Care Home: Beaumanor House

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What the care home does well People at the home have good access to health and social care professionals and meet with them regularly, which provides them with support and helps them to stay healthy.Staff at the home encourage and help people to take part in activities in the home and within the community.Playing pool.Going to shows.Going to Church.Beaumanor House has a room that has two computers so that people who live at the home can use and have internet access.Beaumanor House has an activities room which has a pool table, table tennis table and football table along with other games such as a large Connect-4 and draughts.The home has regular meetings with people that live at the home, so that they can comment on things that are important to them. What has improved since the last inspection? Everyone who lives at the home has had their needs re-assessed, to ensure that the care and support they require can be provided by the home, for some people this has meant they have moved out of the home and are now living somewhere else.People living at the home have been asked what they think about things, people have met with advocates who work for Mencap as well as having meetings at the home with staff and the Manager.Training has been provided to people living at the home to help them understand what bullying is, and what they should do if someone is bullying them.The courtyard garden has improved and is now a pleasant area to sit outside with plants and shrubs and a water feature and fish pond. Some areas of the home have been decorated and new sofas and chairs along with televisions have been bought.A procedure for helping people stay safe and make complaints has been reviewed, and staff have received training about this, these procedures have been produced so that people living at the home understand them.New equipment has been bought for people to use, which includes a football table, and people living at the home now have the use of a kitchenette so that they can make drinks and snacks.The Registered Manager and other staff have spoken with relatives of people who live at the home, and told them what is happening in the home. Relatives have also been told about the advocacy service CLASP. What the care home could do better: Improve how information is recorded and managed where someone is hurt or upset.Improve the layout of the home to make it more intimate and homely. Key inspection report Care homes for adults (18-65 years) Name: Address: Beaumanor House 34 Robert Hall Street Leicester Leicestershire LE3 5RB The quality rating for this care home is: one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Linda Clarke Date: 1 2 1 0 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 38 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 38 Information about the care home Name of care home: Address: Beaumanor House 34 Robert Hall Street Leicester Leicestershire LE3 5RB 01162664833 01162664833 Beaumanor.House@leicester.gov.uk socis209@leicester.gov.uk Leicester City Council care home 21 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 21 1 0 0 learning disability physical disability Additional conditions: No person falling within category PD may be admitted to Beaumanor House unless that person also falls within category LD - ie Dual Disability Service User Numbers LD/PD No one falling within categories LD/PD may be admitted into Beaumanor House when there is already 1 person of categories LD/PD already acommodated within the home. Date of last inspection 1 5 0 6 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 38 A bit about the care home Beaumanor House provides personal care and support for up to twenty one people who have a Learning Disability and is owned and managed by Leicester City Council. The home is situated in a residential area, close to shops, a public house and other amenities. There is a car park to the front of the home. Public transport routes are nearby, and it is approximately ten minutes to the city centre by car. Beaumanor House has several communal rooms, which include a games room that has a pool table and a computer room with two computers that have internet access for people who stay at the home to use. All bedrooms are single. Care Homes for Adults (18-65 years) Page 5 of 38 Beaumanor House has bathrooms and toilets, which are adapted to meet the needs of those with a physical disability. There is a central courtyard with grass and planters, and provides benches and tables to enable people to sit outside. Information about the service is provided to prospective and current service users within the Service User Guide, which is produced in large print and accompanied by signs and symbols to promote the understanding of the reader. Fees for staying at Beaumanor House are dependent upon a financial assessment, which is carried out by a representative of Social Services. Care Homes for Adults (18-65 years) Page 6 of 38 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 38 How we did our inspection: This is what the inspector did when they were at the care home We as it appears in this Inspection Report refers to the Care Quality Commission. We did this inspection by visiting Beaumanor House on 12th October 2009; we arrived at the home at 08:45 and stayed for 6.5 hours. Before we went to Beaumanor House we looked at the information the Registered Manager had sent to us, this give us information about the home. We sent surveys to people who live at the home. We also sent surveys to advocates, health and social care professionals who provide support, guidance and care for people who live or stay at the home. We looked at the care plans and records of three people who were living at Beaumanor House and we talked with people who were at the home when we visited. We also talked with staff and asked them how they help and support people. Care Homes for Adults (18-65 years) Page 8 of 38 We have written about what we found out when we visited the home and what people told us. What the care home does well People at the home have good access to health and social care professionals and meet with them regularly, which provides them with support and helps them to stay healthy. Staff at the home encourage and help people to take part in activities in the home and within the community. Playing pool. Care Homes for Adults (18-65 years) Page 9 of 38 Going to shows. Going to Church. Beaumanor