Inspection on 03/04/08 for The Beeches Residential Home

This inspection was carried out on 3rd April 2008.

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

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 Residential Home 04/04/07

The Beeches Residential Home 04/10/06

The Beeches Residential Home 07/03/06

The Beeches Residential Home 17/02/05

The Beeches Residential Home 18/08/04

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

CARE HOMES FOR OLDER PEOPLE The Beeches Residential Home The Beeches 39 High Street Ixworth Bury St Edmunds Suffolk IP31 2HJ Lead Inspector Mrs Jan Sheppard Unannounced Inspection 3rd April 2008 10:15 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 Residential Home DS0000047597.V361707.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 Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Beeches Residential Home Address The Beeches 39 High Street Ixworth Bury St Edmunds Suffolk IP31 2HJ 01359 230773 01359 233117 the.beeches@btconnect.com 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) S & A Care Ltd Angela Wade Care Home 35 Category(ies) of Dementia (35), Dementia - over 65 years of age registration, with number (35) of places The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th April 2007 Brief Description of the Service: The Beeches Residential Home is owned by a limited company S & A Care Ltd, and registered to provide care for 35 people who have dementia. Located on the main street of the village of Ixworth, the home consists of one adapted large period building, with a purpose built extension to the rear of the home. Easily accessible village amenities include a Public House, Post Office, Doctors Surgery, food shop and café . There are 25 single and 5 shared bedrooms. Of these 19 of the single bedrooms and 3 of the shared bedrooms have en-suite facilities. Communal bathrooms and toilets are situated close to bedrooms and day rooms. Residents have a range of day rooms to choose from, these include 2 dining rooms, lounges, and a large conservatory overlooking the mature secure gardens. Residents are able to access all areas of the home by using stairs, passenger lift or chair lift. However some bedrooms and en-suite facilities are unsuitable for wheelchair users. The current fees range from £495 to £585 per week. Information about the service is available in the Homes Statement of Purpose and Service Users Guide. These and the most recent Inspection report are available from the service. The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that people who use this service experience good quality outcomes. This unannounced inspection took place over seven hours during a weekday. This was a key inspection that focused on the key standards of the Care Standards Act 2000 relating to Older People. During this inspection the inspector made a tour of the building, had in depth discussions with the homes manager who was present throughout, spoke with a number of residents and various staff on duty and made spot checks on a number of the homes records including three care plans, two staff records staff supervision and training records and several of the homes maintenance and safety records. The detail of this report reflects the findings on that day and also takes account of information sent periodically to the Commission by the homes management. Information contained in the AQAA (Annual Quality Assurance Assessment) and information given in a number of pre- inspection surveys sent to residents’, relatives, staff and other professionals was also taken into consideration. This was a positive inspection when we found that the requirements and recommendations made at the last inspection had been met and Although this inspection was completed by just one inspector the wording used in the report will refer to “we” as the report is written on behalf of the Commission. The homes manager intends to make an application for registration. This should be made as soon as possible as the Care Standards Act 2000 requires persons running a home to be registered in respect of that service. What the service does well: We found that the home continues to provide good quality personal care and health care support in a relaxed and homely atmosphere for its residents who all suffer from some degree of dementia. We noted that the staff treat the residents with great respect and dignity and in a calm, reassuring and kindly manner. Comments made included “Staff always consider the individual and care passionately about the people they care for”. Another relative who telephoned the home during this inspection said “The home has enabled my Mother to regain many of her previous skills and interests it is amazing, she now looks so well and happy”. The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 6 Comments from another relative stated “I am endlessly impressed and delighted with the care and kindness which we both ( resident and relative) receive”. One resident who had recently arrived at the home told us “I feel safe here, and I am well looked after”. The home was seen to be well maintained very clean and free from odours. The home had a homely and relaxed atmosphere. We saw that staff were supporting people to go outside into the garden and also into the village to visit shops or to have a cup of coffee in the local café. What has improved since the last inspection? What they could do better: The home is planning to provide assisted bathing facilities that can be accessed by all service users and which enable the staff to assist them in a safe manner. The home is planning for all staff to undertake more in depth training on dementia care. We will monitor the outcomes of these ongoing developments. The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 7 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 Residential Home DS0000047597.V361707.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 Residential Home DS0000047597.V361707.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. Standard 6 is not applicable for this home which does not provide intermediate care. