Inspection on 18/05/05 for The Beeches Care Home

This inspection was carried out on 18th May 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Beeches Care Home 04/01/10

The Beeches Care Home 29/08/07

The Beeches Care Home 30/08/06

The Beeches Care Home 17/01/06

The Beeches Care Home 26/01/05

The Beeches Care Home 11/08/04

The Beeches Care Home 09/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Beeches Luxury Nursing Home 25 Park Road Coppull Chorley, Lancashire PR7 5AH Lead Inspector Anne Taylor Unannounced 18 May 2005 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Beeches Luxury Nursing Home Address 25 Park Road Coppull Chorley Lancashire PR7 5AH 01257 792687 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Mohammed Hussain Care Home with Nursing 34 Category(ies) of OP - Old Age (34) registration, with number PD - Physical Disability (2) of places The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 34 service users to include: 1. Up to 34 service users in the category of OP who need nursing care. 2. Up to 27 service users in the category of OP who need personal care only. 3. Up to 2 service users in the category of PD. 4. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 26 January 2005 Brief Description of the Service: The Beeches nursing home is situated in Coppull, approximately two miles from Chorley town centre. It is located off the main road in three acres of land with gardens to the front and rear. The home can be accessed by a regular bus service. The home is registered for 34 older people with a range of physical and personal needs, including those requiring nursing care. The accommodation has both single and shared rooms. There are two floors accessed by a passenger lift. All rooms have wash hand basins and there are 16 rooms with en-suite facilities. Two of the three bathrooms have hoists for assisted bathing. There are three lounges; one is for residents who wish to smoke. In addition, there is a dining room and an activity room. The home provides a variety of social activities and events that are arranged by an activity coordinator. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over one full day in May 2005. The management team had worked hard to address issues raised at the last inspection and some progress had been made, however some areas still need to be improved and so requirements and recommendations have been made. The inspection involved discussion with the people who lived and worked at the home and visitors, examination of records, policies and procedures and a tour of the premises. As part of the inspection process the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the home. All records relating to these people are inspected along with the rooms they occupy in the home. They are invited to discuss their experience of the home with the inspector, however this is not to the exclusion of other people living at the home. All residents and visitors spoken to were satisfied with the care provided and facilities and services available to them. What the service does well: Care is provided in comfortable, homely surroundings in which the residents feel safe and well cared for. A lot of effort has been put into developing a range of activities for residents to enjoy and the home enables residents to take part in valued and fulfilling activities. Good relationships have been developed between residents and staff so that residents feel comfortable and have some control over their lives. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 6 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 Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 A thorough pre admission procedure ensured that prospective residents could be involved in the process and their individual wants and needs properly assessed EVIDENCE: Although standard one was not fully assessed at this inspection the requirements made at the last inspection in relation to the statement of purpose and service user guide had been addressed. Pre admission assessments carried out by the home and social workers involved prospective residents and or their relatives. This helped residents to know what sort of care they should expect to receive when they came to live at the home. When asked residents said, “my daughter looked round and chose it, (the home) and someone came to see me and talk to me about it”. The senior sister said that the manager or another experienced nurse usually The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 9 Carried out pre admission assessments for the home. The home and any prospective resident could then be sure that an appropriately trained person had done the assessments. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 8 The care planning process was not thorough enough to ensure the needs of residents were consistently met. Risk assessments were not detailed enough to ensure the safety of residents. EVIDENCE: Care records seen showed that each resident had a plan of care that had been agreed with him or her or a relative. This meant that residents or their relatives had some idea of what care they should expect to receive whilst living at the home. It als gave them the opportunity to discuss any concerns and identify any specific needs or preferences. When asked the senior sister and more junior staff said that care plans were drawn up by trained nurses after consultation with the resident or relative whenever possible. And they used information from pre admission assessments undertaken by the home, social worker or nurse from the hospital. Although staff were