skills to meet the needs of residents accommodated. This also ensures residents are in safe hands at all times. Residents are supported and protected by the home’s recruitment policy and practices. The registered provider has ensured staff are trained and competent to do their jobs. EVIDENCE: On the day of this visit two trained nurses were on duty. A team of six nursing assistants supported them. In addition there was a cook, a kitchen assistant and two servery assistants, two house-keepers and two laundry assistants. This is to ensure the premises are kept clean, residents’ clothes and bed linen are laundered, and residents are provided with cooked meals, snacks and drinks throughout the day. The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 22 According to the staff rota there are two trained nurses supported by a team of six nursing assistants from 8am to 2pm each day. From 2pm to 8pm there is one trained nurse supported by a team of five nursing assistants. On some days there is a second trained nurse during the afternoon and evening. There is one trained nurse and four nursing assistants awake during the night to provide residents with care and support as required. It was, therefore, concluded there were sufficient trained nurses, care assistants and ancillary staff to meet the needs of residents accommodated. This also ensures staff are in safe hands at all times. Surveys returned by some residents confirmed staff are available when they are needed. One resident commented, “ Always quick to come to me.” A second resident commented, “Almost always.” A third resident said, “Matron, Deputy Matron and the nurses usually are. Carers are not always available. When you ring your bell it sometimes takes ages before someone comes. During the visit it was noted that call bells rang for sometime before they were cancelled. A nursing assistant passed by without going to answer them. When this was pointed out, Mrs Wyatt indicated that, due to the design of the call bell system, sometimes bells are queuing up to be answered. The system will not stop ringing until the last bell has been answered. However, Mrs Wyatt did go to check to make sure no bell had been left unanswered. On one occasion, Mrs Wyatt did use the Tannoy system to request that the staff answer a bell. On one occasion an emergency bell sounded. Three staff immediately went to answer this call. It was recommended that the manager speaks to all staff to ensure staff are aware of their responsibility to answer bells within an agreed timeframe. Recruitment records were not available. The person who deals with this is the one who can access them. This person was not present at the time of this visit. However, Mrs Heffron has since confirmed that appropriate checks, including criminal record (CRB) checks have been obtained with regard to members of staff who have started working at this care home since the last inspection. This means that vulnerable residents are protected from possible abuse. Records seen showed that all newly appointed staff have undergone a structured induction programme. The model currently used follows the basic principles of good quality of care including understanding how to provide care in a manner that respects residents’ rights of choice, privacy, dignity, independence and being treated as an individual. Records of training provided were also examined and demonstrated that training for all staff has included mandatory training such as fire safety, food hygiene, adult protection and health and safety. Staff on duty confirmed the training they had received. The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 23 According to information supplied by the registered provider, The Beeches employs 23 nursing assistants on a permanent basis. Of these 19 nursing assistants hold the National Vocational Qualification in care (NVQ) at level 2 or above. This means that 83 of the nursing assistants employed currently have this qualification. It was also confirmed that, “All staff receive 3 months induction training and regular updates.” Some surveys completed by relatives confirmed that staff have the right skills and experience to look after people properly. One relative commented, “The nursing staff seemed very experienced and were able to deal with all medical questions…” Another relative commented, “…my experience is limited but the home was highly recommended and seems to live up to its reputation.” However, one relative commented, “Unfortunately due to staff shortages, especially over weekends, my father has not been shaved and I have been told that The Beeches do not employ a cleaner everyday, which has been evident in the way his room looks over the weekend.” The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Beeches has been well managed and has been run in the best interests of residents. Residents’ financial interests are safeguarded. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 25 Mrs Heffron is the registered manager. She is a Registered Nurse on part 1 of the register. Residents and staff spoken to believe Mrs Heffron is approachable and will listen to their views. Surveys returned by some residents and their relatives have confirmed their satisfaction with the management of the Beeches. A resident commented, “Even if one is elderly and has to eventually end one’s days in a home, there is no reason why all homes shouldn’t be run on the same basis as The Beeches.” Another resident commented, “I think that the care we get is of a good and high standard.” However, one resident commented, “Standards of care and personal attention have gone down since the expansion. Staff are overworked and overly dependent on agency staff that are not familiar with residents.” A relative commented that The Beeches is a “ Clean, well run and maintained home.” Information supplied by the registered provider confirmed what they do well is that they have, “Upgraded a second deputy manager to assist and support home and (to ensure) a more solid management team.” Mrs Wyatt provided evidence to confirm that an external assessor, contracted by the care home, visits on a regular basis to conduct an audit of the care and services provided. Mrs Wyatt also confirmed that she uses this information to make improvements when indicated to ensure the care home is meeting the needs of residents accommodated. This was also confirmed in the AQAA when Mrs Wyatt has identified what had improved over the last 12 months, “We have employed the services of an external auditor to audit the quality assurance system.” Residents confirmed they manage their own finances or get help from their relatives. One resident explained that their daughter looks after their financial affairs. When necessary Mrs Wyatt has arranged to have an itemised bill sent to them for incidentals such as newspapers, chiropody and hairdressing. Records of incidents and accidents to residents were examined. Two incidents have occurred where the Commission would expect to have been notified of them. They involved residents requiring hospital treatment following an accident. The purpose of these notifications is to enable the Commission to monitor such incidents and events and the action taken by the care home to ensure residents receive appropriate care and treatment. Mrs Heffron was unable to confirm that the Commission had been notified of them. However, in future she agreed to ensure this has been done. The premises have been well maintained, ensuring a safe environment in which residents can live and staff can work. The registered provider has supplied information that indicates equipment such as boilers, other gas installations and electrical equipment have been regularly serviced and The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 26 maintained. Residents have told the inspector that they are very satisfied with the accommodation and services provided. According to training records staff have been provided training in such subjects as fire safety training, moving and handling, food hygiene, infection control, health and safety. Staff on duty, who were spoken to confirmed the training they had received. The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 27 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 28 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.V347580.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Beeches DS0000024222.V347580.R01.S.doc Version 5.2 Page 30 - 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. 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