Latest Inspection
This is the latest available inspection report for this service, carried out on 29th June 2010. CQC 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.
For extracts, read the latest CQC inspection for Beech Court Nursing Home.
What the care home does well From information obtained from this inspection the people who use the service can be confident that they will obtain a good standard of care and support. They will also be provided with the opportunity to continue to live as they wish. They can be certain that their concerns will be listened to and that they will be protected from possible abuse or harm by the systems in place. There is a consistent team of staff who are friendly and supportive. There is also a good training programme in place for staff to ensure that they have the skills and knowledge to care for them well. The service is run in the best interests of the people who us it. Information from the whole inspection process shows that the service is managed well and effectively. What has improved since the last inspection? The provision and support for activities for residents has gradually improved. They have listened to the residents and expanded the variety of choices for the evening meals. Recommendations given at the last inspection process has been implemented with the names of the occupants on the bedroom doors which will aid staff and others if there is an emergency evacuation of the home and assist some residents to navigate around the building. Action has also been taken to limit access to the cellar of the home to prevent potential accidents to service users as the key to this is now kept securely away from the area. There has also been some redecoration of bedrooms and a sluice disinfector has been fitted on the ground floor. The records for the recruitment practices for new staff support that the necessary information is obtained before a decision is made that they are suitable to be employed. What the care home could do better: They should continue to expand on the activities they provide to residents. As for the management and administration of the service they should endeavour to set aside protected time for the Registered Manager to carry out her role for managing and leading staff. Ensure that comprehensive records are kept for in regard to training for all the staff employed at the home. Key inspection report
Care homes for older people
Name: Address: Beech Court Nursing Home 37 Newland Street Eynsham Oxfordshire OX29 4LB The quality rating for this care home is:
two star good 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: Ruth Lough
Date: 2 9 0 6 2 0 1 0 This is a review of 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 2 1 0 stars - excellent stars - good star - adequate 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. that people have said are important to them: They reflect the things 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 Older People
Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home
Name of care home: Address: Beech Court Nursing Home 37 Newland Street Eynsham Oxfordshire OX29 4LB 01865883611 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): beechcourt@talk21.com Dr Brian Cheung Name of registered manager (if applicable) Glynis Lynette Dunbar Type of registration: Number of places registered: care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 26 The registered person may provide the following category of service: Care home with nursing ( N) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Beech Court is a large listed building of architectural and historical note. It is situated in Eynsham, a village five miles west of Oxford and is close to shops, Post Office and 3 churches. Beech Court is home to 26 older people who are frail and require nursing care 24 hours a day. The home offers convalescence, holiday breaks, long, and short stay care. The accommodation is provided in single and shared rooms on 2 floors and there is a passenger lift to provide access to all areas. The communal rooms are Care Homes for Older People
Page 4 of 27 Over 65 26 0 2 1 1 0 2 0 0 9 Brief description of the care home spacious and large picture windows afford a good view of the delightful garden. There are spacious, well kept grounds on both sides of the house, to which the service users have access. The home is not registered to accept service users with a primary diagnosis of dementia or mental disorder, this would require additional registration categories being registered. The fees range from £552.00 to £692.00 per week for a shared room to £740.00 to £940.00 per week for a single room. Additional costs are incurred for chiropody, hairdressing, physiotherapy, occupational therapy and personal items. Care Homes for Older People Page 5 of 27 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection process included reviewing information provided by the service in the Annual Quality Assurance Assessment (AQQA) and other records sent in to the CQC (Care Quality Commission) before a one-day visit to the home. An AQQA is a self assessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that the CQC receives information from providers about how they are meeting outcomes for people using their service. The AQQA from this service had been returned to the within the last 12 months and had been completed satisfactorily. The registered manager was present for part of the inspection process when the service was visited on 29 June 2010, between 10:45 and 18:50. During the visit the records for care planning, recruitment, and administration of the service were assessed. Four of the people who live in the home and one relative who Care Homes for Older People
Page 6 of 27 was visiting were involved in the inspection process. Four staff were on duty. Findings from this inspection identified that the home provides a good level of support for the people who live there. A small number of good practice recommendations were given at the time of the inspection and can be found in the body of this report. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 27 following this report, you can contact them using the details 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 Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. The people using the service can be assured that their needs are assessed thoroughly before they are offered a place in the home. Evidence: The information that prospective residents are given about the home before they decide to stay there was reviewed. During the last inspection process the Statement of Purpose was found to have incorrect information in regard to the registration conditions of the service and the contact details of the CQC (Care Quality Commission). From what was provided it was clear that the necessary changes have been made. Prospective users of the service can either be referred to the home via a local social service assessment process or as individuals seeking long or short term support fro themselves. We sampled the care records for the most recent admission to the home which supported that the Registered Manager carries out a detailed assessment of the
Care Homes for Older People Page 11 of 27 Evidence: persons needs. Incorporating information from any social services, other health or social care professionals, relatives and who may be involved with supporting the individual. Prospective new residents are offered an opportunity to visit and or stay in the home for a trial period before they make a final decision to live their permanently. Care Homes for Older People Page 12 of 27 Health and personal care
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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. The people in receipt of support and nursing care can be confident that their needs are planned for and will be met. Evidence: A small number of residents and relatives who were present during the day of the inspection confirmed that they felt the personal care and health needs were being met. Three care plans were sampled to see if the records continue to be detailed and informative as seen at the last inspection process. From what we could see there is a holistic approach to providing care and support with effective care planning and monitoring systems in place and that some information about the persons social and emotional needs are now included. The records also supported that individuals have regular consultations with their GP or any other external health care practitioners involved in their care, including chiropodists, and opticians. Physiotherapists and occupational therapists also visit some service users who privately fund their treatment or support.