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to the service. People who use this service can be confident that admissions are not agreed until a full needs assessment has been carried out to satisfy that the persons needs will be met appropriately. EVIDENCE: The Manager confirmed that there had been no major changes to the preadmission assessment procedure since the last inspection and information The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 10 provided on the AQAA return confirmed this. She explained that she did now endeavour to obtain a more detailed social background history of the applicant from relatives at the beginning, as a better awareness of a new residents previous life style and interests greatly assisted the staff in meeting their needs especially during the first days of their stay in the home. The written records relating to a recent admission to the home were examined and were seen to contain details of the assessment made by the manager of the prospective resident who was in hospital awaiting discharge. Details of their medical diagnosis, medication and treatment plan were given along with care needs as assessed by social services. Information from the applicants relatives gave details about the persons life, work and interests. Information given to the Commission by relatives in pre- inspection surveys confirmed that they were kept fully informed during the admission process and that their views and opinions were sympathetically received by the home. The homes recently revised Statement of Purpose and Service Users Guide is given to each prospective applicant along with contractual information and a schedule of fees. One relative had commented on the survey that this information was helpful and that she had found that the home continued to maintain good communication with relatives at all times. The Beeches Residential Home DS0000047597.V361707.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. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to the service. People who use this service can be confident that their personal care will be provided in their preferred manner to ensure that their dignity and respect is maintained. They will receive a care plan which is person centred to ensure that staff know what and how to deliver the care required by them. The home has an efficient medication policy supported by procedures and practice guidance which staff understand and follow. EVIDENCE: Since the last inspection the home has introduced a new care plan format which is more appropriate to recording how to meet the individual care needs of service users with dementia and gives more scope for narrative information. The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 12 Three care plans were examined and these were found to contain good detail, were seen to be maintained up to date on a daily basis and were reviewed each month. Evidence of relatives involvement with reviews was also noted. The changed and changing care needs of residents were seen to be recorded in detail and to contain comments as to how these changed needs could best be met. The home has chosen not to introduce an individual key worker system although all the carers do get to know the particular needs of small groups of residents more closely on a daily basis. The manager explained that being a small home with a stable staff group and a long standing core group of residents meant that all the staff had good knowledge and understanding of all of the residents and evidence of this was noted during the inspection. The manager reported that the residents have prompt access to the full range of healthcare services. All residents are registered with the local surgery which is the main practice covering Ixworth. A Doctor from the practice attends the home for a weekly surgery and during the inspection we heard residents being asked if they wished to meet and speak with the doctor during the next visit and for one resident with a more pressing problem an urgent visit was arranged. The Manager stated that the home received an excellent service from the surgery and from its allied district nursing service. The care records evidenced that nurses were visiting the home regularly to attend to leg wounds and to assist with the prevention of the development of pressure areas for other residents. The manager said that their assistance with these aspects and with the loan or provision of specialist equipment greatly assisted the home in continuing to maintain all of its residents free from such wounds. Care plans were seen to contain information about the monitoring of residents levels of nutrition and of their weight. The manager and deputy manager discussed with the inspector the varied ways in addition to the homes normal menu in which the nutritional needs of very active and low weight residents might be maintained; for example the introduction of freely available finger food and more cooked mini meals particularly in the late evenings and during the night. Information given in the daily diary evidenced that extra night meals were regularly offered to one resident whose sleeping pattern was sparse. The daily diary appeared to be being well used by the staff throughout the twenty four hour period. It was seen to contain good detail as to the care given activities or outings that the resident may have participated in and of any untoward incidents or accidents. The home continues to use the blister pack MDS monitored dosage system for medication storage and administration which is now supplied from the local pharmacy at the village GP practice. The manager reported that they receive an excellent service with very prompt attention and good support and training being offered by the pharmacist. The medication administration records (MAR) sheets were examined and found to be well recorded with no gaps in signatures. The regular management checks made of the accuracy of these The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 13 records could not however be evidenced. One medication stock was checked against their recorded administration and the correct amount of medication remained. The home has the correct facilities (double locked cupboard and register), for storage and administration of Controlled Medication and the manager demonstrated a good awareness of this aspect. Medication given at lunchtime was observed. The carer took one