Care Home: Beech House

Similar services:

• Claremont House
• Oak Ridge
• Sun Court Nursing Home
• Ashville House
• Bilney Hall
• Hill Barn
• Mabbs Hall Nursing Home
• Henrietta House

What the care home does well The manager provides people with good information on the service provided at Beech House. A very detailed assessment of needs is carried out before a person moves into Beech House to make sure that the home can meet their needs. People living in the home have good care plans that inform staff of the level of help that they require and the manager and staff make sure that people are given medical help whenever it is needed. Relatives of people living in the home said "Beech House is homely and provides excellent care" and "everything is done professionally and with loving care" and "the care my mum receives is wonderful, staff are always cheerful and have time for you".The manager is well liked by staff, people living in the home and their relatives and she provides the staff with good leadership; staff are well trained and supervised and many already have or are in the process of doing their NVQ in care qualification. What has improved since the last inspection? The manager has updated the Service User Guide and it now contains all of the information that people need. There are now protocols in place for as and when required (PRN) medication to make sure that staff know why, how, when, what dose and how often it should be administered. People now have their own laundry bins and the staff no longer leave dirty laundry on the floor outside bedroom doors. Signage has been improved upon around the home. Incontinence pads are now stored better and were not clearly visible in people`s bedrooms. Equipment is now stored safely. CARE HOMES FOR OLDER PEOPLE Beech House Brownlow Bend Basildon Essex SS14 1QD Lead Inspector Pauline Marshall Unannounced Inspection 12th September 2008 09:00 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 Beech House DS0000018103.V370989.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. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech House Address Brownlow Bend Basildon Essex SS14 1QD 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) 01268 286863 F/P 01268 286863 cchbeechhouse@yahoo.co.uk Christian Care Homes Miss Kaye Andrews Care Home 28 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (28) of places Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Total number of service users for whom personal care is to be provided shall not exceed 28. Personal care can be provided for up to 28 older people over the age of 65 years of age. Personal care can be provided for up to 22 older people who have dementia and are over 65 years of age. 9th October 2006 Date of last inspection Brief Description of the Service: Beech House is owned and managed by a registered charity, Christian Care Homes. The home provides care and accommodation for up to twenty-eight older people that may require dementia care. The home is in a residential area of Basildon with local amenities and the town centre nearby; it has its own transport in the form of a minibus. The home has six shared bedrooms and sixteen single some of which open out into an enclosed courtyard; all bedrooms are on the ground floor of the building. There is a small area on the first floor that is used by staff only. There are two comfortable lounges and two conservatories where people can sit, watch television or listen to music. At the front of the home there is a grassed area and hard standing for three cars and there is further parking space to the side of the building; there is also on street parking. A copy of the home’s Statement of Purpose and Service User Guide is available on request and is provided to all people with an interest in living at Beech House. Current fees range from £431.20 to £442.57 per week and there are additional variable charges for newspapers/magazines hairdressing, chiropodist, holidays and outings. Beech House DS0000018103.V370989.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 the people who use this service experience good quality outcomes. This was an unannounced key inspection that lasted for five hours. The process included discussions with people living in the home, their relatives, the responsible individual, the manager and staff; an examination of a random sample of the files (including those of staff and people living in the home) and some of the records that the home is required to keep. The inspection covered all of the key standards and included a tour of the property. The manager completed her annual quality assurance assessment (AQAA), a self- assessment that providers are required by law to complete and information from this has been used throughout this report. The AQAA is a form used by the manager to carry out an assessment of how well the outcomes of people using their services are being met. Surveys were sent to the manager to distribute to ten people who live at the home, ten of their relatives, four health and social care professionals and ten care staff. At the time of writing this report surveys had been returned from ten people living in the home and three of their relatives and five of the home’s staff; they contained mainly positive comments about Beech House and are reflected throughout the report. To date no other surveys have been returned. What the service does well: The manager provides people with good information on the service provided at Beech House. A very detailed assessment of needs is carried out before a person moves into Beech House to make sure that the home can meet their needs. People living in the home have good care plans that inform staff of the level of help that they require and the manager and staff make sure that people are given medical help whenever it is needed. Relatives of people living in the home said “Beech House is homely and provides excellent care” and “everything is done professionally and with loving care” and “the care my mum receives is wonderful, staff are always cheerful and have time for you”. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 6 The manager is well liked by staff, people living in the home and their relatives and she provides the staff with good leadership; staff are well trained and supervised and many already have or are in the process of doing their NVQ in care qualification. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can expect to receive accurate information about the home and the thorough assessment process ensures that people know that their needs will be met. EVIDENCE: The manager said that the review of the home’s Statement of Purpose and Service User Guide is ongoing and that the most recent review was in August 2008. The copies supplied for this inspection were undated and they contained some out of date information regarding the CSCI and the homes’ complaints procedure. The Service User Guide contains pictures of the home and includes a list of frequently asked questions, which would provide people intending to use the service with useful information. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 9 Four care files were examined and they all contained a thorough detailed assessment of the individual’s needs that was prepared by management and they all included information from the funding authorities. All of the assessments examined were carried out prior to the manager providing a service. People living in the home and their relatives said that staff visited them before they moved in and that a full assessment was carried out. Beech House does not provide intermediate care. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care planning ensures that people are cared for in the way they would like to be and they are treated with dignity and respect. EVIDENCE: The manager said and care plans reviewed showed that the care plans are devised from the initial assessment documentation and that they are subject to ongoing review and that the key worker reviews all care plans on a monthly basis. In addition to the monthly reviews a full review that includes people living in the home, their relatives and any relevant professionals that are involved, takes place every three months. The quarterly review looks at all areas of need including behaviour, medication, skin condition and relationships. The care files examined contained evidence of a thorough review having taken place that included all areas of need. The four care files examined were person centred and contained detailed information on the level of assistance staff was to provide. Each care file included, where necessary, risk assessments with management plans and Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 11 monitoring charts. There was full details of all health care visits which including the outcomes and any further actions that were required; each care file contained documents and letters regarding the individual’s health appointments. Medication is administered by the person in charge of each shift and is mainly supplied in a monitored dosage system (MDS). Medication that cannot be stored in this system is provided in bottles and packets. An observation of the morning medication round was undertaken and the process was seen to be well managed. The staff administering the medication followed the home’s procedures and ensured that all of the medication she administered was accurately signed for and fully explained the procedure she would use if a person refused their medication. All the staff administering medication have received medication training. Members of staff were observed interacting with people living in the home throughout the day and this was seen to be respectful, in the person’s own time and in a sensitive and caring manner. People spoken with and surveyed said that they felt well treated and that staff were very understanding and listened to them. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s well-being is enhanced by a range of internal and external activities and they will be offered a good range of healthy nutritious meals. EVIDENCE: People spoken with said, “there is a lot going on but I don’t always want to join in the activities” and “I enjoy the bingo and also like a singsong and watching TV”. The manager said in her annual quality assurance assessment (AQAA) “we employ a part time activities co-ordinator and we have regular social evenings and afternoons and we keep a scrapbook of photos”. There were photos of people enjoying various activities displayed on the wall and also on the home’s computer as a screen saver. The relatives of people living in the home said “my relative always looks good and seems happy and content” and “trips out in the mini-bus take place and people play games like bingo etc.” Another relative said in their survey “ visitors are always made to feel welcome and are regularly invited to various functions”. There were several visitors throughout the day and those spoken with were very complimentary about the home and its staff. Relatives both spoken with and surveyed said that people living in the home were assisted to keep in Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 13 contact with their family and friends and that people were regularly able to out for mini-bus rides. The manager said that regular meetings take place for people living in the home and their relatives; notes are kept of these meetings. Relatives of people living in the home confirmed that regular meetings take place and that they are able to air their views on any matters or concerns and that staff and management have asked relatives if they have any ideas to improve peoples lives and that they listen and act upon what is said. The home operates a four-week rolling menu that provides people with a daily choice of main meal; the menus examined contained a good range of healthy varied foods. People spoken with said, “meals are really good, you can choose what you want” and “food is always nice” and “the grub is good”. The manager said in her annual quality assurance assessment (AQAA) “residents participate in choice of meals through residents meetings”. Relatives of people living in the home said in their surveys “when I visit at mealtimes the food always looks good, they are given a choice” and “management have asked us to have meals with our relative and drinks are always offered, we always feel welcomed”. People spoken with confirmed that food is often discussed at their meetings and that they are always offered a choice of what they want to eat or drink. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that their complaints will be dealt with effectively and that they will be protected from abuse. EVIDENCE: The manager has a complaints policy that was recently reviewed but it is not clear about the level of CSCI involvement. The manager and the responsible individual said that changes would be made to reflect this in the home’s complaints procedure and in the summaries of the Statement of Purpose and Service User Guide. The manager said that there has been no complaints made since the last inspection and that minor complaints were dealt with immediately and were not recorded. The manager said that she would record all complaints in future including those of a minor nature to ensure that any patterns are identified and dealt with. Relatives of people using the service said in their surveys “if I ever have any concerns the staff are always willing to listen and act accordingly to the situation”. People using the service said that they were able to tell staff about any issues they had and that they would deal with them quickly. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 15 The manager said that there have been no adult safeguarding issues since the last inspection and that she uses the 2002 “No Secrets” document as her abuse policy and that she works within the Essex County Councils’ guidelines. All of the staff files examined contained evidence of adult safeguarding (POVA) training and staff spoken with were fully aware of the steps to take should suspicion of abuse occur. