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Inspection on 16/09/05 for The Beeches Nursing Home

Also see our care home review for The Beeches Nursing Home for more information

This inspection was carried out on 16th September 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is domestic in appearance and very clean. Residents said it was like home from home and they could do as they pleased. One resident stated that people can, and do, express their views. Everyone who was spoken with said they felt well cared for. All bedrooms are spacious, with many of them with a panoramic view overlooking Bradford. The proprietor visits the home almost daily, and many of the residents know who she is. The home has been built to a high standard, and the owner makes sure that repairs, renewals and refurbishment is on going. Entertainment in the home is high priority. One resident said there was always something going on, and that she was looking forward to Christmas. She also said that she could provide her own entertainment if she wanted, and was not expected to take part in entertainment arranged for them. Staff education is high on the agenda, with many of the care staff having achieved NVQ at either level 2 or 3.

What has improved since the last inspection?

Since the last inspection, the provider has developed two of the double bedrooms into single rooms. The staff room has also been converted into a single bedroom. All new accommodation is provided with en-suite facility A deputy manager is now in post to support the manager who has gained the respect and confidence of staff and residents. Provision of resident centred activities has improved an already first class service. Monthly theme days are provided with specialist food, entertainers and resident participation.

What the care home could do better:

The recruitment process could be better. At the present time, staff files inspected identified that the process is not robust in that two of the staff had not had a CRB completed by the management, but had brought one with them from their previous employer. All had no photo identification, and three did not contain copies of passport and birth certificates.