Care Homes for Older People Page 13 of 27 Evidence: The medication practices carried out in the home were reviewed. Information given by staff included that the local pharmacist who provides support to the home had recently carried out an assessment of the medication administration and they had not highlighted any concerns. The records and storage for medications appear to be maintained appropriately. The Registered Manager has already identified that the trained staff need to update their medication skills and is on the process of commencing training herself to do this. They do need to ensure that they have information to support that the bank nursing staff who work in the home have the necessary competencies. All of the residents who were observed during the inspection visit appeared appropriately dressed and supported with personal grooming. Care Homes for Older People Page 14 of 27 Daily life and social activities
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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. 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. The people who use the service are given the opportunity to exercise choice over their lives and be able to maintain some of their interests. Meals and menu planning meet their health needs and personal choices and support given when required. Evidence: The provision for social contact, activities and maintaining the interests of the individual service users was reviewed. During the last inspection process it was found that the variety and frequency of activities provided did not always meet the needs or wishes of the residents living in the home. The care records reviewed supported that interests and some of the life histories of individuals are recorded but not always incorporated in the planned care. A copy of the recorded planned activities for June going on in the home supported that usually something planned for each afternoon during the week for residents to join in with, although what this involves is not recorded. In addition on Fridays there is a film show, using the large screen in the lounge and the Baptist Church visit on Mondays to take a service with the residents who wish to participate. Visiting musicians providing entertainment perform on a regular scheduled basis. Staff were able to inform that some residents would be participating in the village fair and events that was occurring
Care Homes for Older People Page 15 of 27 Evidence: that week. A resident and a relative confirmed that preferences and personal choices such as for getting up in the morning, where they wish to be and what they want to participate in all appear to be listened to and supported be the nursing and care staff. Comments from residents and relatives confirmed that the provision for activities had improved over the last few months although at there were times that they thought more could be done. During the last inspection process there were some concerns about choice and variety of food provided, specifically that for the evening meal. Since then the choices for the evening meal have been expanded to include alternative hot food in addition to soup and sandwiches. This appears, according to staff, to be appreciated by residents. The staff continue to look for improving the dining facilities available in the home. Due to limited space in the communal areas they are unable to accommodate all residents to sit at dining tables for their main meals. Choices of where they wish to take their meals and when they would like to have them are all listened to and supported by staff. If residents wish to have a late breakfast or eat in their rooms this is adhered to. Care Homes for Older People Page 16 of 27 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. Service users concerns or complaints are listened to and acted upon. The have systems in place to protect the people living in the home from possible abuse or harm. Evidence: The residents and relative involved in the inspection process expressed that they were confident to speak to the Registered Manager or staff if they had any concerns or worries. The complaints process for the home is left on display in a central area and is included in the information, given to new and current residents, about the home. A copy of the complaints information was reviewed and it supported that it has the necessary information including that of the contact details of the CQC (Care Quality Commission). The service has been in receipt of one complaint since the last inspection process and it could be seen that this was managed well. The home has policies and procedures available to staff for the safeguarding of vulnerable adults(SOVA) from possible harm or abuse. From information available it could be seen that the senior nursing staff and the permanent care staff all have been provided with the necessary training to support that they have the knowledge to manage any concerns should the arise. However, there were gaps in information in
Care Homes for Older People Page 17 of 27 Evidence: regard to the bank staff in regard to training for SOVA and this will be reviewed further in the report. The CQC (Care Quality Commission) has not been in receipt of any concerns or complaints made about the service or informed that any safeguarding issues have been referred to the local authority since the last inspection process. Care Homes for Older People Page 18 of 27 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, 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. 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. The home is generally maintained well and meets the needs of the people who live there. Evidence: The home can provide accommodation for up to 26 residents over 2 floors. The listed building been adapted over time to provide a variety of sized personal and communal spaces that has some limited flexibility for furniture, fittings and access. The main areas of constraints are for providing dining facilities for all the residents and some of the bedrooms are small and not able to accommodate people who need assistance by the use of a hoist. Residents are able to personalise their rooms with their own furniture and possessions. Some of the bedrooms that were reviewed supported this, others through choice of the individual, had minimal personal items on display. The majority of the residents appear to spend most of their time during the day in the communal areas and only a small number remain in their rooms and this is through choice or if their physical health is poor. Advice given at the last inspection process has been implemented with the names of the occupants on the bedroom doors which will aid staff and others if there is an emergency evacuation of the home and assist some residents to navigate the building. Action has also been taken to limit access to the cellar of the home to prevent potential accidents to service users as the key to this is