House has a room that has two computers so that people who live at the home can use and have internet access. Care Homes for Adults (18-65 years) Page 10 of 38 Beaumanor House has an activities room which has a pool table, table tennis table and football table along with other games such as a large Connect-4 and draughts. The home has regular meetings with people that live at the home, so that they can comment on things that are important to them. What has got better from the last inspection Everyone who lives at the home has had their needs re-assessed, to ensure that the care and support they require can be provided by the home, for some people this has meant they have moved out of the home and are now living somewhere else. Care Homes for Adults (18-65 years) Page 11 of 38 People living at the home have been asked what they think about things, people have met with advocates who work for Mencap as well as having meetings at the home with staff and the Manager. Training has been provided to people living at the home to help them understand what bullying is, and what they should do if someone is bullying them. The courtyard garden has improved and is now a pleasant area to sit outside with plants and shrubs and a water feature and fish pond. Some areas of the home have been decorated and new sofas and chairs along with televisions have been bought. A procedure for helping people stay safe and make complaints has been reviewed, and staff have received training about this, these procedures have been produced so that people living at the home understand them. Care Homes for Adults (18-65 years) Page 12 of 38 New equipment has been bought for people to use, which includes a football table, and people living at the home now have the use of a kitchenette so that they can make drinks and snacks. The Registered Manager and other staff have spoken with relatives of people who live at the home, and told them what is happening in the home. Relatives have also been told about the advocacy service CLASP. What the care home could do better Care Homes for Adults (18-65 years) Page 13 of 38 Improve how information is recorded and managed where someone is hurt or upset. Improve the layout of the home to make it more intimate and homely. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Linda Clarke CPC1 Capital Park Care Homes for Adults (18-65 years) Page 14 of 38 Fulbourn Cambridge Cambridgeshire CB21 5XE 01223771300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 15 of 38 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 16 of 38 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments are carried out in a timely manner and are reviewed to ensure individual needs are met. Evidence: We wanted to find out how people were supported to move into the home for long term care or respite care, and how their needs were assessed to ensure that the staff at Beaumanor House could support them effectively. We looked at the assessments of three people whose records we viewed, which identified that their needs were being met, and for some included long term plans for their future. Assessments had been used to develop and review care plans. The self assessment tool completed by the Registered Manager prior to our visit told us that senior staff have met with health colleagues to address concerns previously identified, and that meetings take place on a regular basis to ensure that the needs of everyone are being met. Beaumanor House is currently not admitting anyone to the home. The previous Key Inspection which took place on the 15th June 2009 found that Beaumanor House was unable in some circumstances to meet the needs of everyone living at the home due to the diverse and complex needs of some. Everyone who lived at the home has had their needs re-assessed, and for some people this has meant that they have moved out of the home into alternative accommodation. Care Homes for Adults (18-65 years) Page 17 of 38 Evidence: We sent surveys to Social Workers and Community Support Workers to find out their views about the assessment process, but no surveys were returned to us. Care Homes for Adults (18-65 years) Page 18 of 38 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals living at Beaumanor House are supported to make choices and decisions about their day to day lives and influence future and long term decisions. Evidence: We looked at the records and care plans of three people who live at the home, all care plans have recently been reviewed and provide a comprehensive guide to staff as to the care and support each person requires. We found that care plans include information as to people’s aspirations and goals, and information about how they wish to be supported. Care plans are also supported by Communication Passports which provide information as to how an individual communicates, and the meaning they are conveying through word and gesture. We sent surveys to Social Workers and Community Support Workers to find out their views about the care and support of those living at the home none were returned to us. We found that individuals goals were being encouraged, and that views and opinions were acted upon. One person had indicated that they wished to attend a First Aid course, Care Homes for Adults (18-65 years) Page 19 of 38 Evidence: this has been organised by the home and the person was being supported to attend the course by a Volunteer. By reading records we found that someone had written a letter to the Registered Manager, saying they were unhappy that the computer did not enable them to access facebook or u-tube, this had been acted upon, and the person told us that they now use both programmes regularly. Information in the self assessment tool completed by the Registered Manager told us that opportunities are now in place for people living at the home to make decisions and contribute to the running of the home. Meetings are now held weekly with people living at the home providing an opportunity for people to discuss things which are important to them. We found that these meetings had a positive impact on the service people receive, an example of this was that an issue raised was the need for additional equipment within the activities room; this has resulted in items being purchased which included a football table and table tennis table. We spoke with one lady, who took us to look at the new equipment; they told us that they enjoy playing pool, along with the other games. We found that