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe, homely, clean and comfortable environment. EVIDENCE: A tour of the premises including the garden and car parking area was carried out and the property was found to be in a reasonable decorative order. There was painting and decorating work being carried out at the time of the inspection and the fridges and freezers had to be temporarily resited to a different area to allow the handyman to carry out decorating and repairs to the walls. The cook said that the resiting of the fridges and freezers did not present her with any problems as she still had clear access to them. There are sixteen single bedrooms and six shared bedrooms, some of which open directly onto the enclosed courtyard garden where there is adequate seating for people to use. All of the bedrooms were nicely decorated and furnished to individual tastes and people spoken with said, “my room is always Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 17 kept clean and tidy and I like having my personal things around me”. One relative said in their survey “Beech House is a very homely residential home, it is always clean and tidy and there are never any unpleasant smells” and “the care home has a homely feel, you are always made to feel welcome”. The manager said in her annual quality assurance assessment (AQAA) “we have purchased new chairs and carpets and residents chose the colours of them”. People spoken with confirmed that they had discussed the colours they preferred at their residents meetings. The home was clean, pleasant and hygienic. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at Beech House are cared for by competent well-trained and skilled staff. EVIDENCE: The duty roster showed that the staffing levels are four care staff and one senior between the hours of 7am- 2pm, four care staff and one senior between the hours of 2pm – 6pm and three care staff and one senior between the hours of 6pm – 10pm. In addition to care staff there are two domestic staff, two cooks and two laundry staff employed during the week and at week ends there is one domestic and two cooks employed. An activities co-ordinator is employed five afternoons each week and there are two waking night staff and one person on call. The manager works from 9am – 5pm Monday to Friday and there is administrative support for six hours each weekday. The manager said she has recently increased care hours at mealtimes to assist people that require help with eating and that she has allowed an extra hour three times a day but there has been some difficulty in filling these short shifts. The roster confirmed that on some days additional staff is employed at mealtimes for one hour. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 19 The manager said in her annual quality assurance assessment (AQAA) “more than 75 of care staff either have or are working towards their NVQ2 or above in care”. Staff records confirmed this and staff spoken with said that they found their NVQ training to be beneficial to their role. The manager said that the most recent employee started work at the home in March 2008; the staff file was examined and contained all of the relevant information with the exception of evidence of fitness. There was good evidence on the file of a thorough induction; training included health and safety, adult abuse, death and dying, challenging behaviour, palliative care and dementia. Two other staff files were examined and contained all of the relevant information with the exception of evidence of fitness; each of the files had evidence of induction and good up to date training. The manager said that the homes’ application form would be amended to incorporate the declaration of fitness and that current staff would be asked to sign a declaration that would be kept on the their staff file. Staff spoken with and surveyed said “induction covered all I needed and I have frequent refreshers” and “I have had extensive training in different aspects of care that has improved my work and that of others”. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe well managed home that is run in their best interests. EVIDENCE: The manager has worked in care for many years and she has achieved the registered managers award and holds an NVQ4 in care; she regularly attends training courses to update her practice. Staff said in their surveys “my manager is open and approachable and we always strive to improve”. Staff spoken with confirmed that the managers’ style is open and that they feel able to discuss any issues as they arise. The manager said that she has a quality assurance system that includes obtaining the views of others by means of questionnaires, regular resident and Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 21 relatives meetings, staff meetings and person in control visits; there were notes of these meetings and copies of the person in control visit report’s to confirm this. The manager completed the home’s annual quality assurance assessment fully and returned it to us in good time. The manager said that all monies held by the home are stored securely and that regular monthly balance checks are carried out. All expenditure is receipted and people living the home can request their money at any time. An audit of four cash transaction sheets and their corresponding cash was carried out and was correct. There was evidence on each of the staff files examined that regular supervision takes place and staff spoken with confirmed this. Staff said in their surveys “I feel well supported and can go to my manager at any time” and “issues are dealt with on the spot”. The manager said that she carries out two fire drills each year and that one is due to take place shortly. The records showed that the last fire drill took place on 9/2/08. All safety certificates were in place and up to date and there was evidence of equipment being regularly serviced. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 4 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 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP1 OP15 OP16 Good Practice Recommendations To ensure that people wishing to use the service receive correct up to date information it is recommended that your Statement of Purpose and Service User Guide are dated. To ensure that peoples’ nutritional needs are fully met it is recommended that all of your nutritional records are dated. To enable you to identify any trends in complaints it is recommended that you record all of them including minor complaints. Your complaints procedure should include CSCI details and inform people of our responsibilities. Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 24 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. Extracts may not be used or reproduced without the express permission of CSCI Beech House DS0000018103.V370989.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!