Care Homes for Older People Page 19 of 27 Evidence: now kept securely away from the area. Since the last inspection process there has been some redecoration of bedrooms and a sluice disinfector has been fitted on the ground floor. Generally there home is kept clean, hygienic and pleasant to live in. However, one mechanical hoist was not as clean as it could be and they were advised to ensure that the routine cleaning programme for the equipment used, is maintained. Practices for the control of infection are supported around the home with liquid soap, paper towels, aprons and hand gel available. Care Homes for Older People Page 20 of 27 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. 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. The homes staffing levels meet the current needs of the service users and that the majority have had the necessary training they may require. The recruitment process is carried out appropriately. Evidence: During the last inspection process there were some concerns raised about limited time the Registered Manager had to carry out any management administration of the service as well as being the only registered nurse on duty. From the information provided the situation has not changed significantly, although the manager has had time allocated to attend training and external meetings. Information available shows that there continues to be a very consistent team of staff employed at the home including regular bank registered nurses who compliment the two permanent members of nursing staff. Listening to comments made by residents and a relative, the staff are very busy but are always present and supportive. Following the inspection visit the Registered Manager has provided information about the NVQ qualifications of both the carers who permanently and as and when required, work in the home. All but two have the minimum of an NVQ 2 in care and the home are awaiting confirmation of funding for them to commence training for this. At least two staff have achieved an NVQ 3 and one is an NVQ Assessor. The home is now able to provide experience placements for university undergraduates undertaking a nursing
Care Homes for Older People Page 21 of 27 Evidence: degree. To accomplish this, the Registered Manager is both a qualified assessor and mentor and the Deputy Manager an assessor. The training programme for permanent staff appears to be comprehensive and includes both mandatory health and safety topics and those appropriate to the staffs roles in the home. This has included palliative care, stroke, nutrition and dementia. Staff have also had talks and instruction from the falls specialist nurse. The information available in regard to the bank registered nurses and carers was less detailed and did not support that sufficient training had been either attained or provided to them. The Registered Manager stated that was in the process of being rectified. A sample of the recruitment practices was reviewed as to see if the process is carried out robustly and that the key information has been obtained. During the last inspection process it was found that there were some gaps in the information held for two members of staff, this was in regard to the verifying of references, interview process, start date or photograph. The service provided information after the inspection that they had rectified the concerns seen. The records for one new member of staff, who had recently been appointed was reviewed and these supported that the process is now appropriately carried out. The application form requests the key information, the interview notes are now quite detailed and show what was discussed during the process and indicate the decisions to employ and why. Copies of written references were in place, proof of identity and contractual agreement are all included. As the individual had only commenced working in the home two weeks previously the induction process was still in process and the records were not available to view. Other comments made by residents and a relative showed that staff were pleasant, cheerful and friendly. At the time of the inspection visit there were twenty residents living in the home. Care Homes for Older People Page 22 of 27 Management and administration
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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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. The service is run in the best interests of the people living there, and is managed effectively by a knowledgeable manager and provider. Evidence: As previously identified the staffing and management of the home has not changed significantly since the last inspection of the service. The Registered Manager continues to lead staff with the clinical nursing and care provision to the residents, the provider takes the lead for the general administration, recruitment practices and financial management of the home. The service has quality assurance processes for consultation with residents, relatives and staff. Annually residents and relatives are requested to complete surveys to seek their opinion of what is provided. They use the information from these for development plans for the service. The last process has occurred since the inspection in 2009 and the results show that the provider has listened to comments and acted upon some of the issues identified to improve facilities and services provided. Staff
Care Homes for Older People Page 23 of 27 Evidence: meetings are held at least twice a year, the last in February 2010, which gave staff the opportunity to discuss practices and outcomes from activities going on in the home. The service does not generally hold any money on residents behalf. They or their representatives are invoiced for any transactions carried out, such as hairdressing, physiotherapy or toiletries. A sample of records for the safe working practices carried out in the home, were reviewed. There are a number of risk assessment processes in place for the daily activities, such fire safety, use of equipment and the use of equipment which are reviewed, updated and actions implemented to maximise safety. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Older People Page 25 of 27 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 Requirement Timescale for action 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 Requirement 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 Older People Page 26 of 27 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 27 of 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!