records contained risk assessments where risks had been identified, and the assessment provided information as to how the risk could be minimised, this ensures that staff work consistently to promote the well-being and safety of people without restricting their choices and freedoms. Care Homes for Adults (18-65 years) Page 20 of 38 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Beaumanor House supports and arranges for people to engage in a range of activities and leisure pursuits within the home and wider community. Evidence: When we arrived at Beaumanor House several people were waiting to go out to various clubs and colleges. We found care plans contained information about what people did with their days. There was one person living at the home who receives one to one support this enables them to receive the care and support, including accessing various activities as detailed within their care plan. One lady sat with us whilst we looked at their care plan, she told us about the things she had been doing since we last visited the home, which included going to Butlins at Skegness on holiday, and she showed us photographs of her holiday which she had in a photograph album which she kept in her bedroom. They went onto to tell us that they liked playing table football and pool. The lady spent time on a one to one basis with a member of staff working the computer. Care Homes for Adults (18-65 years) Page 21 of 38 Evidence: We spoke with a gentleman who also told us about his holiday to Butlins at Skegness, and also told us about the activities hed been involved in, which included going to watch the Special Olympics held at the Walkers Stadium in Leicester, going out to the pub and going shopping. They also told us that their sister regularly visits. Another lady told us that she likes spending time on the computer talking with her friends on facebook and listening to music on u-tube. She told us that she had enjoyed her time at Beaumanor House, but was also looking forward to moving out of the home in a few weeks time. She went onto say that she attends the resident meetings, which she sometimes finds boring, but went onto say that the meetings kept her informed about what was happening at the home. Information we received from the Registered Manager within the self-assessment tool told us that people were able to go out regularly, and that the home has its own transport. Activities have recently included accessing the cinema, shows and clubs, which for one person included going to see The Little Shop of Horrors. Information provided also stated that people living at Beaumanor House have contributed to the Leicester City Partnership Board Hobbies and Leisure Group consultation, by completing questionnaires to influence the development of ongoing plans to increase opportunities for people with learning disabilities. We looked at the records of three people living at the home, and found that everyone had been involved in events and activities within the community since our previous visit in June 2009. Excursions included going to Church, Abbey Park, Twycross Zoo and New Walk Museum. We sent surveys to people who are living at Beaumanor House; keyworkers helped some people to complete the surveys. Surveys told us that people are encouraged to make decisions and have choices as to what they wish to do with their evenings and weekends. One person wrote an additional comment: Listen to me, very friendly and kind. Staff members told us that they are able to support people more effectively now, as several people who had diverse and complex needs have recently moved out of the home, which has enabled them to spend time with those still living at the home. Staff now have the opportunity to spend one to one time with people, engaging in activities both in and outside of the home. Information provided within the self assessment tool, told us that the menu is now displayed in pictorial format, and that photographs of meals have been taken to enable those people with limited verbal communication to express choices as to what they wish to eat by pointing to the photographs. When we visited we noted that the dining room Care Homes for Adults (18-65 years) Page 22 of 38 Evidence: now has fewer dining tables as people have moved out of the home which has provided more space. We spoke with one person who told us that he now serves himself, which has come about by serving dishes being placed on dining tables. When we asked people about the food they said they enjoyed the meals, and surveys completed by people living at the home confirmed this. A member of staff we spoke with said that evening meals were now relaxed, due to the reduced number of people at the home. Care Homes for Adults (18-65 years) Page 23 of 38 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals have access to a range of health and social care professionals who support them with their physical and emotional needs. Evidence: We looked at the information provided to us by the Registered Manager within the self assessment tool before visiting the home; we read that everyone has access to specialist health care facilities, and that everyone’s health care needs are detailed within a Health Action Plan. It also told us that reviews about people and their needs are held at the home, and that health and social care professionals attend these. Information advised us that since the previous Key Inspection in June 2009, staff have attended a half day training course on mental health. We looked at the records of three people living at the home and found that theyre being supported by a range of health care professionals, which for two people included the involvement of an Occupational Therapist to assess individual’s abilities with reference to their moving out of the home into supported living accommodation. We also found that people were receiving specialist health care support, where their medical conditions had deteriorated, which was being monitored well by staff at the home. We sent surveys to health care professionals for them to comment on the care and Care Homes for Adults (18-65 years) Page 24 of 38 Evidence: support people living at the home receive, but none were returned. We looked at the medication and medication records of three people and found that medication storage and recording were managed well, and that medication is administered by senior staff who have receiving training in the safe handling administration of