residents medication to them, administered this and then signed the MAR sheet when she returned to the drug room. She explained that administrating medication individually from the drug room had been found to be safer than trying to administer from a medication trolley which was now not used. The home has a good sized secure medication room which offers a sink, sufficient sized secure storage facilities including a Controlled Drugs cupboard, a fridge with temperature monitoring, adequate flat surfaces for written work and fans for overall temperature control. During this inspection we noticed that staff addressed residents in a cheerful respectful manner taking care to go at a pace with which the resident could comfortably manage. Residents who were anxious or bewildered were reassured and given the information they needed to ally their fears. During our tour of the building many residents spoke warmly with the Manager demonstrating their confidence in her abilities as home manager and several said that they were very happy and were well looked after in the home. This sentiment was echoed by comments on several of the surveys from relatives. “I arrive unannounced and always find my Mother clean, well dressed and comfortable”. “Staff are so kind, friendly, helpful and patient and are aware of all aspects of care”. The Beeches Residential Home DS0000047597.V361707.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. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to the service. People who use this service can be confident that they will be offered appropriate leisure activities and access to community facilities that meet their needs and aspirations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the home has continued to develop its range of social activities so as to better suit the residents abilities and wishes. Each care plan has a section for Social Activity Plans and it was seen that a record is kept of all activities, the names of the residents who participated and their comments and reactions to each activity. Information on the AQAA evidenced that training on activity running and planning had been attended by some staff and comments from other staff indicated that they felt that this was an area which had progressed over the past year. One resident told the inspector that “there The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 15 is always plenty to do here – it can be very interesting”. Several positive comments were made about the Film Shows, the Cookery Sessions and the Outings that were being planned for the summer months. The activity programmes evidenced that Arts and Crafts classes are popular and examples of work created for the recent Easter celebrations, decorated chocolate egg containers, were shown to the inspector. One resident who enjoys gardening spoke to the inspector about visiting a local garden centre and keeping the tubs freshly filled. The positive approach by one staff member to a resident’s request for a particular item from a chemist was to offer to accompany her to the chemist shop just down the street. On her return the resident commented how much she appreciated being enabled to make such visits out and about in the village. This incident demonstrated the homes ability to enable the residents to exercise choice and control over their own lives. The menus continue to offer a good choice of dishes and staff frequently ask the residents for their comments and requests for particular favourite dishes. A daily choice is available with staff asking residents individually to make a choice the day before, although the manager explained that daily variation requests are also accommodated. Lunch and afternoon tea was observed being served. The atmosphere in the dining areas was calm with staff giving individual help in an unhurried manner. Residents confirmed to the inspector that the food was always very good, one commenting that there is sometimes really too much. The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 16 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. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to the service. People who use this service can be confident that the policies and procedures in place will ensure that people are listened to and protected from abuse. EVIDENCE: The homes Complaints policy is clear and was understood by the staff. Comments on the pre-inspection surveys from both relatives and residents also indicated that they understood their right to complain and how the procedures would operate. The home has received no formal complaints since the last inspection. The home records any complimentary letters which are received and a number were shown to the inspector. During this inspection a relative phoned the Manager to express her gratitude for the special one to one care that her relative has recently been given and mentioned particularly the improvement that she had noticed in her social functioning, whilst chocolates for the staff were delivered by another family as a mark of their appreciation. The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 17 Information given by staff confirmed that they had all attended an in house training session on the protection of vulnerable adults and the manager confirmed that refresher discussion sessions were regularly undertaken to maintain staffs alertness to this area for their very vulnerable group of residents. An un-witnessed incident (a fall) which was reported to the Social Service Adult Protection team during July 2007 was seen to have been handled following the correct procedures. The Manager said that following her recent discussions with the CPN (Community Psychiatric Nursing) service concerning the management of one residents aggressive and unpredictable behaviour. Breakaway training is to be undertaken by some staff which will then be cascaded down to others so that all staff will have the knowledge and skills to deal with any such behaviour. The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 18 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 22 and 26. People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to the service. People who use this service will find that the home is homely. It provides good quality