CARE HOMES FOR OLDER PEOPLE The Beeches Nursing Home 320 Beacon Road Wibsey Bradford BD6 3DP Lead Inspector Pamela Cunningham Unannounced Inspection 16th September 2005 10:20 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 Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 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 Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Beeches Nursing Home Address 320 Beacon Road Wibsey Bradford BD6 3DP 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) 01274 608656 01274 870099 Victorguard Care plc Mrs Janice Low Care Home 64 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (1), Physical of places disability over 65 years of age (64) The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The place for MD(E) is specifically for the service user identified in the application dated 26.8.4 21/10/04 Date of last inspection Brief Description of the Service: The Beeches Care Home is a purpose built facility situated in the Wibsey area of Bradford It provides care for 64 Elderly people with Physical Disabilities over the age of 65 yrs. It is serviced by a regular bus route, and there are ample parking places available. There are pubs, shops and churches nearby.Care is provided on two floors, in a mix of 62 single and 1 double room. There is also a spacious dining room on the ground floor of the home with panoramic views over Bradford where residents can sit and dine in congenial settings. There are three ample sized lounges where residents may choose to spend their day. The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection, which was Unannounced, was undertaken by one inspector on the 16th September. The inspection started at 10.00am and finished at 4.30pm. The purpose of the inspection was to ensure the home was operating and being managed for the benefit and well being of the residents. Comment cards were taken to the home on the day of the inspection to give people the opportunity for residents and relatives to comment anonymously. It is expected that a number of these will be completed and returned. The inspection consisted of reviewing care documentation and staff files. Talking to residents and staff, and looking around the premises. Because of the detailed information package provided to prospective residents, they are able to make an informed choice whether or not to come to live at the Beeches. Pre admission assessments ensure resident’s needs are assessed and documented. This assures their needs can met once admitted. Care pan documentation is of a good standard providing staff with a tool by which they can ensure the residents needs, and any special needs are met. The medication system is safe, however it is advised that signatures are not present on hand written instructions on MAR charts of medication prescribed out of the normal monthly cycle. Social activities are provided at the home, and residents said they enjoyed them. They also said they enjoyed the food, especially the variety on the themed days recently implemented. The environment, which has been built to a high standard is kept very clean, and well maintained. Since the last visit two of the double rooms, and the staff room have been converted into single en-suite rooms. Staff now take their meal breaks in the dining room which gives the home a more homely look. Staff continue to be provided with training with many of the staff achieving NVQ at level 2 and 3. Staff spoken to said they looked forward to the training offered, as it gave them a better insight into the care residents should have. What the service does well: The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 6 The home is domestic in appearance and very clean. Residents said it was like home from home and they could do as they pleased. One resident stated that people can, and do, express their views. Everyone who was spoken with said they felt well cared for. All bedrooms are spacious, with many of them with a panoramic view overlooking Bradford. The proprietor visits the home almost daily, and many of the residents know who she is. The home has been built to a high standard, and the owner makes sure that repairs, renewals and refurbishment is on going. Entertainment in the home is high priority. One resident said there was always something going on, and that she was looking forward to Christmas. She also said that she could provide her own entertainment if she wanted, and was not expected to take part in entertainment arranged for them. Staff education is high on the agenda, with many of the care staff having achieved NVQ at either level 2 or 3. What has improved since the last inspection? What they could do better: The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 7 The recruitment process could be better. At the present time, staff files inspected identified that the process is not robust in that two of the staff had not had a CRB completed by the management, but had brought one with them from their previous employer. All had no photo identification, and three did not contain copies of passport and birth certificates. 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 Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 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 Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, and 5. The home does not provide intermediate managed care People are able to make an informed decision about the home from the written information they are provided with before they decide to live at the home, and what they see when they have a trial visit to the home. Appropriate assessments make sure the prospective residents can inform the home of their expectations and preferences. Pre-admission documentation was of good quality. EVIDENCE: Very good information is provided to prospective residents showing how the home is run and how the staff are trained. The manager takes responsibility for checking the prospective residents needs can be met before admission is agreed. A trial visit is then offered so that the prospective resident can check if the home is suitable for them. The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 10 All residents have contracts of residency, which states in detail all charges. These documents are kept in the managers office, and are signed by either the resident or their next of kin. Certain residents were able to confirm that they had personally visited the home prior to admission or had been assessed by the manager, or deputy. The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 The assessments and care plans give clear details of the actions staff must take to meet the needs of the residents. Person centred care documentation and practices were observed, taking full account of the resident’s personal, health, social and emotional needs. Care is provided in such a way that the resident’s privacy and dignity is ensured. All care plans are up to date, and reviewed monthly or when there is a change in the residents’ health. There were slight anomalies in the medicine administration records. EVIDENCE: Three of the resident’s case records were inspected and case tracking undertaken Two related to new admissions and one to a long term resident with complex nursing needs. The assessments and care plans gave good details about the residents care needs and any special medical needs that had been identified. The case records also give good details about the resident’s personal preferences and expectations. All necessary risk assessments were documented. The resident’s wishes in respect of their preferred life style and The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 12 routine are well recorded. This also resulted in residents being treated as individuals by the staff team, as observed. Review of the medication system identified that there were occasions where signatures were not present on hand written instructions on MAR charts of medication prescribed out of the normal monthly cycle. Otherwise the medication system appears to be robust. The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15 Residents’ choices are respected and contact with family and friends is encouraged. Residents comments about the food are welcomed and any suggestions acted upon. Social activities are well planned. EVIDENCE: Residents and relatives spoken to during the visit confirmed that they were able to visit at any reasonable time. Those who wish, and can, go out with families, to church related events, and for walks. One resident confirmed she took part in communion, which is provided by the Roman Catholic representative who visits the home. Relatives spoken to said they were invited to discuss their relatives care during 6 monthly reviews, or at any time if they had concerns. The pre admission assessments gave a good background history of lifestyle preferences. Residents spoken to during the visit said they were ‘ very well looked after’. One resident said she preferred to spend time in her room, but that the care staff were always “popping in” The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 14 Although the food was not sampled, residents spoken to confirmed they were pleased with the quality and quantity served during mealtimes, and that they could ask for drinks and snacks outside mealtimes. The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Complaints are dealt with appropriately by the manager, with meetings being arranged between the complainant and the home to try and resolve the concerns raised. The majority of care staff have had some training in the protection of vulnerable adults, and therefore residents are protected from abuse. EVIDENCE: The home has an adequate complaints procedure. People spoken with said they found the manager approachable and felt they could express their views. Staff who have completed NVQ levels 2 and 3 have had training on abuse but there have been several staff changes since that time. The home has made a referral to The Bradford Adult Protection unit for further training on adult protection. Staff awaiting the training, are briefed on the procedure to be taken should abuse be suspected and observed by the manager and senior staff during the induction period. The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 The home offers a comfortable, well-maintained environment for the residents. The standards of cleaning are consistently high throughout the home. EVIDENCE: The owners keep a high profile in the home to ensure that health and safety standards are implemented. The manager being the Health and Safety representative for the home has completed training in this. Communal areas are kept to a high standard and are spacious and comfortable. Bedrooms are redecorated and refurbished as they become vacant. Residents who wish, have keys to their personal accommodation, and have had risk assessments undertaken. Each bedroom contained personal belongings and was arranged according to the preferences of the occupant. Some residents have a private telephone line. The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 17 All rooms have en-suite facilities, however there are also a sufficient number of communal toilets around the home The standard of cleanliness in the home was very good. Since the last inspection visit the providers have converted the staff room and two double rooms into single en-suite accommodation, in order to be able to provide more residents with a single room The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Staff were polite and respectful. Staffing numbers and skills ensure that residents’ needs can be met. The homes recruitment policy is not robust which could lead to the residents not being protected. EVIDENCE: The home employs a total of 37 care staff, 65 of which have achieved the NVQ award, at either level 2, or 3. The nurse in charge confirmed very little agency staff were used, with the existing staff taking on any extra shifts to ensure the needs of the residents were met by staff that know them. In addition to topics covered as part of the induction programme for new staff and the NVQ award, training has included first aid, food hygiene, fire safety, moving and handling, health and safety at work and Adult Protection. Staff personnel files inspected showed that two of the staff had not had a CRB completed by the home, but had brought one with them from their previous employer. All had no photo identification, and three did not contain copies of passport and birth certificates. The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 19 The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 37 and 38 With the exception of the problems identified in the recruitment process, the home is well managed and the manager is well able to fulfil her responsibilities. She offers good leadership to the staff and ensures the residents are protected and cared for in a correct manner. Record of the checks of the hot water in the home were unclear. EVIDENCE: The manager, who is a Registered General Nurse, also has a Further Education Teachers Certificate, a Certificate in Education, and a Masters and Honours Degree in Education. In addiction to these qualifications, she is also a Clinical Teacher and has a Diploma in Counselling, and has completed the Registered Managers Award. The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 21 A deputy manager has recently been appointed who will also undertake the award. Residents and staff said the manager was well liked and inspired confidence. The home does not manage any resident’s personal allowances. Some people manage their own finances and others have the support of families or people appointed to manage their affairs. Records showed that staff receive regular fire safety and manual handling training updates. The home’s maintenance book gives a record of all maintenance and repair work. Routine safety checks are done and recorded, bed safety rails, and checks of a nursing equipment in use in the home. Record of the checks of hot water outlets should contain more detail of the temperature of the water. The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 22 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 4 4 3 4 4 4 4 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 3 3 The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 23 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. 1 Refer to Standard OP9 Good Practice Recommendations Any hand written entries onto MAR charts should be signed by the nurse making the entry. The Beeches Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Nursing Home DS0000029133.V255700.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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