able to discuss individual needs and how the home met those needs this was not reflected in the care records. Care plans were The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 11 sometimes too brief and instructions for staff not specific enough to help the care process and promote the welfare of residents. Risk assessments, particularly those relating to the use of bed rails were also too brief and need to be improved to ensure the continued safety of residents. Records showed that people living at the home had access to health care services according to individual need so that specialist advice and treatment could be provided. Residents were generally satisfied with the care they received, comments included “It’s always been alright here, and we’re well looked after”. One visitor said, “I’ve been coming every day for a few years and the care has always been good”. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 & 13 The daily routines were flexible so that residents were able to exercise choice, have some control over their lifestyle and maintain contact with family and friends. The range of social activities available met the expectation of people living at the home. EVIDENCE: The statement of purpose and service user guide contained information about maintaining contact with family and friends, activities available and residents’ right to choice and fulfilment. These documents were available to residents and visitors so they could refer to them if they wanted information about the facilities and services available to them. Residents spoken to said that they were able to exercise choice about what time they got up and went to bed and what clothes they wore, giving them some control over their lifestyle. For residents unable to make such choices, personal preferences were recorded in care plans. When asked how they helped residents to exercise choice staff said, “we ask if they want to get up and what they want to wear every day”. Records showed that appropriate attention was paid to helping residents to take part in valued and fulfilling activities that were already established or The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 13 developed in the home so that the lifestyle experienced by residents met their expectations and preferences as much as possible. The activity organiser produced a monthly newsletter, which informed residents of forthcoming events, activities and the dates of religious services to be held in the home. Some of the people spoken to preferred to spend time in their rooms and were happy that they were not forced to participate in the activities provided. They said, “there are activities but I like doing my own thing, I like to paint and go outside in the summer”, “I like to stay in my room and watch television I don’t like the main lounge where activities are but I can join in if I want.” One visitor said “there is always something going on, although my aunt is not able to join in”. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Not enough attention was paid to ensuring that residents knew about the complaints procedure so that they would know how and who to complain to. EVIDENCE: A complaints procedure was in place however, residents spoken to did not know how or who to complain to they said “I’ve never had to make a complaint but wouldn’t know how” and “I wouldn’t know what to do if I had a complaint, I’ve not seen a complaints procedure”. One visitor said, “I did complain once when my mum was here, it was dealt with properly and I felt that I had been listened to”. A complains log contained details of any complaints made about the home. Complaint records need to include details of the investigation undertaken, action taken and eventual outcome so that residents can be reassured that the complaints process is managed effectively and to improve the service if necessary. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 The home was clean, comfortable, and homely and provided an environment that was suitable for its stated purpose. Improvements were needed to ensure the continued comfort and safety of residents. EVIDENCE: The home was accessible to all residents. Ramps allowed easy access to the outside and a passenger lift was provided to access all floors. Outside the grounds were tidy and well maintained, providing a pleasant area for residents to enjoy if they wished. One visitor said, “It is home from home here”. Some parts of the home were looking a little tired and shabby. Some carpets were stained and some furniture dated. The person in charge said that rooms were redecorated as residents left. A formal planned programme for maintenance and refurbishment needs to be in place so that furnishings, fittings and décor in all parts of the home can be renewed and kept up to date when needed. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 16 Not all pipe work was guarded and hot water pipes present a possible health and safety risk to residents. Pipes should be appropriately covered to ensure the continued safety of residents. One resident said that the lighting in her room was quite dull and she needed a brighter light to read, write and paint. She said that she had asked staff about it but was still waiting for something to be done about it. The home was clean and free from offensive odours. One resident said, “My room is always clean and tidy”. One visitor said, “it’s always clean and tidy, it never smells or anything”. Cleaning schedules were kept in each bedroom and domestic staff signed them when cleaning tasks had been completed. This provided an effective way of making sure residents accommodation was kept clean and hygienic. Policies and procedures were in place that identified infection control measures in place at the home. However, the clinical waste bin in one of the sluice rooms did not have a lid or a disposable plastic liner, which increased the risk of cross infection. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 The recruitment process was not thorough enough to ensure the continued protection of residents. The skill mix and the number of staff on duty was sufficient to ensure the needs of residents were met. EVIDENCE: Staff rotas were in place, which showed the number of staff on duty and the capacity in which they were employed. Staffing levels met the minimum requirements of the previous regulatory body and were rostered in sufficient numbers to ensure the needs of residents could be met. When asked about staff residents said, “the staff are good here”, “staff treat me well and I like a bit of banter with them”. One visitor said, “above all is a feeling that staff genuinely care”. A recruitment checklist had been introduced to assist the recruitment process and records showed that in general the recruitment procedure had improved since the last inspection. However, in order to protect residents all necessary checks need to be carried out before an employee starts work. Staff recently employed at the home were able to discuss their interview and confirmed that they had been asked about previous experience and what training they had done that was relevant to the job of care assistant. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 18 Clear lines of accountability were in place regarding staffing and recruitment. The senior sister said that the manger usually carried out interviews and had overall responsibility for ensuring the right person was selected and that all checks relating to ”fitness” were carried out. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The current management processes do not make sure that systems and equipment used by the home are properly maintained so that the health, safety and welfare of residents and staff are fully protected. EVIDENCE: Certificates to confirm that systems and equipment used by the home were not all up to date. Requirements made at the last inspection in relation to safe working practices and the development of a fire risk assessment remains outstanding. Staff confirmed that they had received some training in relation to health and safety such as moving and handling and fire safety. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 20 When asked residents said that they felt safe living at the Beeches one resident said, “yes I feel safe here, staff are careful when helping me move”. The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x x x x x x 2 The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15(1) Requirement A written plan of care that clearly shows how a residents needs in respect of his health and welfare are to be met must be in place. The plan should give clear instructions for staff to follow and be specific to individual needs. Risk assessments relating to the use of bedrails must include the reason for their use, the risks associated with their use and management strategies to remove or reduce the risk. Residents must be made aware of the homes complaint procedure and advised of how and who to complain to. Complaint records must detail any action taken by the registered person in respect of any complaint made. Lighting suitable for residents must be provided. Lighting in bedrooms must be bright enough to allow residents to read and carry out recreational activities. Worn furniture and fittings must be replaced. Stained carpets must be cleaned and if unsuccessful replaced. Timescale for action 31st August 2005 2. 8 13(4)(c) 31 August 2005 3. 16 12(1)(3) 31st July 2005 31st July 2005 31 July 2005 4. 16 17(2) Schedule 4 23(2)(p) 5. 19 6. 19 23(b)(d) 30th December 2005 Page 23 The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 7. 8. 9. 19 26 29 13(4)(c) 16(2)(j) Hot water pipes must be appropriately guarded. 10. 38 11. 38 12. 38 Clinical waste bins must be fitted with lids and the correct disposable liner. 17(2)Sche All checks pertaining to the dule 4 fitness of prospective employees must be obtained prior to the start of employment. (Timescale of 31.12.04 not met) 23(2)(c)1 Systems and equipment used at 3(3) the home must be properly maintained. A gas safety certificate and confirmation that controls are in place to reduce the risk of legionella must be sent to the Commission. 12(1) Risk assessments in relation to safe working practices must be undertaken and properly recorded. 13(4) A fire risk assessment must be carried out and properly recorded. 30th September 2005 31st July 2005 31st July 2005 31st July 2005 31st July 2005 31st July 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 7 8 19 Good Practice Recommendations Trained nurses should be aware of the guidelines for record and record keeping produced by the Nursing and Midwifery Council. The home should obtain a copy of the advice booklet on the safe use of bedrails issued by the medical devices agency. A formal planned programme for maintenance and refurbishment should be developed The Beeches Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road Chorley, Lancashire, PR7 1NW 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 Luxury Nursing Home F57 F08 S25548 The Beeches V227684 180505 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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