outcomes for standards 19 and 26. However the overall rating for this section has to be rated as adequate as the physical design and the layout of the bathrooms means that not every person’s need can be fully and safely met. EVIDENCE: Since the last Inspection the home has been subject to a number of works of repair and refurbishment and the Manager could evidence that a planned and on going maintenance programme is now in place and is appropriately funded. The Beeches has a homely appearance is well appointed, brightly and attractively decorated with cleanliness given a high priority. The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 19 The manager explained that since the recent change in ownership of the home a considerable amount of new equipment had been purchased including new curtaining, new table linen, redecoration of bedrooms and the hallways and some of the sitting areas. New lounge chairs have been ordered along with new furniture for some of the bedrooms. The kitchen has benefited from a new cooker and dishwasher and the shaft lift has been subject to major repair and an additional stair lift has been obtained. A new electronic hoist has also been purchased. In the garden a gazebo has been erected and new furniture bought. Works to level an uneven area of the patio to render this fully safe are to commence later in the month. Risk assessments for residents who use the secure garden are now in place. The garden was seen to be well maintained and staff said that the aviary is of great interest to many of the residents who also enjoy helping to fill the patio tubs. Residents indicated that they were very happy with their bedrooms which have been individually personalised to reflect their tastes and interests. Of the twenty five single bedrooms nineteen have en-suite facilities. Three of the five shared rooms also have en-suite facilities. All shared rooms have screens for added privacy and only residents who elect to do so are offered shared bedroom accommodation. The home demonstrated a good awareness of infection control measures, soap dispensers and paper towel holders are fitted in all the communal washing facilities, red bags are used for all soiled linen and a good supply of aprons and gloves were seen to be readily available throughout the home thus improving the control of cross infection. All areas of the home visited during this inspection were found to be very clean and tidy and with no mal-odours. All the hot water outlets have now been fitted with new thermostatic controls, temperatures are checked weekly and these records evidenced that all now maintain the water temperature below 43 degrees. Whilst the number and location of the homes bathrooms give adequate provision for the size of the home, the bathroom equipment does not enable good care to be safely delivered to all of the residents, two of whom are currently unable to access any bath. All the current baths are of a domestic style with integral rise and fall bath seats but being positioned against a wall with no space provided between the floor and the bottom of the bath care cannot be safely delivered from them. The showers are only accessible via the bath rendering these inaccessible for several residents. The manager is aware of these inadequacies and showed the proposed refurbishment plans for the bathrooms to the inspector. More easily accessible fully assisted baths are to be fitted along with a level shower in a fully wet room environment. Such provision would enable the bathing needs of all the residents to be fully met and the health and safety aspects for the staff to also be accommodated. The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 20 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. People who use these services experience good outcomes in this area. This judgement has been made using available evidence including a visit to the service. People who use this service can be confident that they will be supported by appropriate numbers of skilled and trained staff who have been robustly recruited to support the people them meeting their assessed care needs and to ensure the smooth running of the home. EVIDENCE: The staff rotas evidenced that sufficient staff are on duty at all times to adequately meet the care needs of the residents. Relatives commented positively about the number of staff on duty. The manager explained that the pattern of having eight staff working during the mornings and six during the afternoon/evenings seemed to provide adequate cover to meet the residents care needs. At night there are two waking staff who start their duties at nine pm so that they overlap with the day/evening staff by one hour this additional staff cover having been found to promote a more relaxed pre bedtime atmosphere in the home. The home is fortunate in being able to retain a very stable staff group many of whom have worked at the home for many years. The home currently has no staff vacancies and the records evidenced that agency staff are never used. The manager emphasised the importance of staff getting to know the residents needs thoroughly so as to be-able to competently meet their very complex care needs. Temporary staff did not have the opportunity to build up this knowledge and expertise. However she The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 21 explained that she hopes to appoint some regular bank care staff who are able to work on an as and when basis and to cover unexpected gaps. The percentage of qualified staff has increased since the last inspection. All the care staff except one, (recently appointed who is completing an Induction Programme) either have already obtained NVQ at level 2 or are studying for this. Four carers have completed NVQ at level 3 and eleven others are currently studying for this level. The Manager has virtually completed NVQ at level 4 and the Registered Managers Award; the deputy manager has obtained NVQ at level 3 and is waiting to start Level 4. One team Leader is also undertaking the Level 4 course on a self funding basis. This level of commitment to training is to be commended especially as many of the older staff had never before undertaken such formal training. Staff who were spoken with told us that they were well supported