medication. Beaumanor House has recently purchased and installed a new cabinet for the safe storage of Controlled Drugs, should anyone at the home be prescribed such medication. Care Homes for Adults (18-65 years) Page 25 of 38 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals receive guidance and support to raise concerns, and their rights are promoted by staff however there are inconsistencies as to how these are taken forward. Evidence: We looked at the self assessment tool completed by the Registered Manager, which told us that since the previous Key Inspection of Beaumanor House which we carried out on the 15th June 2009 a number of safeguarding referrals had been made where it was thought that people living or staying at the home had been verbally or physically abused by others living at the home. We discussed the referrals with the Registered Manager, who confirmed that these had been accepted as safeguarding events and had been investigated in accordance with the multi agency policies and procedures. We viewed records of meetings held, which included good practice recommendations as to how any future events should be managed and recorded. We looked at the records of three people living at the home, and found that where inappropriate behaviour had occurred between people living at the home, this had been recorded and the appropriate Social Services department notified, this is known as a safeguarding referral. We found instances where good practice recommendations identified in previous meetings had not always been implemented. In one instance a referral had been made verbally, but the referral form had not been completed, we were told that the form hadnt been completed as it was not accepted as a safeguarding event; we explained that the form should be used for referrals, and its Care Homes for Adults (18-65 years) Page 26 of 38 Evidence: completion was not dependent upon the safeguarding referral being accepted. We also found an instance of where a referral had been made, but the information as to whether the referral had been accepted as a safeguarding event was not comprehensively recorded. We spoke with the Registered Manager about improving the recording and documentation of these events, this was accepted by the Registered Manager at the time of our visit, and the form was revised during our visit to enable the home to record the relevant information. This has highlighted the inconsistencies which were not recognised prior to our visit. We spoke with one lady living at the home, and we saw in her bedroom a certificate stating that she had attended a course about bullying recently, she was able to explain to us what bullying was, and what she would do if someone bullied her. She went onto to tell us that she would speak to a member of staff or Pauline the Manager. The Registered Manager within the self assessment tool had identified that since the previous Key Inspection people living at the home had attended an awareness exercise as to their rights and what they should do if they felt unhappy or unsafe. People living at the home are invited to attend weekly meetings, to discuss things which are important to them, we looked at the minutes of these meetings, which are produced in large print and incorporate signs and symbols to promote the understanding to its reader. The minutes of these meetings showed us that individuals living at the home are reminded about how to raise concerns, and what they should do if they feel unhappy or unsafe. Mencap Advocacy services had been commissioned to work with people living at the home both individually and as a group, to find out the views of people living at the home, a report has been produced which includes recommendations for the home to put into practice. The report has been made available to those who took part in the consultation, in a format that helps them to understand the information it contains by the use of plain English, signs and symbols. Recommendations are in the process of being implemented. We sent surveys to advocates to find out their views about Beaumanor House but none were returned to us. We found by looking at records that staff have attended a one day refresher course as to their role and responsibility in reporting concerns to ensure that the welfare of people in their care is supported. The complaints and concerns procedure has been reviewed. We were also informed that staff discuss each person living at the home on a daily basis during handover to improve communication and consistency of information and to promote staff accountability. Staff meetings are also held on a regular basis, to ensure information is communicated effectively. Care Homes for Adults (18-65 years) Page 27 of 38 Evidence: Care Homes for Adults (18-65 years) Page 28 of 38 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Beaumanor House provides accommodation and equipment which supports personal care and has equipment to encourage activities and relaxation. Evidence: Beaumanor House has two lounges, a dining room, a games room, snoozelem and I.T. suite. The larger lounge has recently been painted and has had some new soft furnishings purchased, and has had a new flat screen television installed onto the wall. One person we spoke with told us that he enjoys watching television. The smaller lounge has also had a new television and some new soft furnishings. The layout and design of the building make it difficult for the home to have a homely and intimate feel, with a number of bedrooms and areas within the home not in use due to the reduction in the number of people living at the home. Communal areas are large, and the home layout makes it difficult to support flexible living, such as providing the choice for people to entertain friends and family in their room due to lack of space and seating. Bedrooms are relatively small and do not provide en-suite facilities, but have been personalised with individual belongings, including pictures and have storage facilities, which include a wardrobe and chest of draws. The courtyard garden has been developed by Volunteers from the Princes Trust, and Care Homes for Adults (18-65 years) Page 29 of 38 Evidence: includes seating areas, beds which have been planted, and a pond. A gentleman living at the home told us that fish live in the pond. Individuals living at the home now have access to a kitchenette for making drinks and snacks which reflects their care plans as to promoting independence. We found