by the management and we saw that they were working well together as a team. Regular staff meetings were evidenced by the keeping of minutes and a regular supervision plan for each worker could also be seen during which future training needs were identified. The home has an annual training programme covering the needs of all staff. The manager stated that more specialist training on Dementia Care remains a priority but that it is proving difficult to find the appropriate level of training in this area. We noted that plans were being made to arrange such training at an appropriate level on an in service basis. The recruitment records of two staff were checked and showed that the necessary checks (identity, financial, CRB) were carried out to ensure the residents safety and protection. The most recent appointee also had an induction checklist in their file, signed by the member of staff. The evidence provided in the pre- inspection survey questionnaires completed by relatives evidenced their satisfaction with the levels of staff and the manner in which care was delivered to their relatives. Comments included “I am endlessly impressed and delighted with the care and kindness which is offered both to my relative (the resident) and to myself as their relative”. “Staff are so kind, friendly and helpful and patient and aware of all aspects of care”. The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 22 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. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to the service. People using this service can be confident that people are safeguarded by a sound management approach led by an experienced and trained manager whose open approach encourages residents independence and choices. EVIDENCE: The new ownership of the home has been in place since November 2006 and the current manager in post for the past fourteen months. She had previously worked at the home for many years; she is an experienced and well trained Manager who is now just completing her studies for NVQ level 4 and the Registered Managers Award. She has stated that once achieved her application for registration by the Commission will be made. The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 23 The deputy Manager who was appointed at the same time holds NVQ at level 3 and is to commence studies for Level 4 shortly. Previously she had several years experience working in this and in another home both as a carer and at senior carer level. Both these staff confirmed independently that the new management team was working well and this was confirmed by the survey comments made by other staff “We all work very well together as a team”, “The management is always very approachable we can always talk with them”. During this visit we saw evidence of the managers ethos, leadership skills and open management approach. She demonstrated a good rapport with the residents and an easy empowering relationship with the staff which demonstrated that their prime objective in working together was to deliver the very best care services for their residents. Since the change of ownership a great many changes and improvements have been made to the home (the building) and to its operational procedures and it could be seen that the good maintenance of the homes records ensure good safety and protection for the residents. Comments on a survey from a relative confirmed that “the change in ownership and the manager went smoothly with good information given to residents and relatives and since when various improvements to the service have been noticed”. Spot checks made on a number of the homes records (water temperatures, fire testing, accident recording, health and safety risk assessments) evidenced that these were well maintained with good detail and consistency this safeguarding the residents rights and interests. Prior to this inspection we received a number of survey questionnaires from relatives and also from staff. Relative replies were entirely positive about the standard of care their relative was receiving. Comments such as “Staff are always very approachable and kind”, and “my relative is very well cared for and has her views listened to”, were made. Staff comments were also positive, “we always have good support from our managers”, “ we can work well together as a team” and several commented that it was a happy place to work that it had got better over recent months and that is why so many staff had worked there for so long. A programmed system of formal staff supervision is in place and could be evidenced by the records kept of these sessions. Annual appraisals for all staff have been commenced and the identified individual staff training needs could be seen to be planned for in the homes annual training programme. The manager said that the owner makes very regular visits to the home and copies of the Regulation 26 monthly visit reports seen by us evidenced this and that the owners are giving good attention and resources to making various quality improvements in the home. Staff meetings are held monthly and the minutes of these were available for inspection. Relatives meetings are also held periodically, (last in March 2008) and we saw that Quality Monitoring Surveys are regularly sent to relatives. A number of The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 24 relatives and visitors were seen to be made welcome in the home on the day of this unannounced inspection and the homes emphasis on developing a sound family and friends network is to be commended. The manager advised that residents’ monies were not held by the home. They or the funding authority are billed by the company for their care and any additional expenditure which included Hairdressing, chiropody and toiletries. The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 25 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 2 x x 2 x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 The Beeches Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 26 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 Residential Home DS0000047597.V361707.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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. 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