by looking at the information provided by the Registered Manager within the self assessment tool that the home has benefited from a deep clean, and by looking at minutes of both staff and service user meetings, found that information about Swine Flu had been discussed, which had included talking about the need for everyone to wash their hands. This shows that topics related to infection control are discussed. Care Homes for Adults (18-65 years) Page 30 of 38 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have undertaken training and gained qualifications which enable them to support individuals in their care appropriately and effectively. Evidence: We observed a positive relationship with staff on duty and people who were at the home when we visited, and people we spoke with made positive comments about staff. We saw one lady spend one to one time with a member of staff when using a computer in the I.T. suite, whilst we saw other people who had been out being greeted when they returned home and were asked by staff about their day. One gentleman was heard to request during the morning crab sticks and vinegar; staff were quick in responding to their request. We sent surveys to people living at the home, and surveys told us that they like the staff who look after them, and feel that they are looked after well. One gentleman told us that he had enjoyed his holiday with staff, and that they had helped him to have a good time. The daily staff rota is displayed in the main hallway, and includes a photograph of staff which shows that is on duty throughout the day. The staff rota also includes agency staff who provide one to one support for someone who lives at the home. Beamanor House has seven people living at the home, and we found that their are three Care Homes for Adults (18-65 years) Page 31 of 38 Evidence: members of staff on duty at all times, which enables people to receive one to one support and go out and enjoy activities and recreational events within the community, staffing levels would need to be reviewed if more people were to move into the home. We looked at the training records of staff and information we received within the self assessment tool, and found that 85 of staff have attained a National Vocational Qualification in Care and many staff have also attained a Learning Disability Qualification. Training records showed that in recent month’s staff have attended a one day refresher course on safeguarding, which provides staff with information as to their role and responsibilities in making sure people are safe and free from harm. Staff have also attended a half day course on mental health. Training has also been provided on the Mental Capacity Act and managing challenging behaviour. Training records show that staff have received training in health and safety topics which includes moving and handling and first aid. The training staff receive enables them to provide good quality care and provide support as people wish and as identified within their care plan. Staff receive good support from the Registered Manager and other members of the management team through regular team meetings and supervisions, this means that staff are well informed and know what is expected of them. Care Homes for Adults (18-65 years) Page 32 of 38 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management systems have been reviewed that have brought about improvements but inconsistencies remain with reference to recording and managing events which affect the welfare of people who receive a service. Evidence: The Registered Manager has worked at Beaumanor House since June 2006 and has a qualification in Social Work; she told us that she will be commencing a course in Management in October 2009 entitled NVQ Level 4 Leadership and Management in Care Services. In response to the previous Key Inspection we receive a comprehensive action plan which addresses the requirements and recommendations we previously made. We found by looking at safeguarding referrals that good practice recommendations identified by the service were not always followed with inconsistencies identified in the recording and referral process, which were discussed and accepted by the Management Team when we visited. Care Homes for Adults (18-65 years) Page 33 of 38 Evidence: On reviewing peoples records and speaking with people living at the home, we found that they are being supported and cared for well. Staff have received a number of refresher training courses to enable them to meet the needs of the seven people living at Beaumanor House. Individuals living at the home have been supported through a range of advocacy services, and these services have also been made available to their relatives. Those living at the home have received guidance and reassurance as to their rights and are supported to make decisions and express their views, through regular meetings and one to one support provided by staff. The Registered Manager has organised events for relatives of those living at the home, who have been kept informed of developments over recent months. The Registered Manager told us that relatives will continue to receive information and support, and will be told about events happening within the home. Information supplied by the Registered Manager before the site visit advised us that systems which promote the health and safety of people in the home, such as fire equipment, central heating and electrical appliances are regularly checked and maintained. Care Homes for Adults (18-65 years) Page 34 of 38 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 35 of 38 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action 1 23 12 The safeguarding referral 27/11/2009 form is completed and submitted consistent with the organisations policies and procedures. To promote an open and transparent audit trail. 2 23 12 Accurate and comprehensive 27/11/2009 information is recorded following safeguarding referrals is kept with reference to decisions made by whom. To promote an open and transparent audit trail. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 36 of 38 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 24 The environment is reviewed with regards to the layout to promote a homely and adaptable environment, which is flexible and promotes an intimate living style. Care Homes for Adults (18-65 years) Page 37 of 38 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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