Care Home: Beech House

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What the care home does well The manager visited everyone in their home or at hospital before they were offered a place at the home. During this visit they were given a service user guide, a copy of the complaints procedure and a copy of the menus. The manager also completed a care needs assessment. This information helped both the service user and their families to make sure that they were able to make an informed choice about the home. Everyone had a care plan which included the information the manager had received during the assessment such as the person`s likes and dislikes, past and current medical history. The care plans were contained in a care file which was well organised with information clear and easily accessible. Medication was stored safely and the records kept were satisfactory. Each of the people who used the service had a key worker who was responsible for their day to day care needs. A photograph of the key worker was displayed in the person`s bedroom with a description of what they did and what they were responsible for. Everyone had a single room which meant that they could receive any visitors in private away from the communal areas. All the people were clean and suitably dressed in their own clothes. People also said that they had a choice of when they went to bed and when the got up. There was an activities organizer who worked three afternoons a week. This person was also a care worker at other times. Outings had taken place to the theatre, pub lunch and a trip to the illuminations at Blackpool was planned with Beech House DS0000025463.V378087.R01.S.doc Version 5.2 a fish and chip supper. In house activities took the form of bingo, dominoes card games and an entertainer who conducted sing-a-longs. There was a bowling green next to the home where people went to watch the games weather permitting. Two always, one usually and two sometimes said that the home arranged activities that they could take part in. Monthly visits were made to the home by the local vicar. A small library with large print books was available for anyone who liked reading. The books were changed every month. Visits from relatives and friends were welcomed at all times. The manager was looking at including a `healthy eating option` such as lighter meals which included salads and more fish. The majority of the people we had contact with either through the surveys or during our visit to the home said that they liked the meals at the home. There was just one negative comment which is included in the previous summary section. All of the people who completed a survey form said that there was someone they could talk to informally if they were not happy. The majority also said that they knew how to make a formal complaint. No one we talked to or who completed a survey form (apart from the meals) had any complaints. Many of the staff had worked at the home for a number of years. Staff had received training such as; moving and handling, health and safety, safe handling of medication, dementia care and infection control. Also many staff had a National Vocational Qualification (NVQ) level 2 and or level 3. The new staff had gone through a recruitment and selection procedure which included the completion of an application form and two references. They also had an induction which over a period of twelve weeks which included a two day induction workshop at Oldham College. All the staff had completed a Criminal Record Bureau and Protection of Vulnerable Adults check prior to them starting work. They had also all received training through Rochdale Council on the protection of vulnerable adults. The manager seeks the views of the people who use the service, their relatives and the staff team through resident meetings, resident reviews, staff meetings and staff supervision. During our visit the staff team was seen to treat the people who lived at the home with dignity and respect. The people we spoke with said that the girls were marvellous. From the surveys we had returned to us the majority said that; they always received the care and support they needed; that the staff were always available when they needed them and three always/three usually said that the staff listened and acted on what they said. Over the past twelve months a small number of bedrooms had been redecorated and re-carpeted. Beech House DS0000025463.V378087.R01.S.doc Version 5.2 Page 8 What has improved since the last inspection? The hoist had been serviced to make sure that it was safe to use. Anyone who had been assessed as a high risk of falling was now recommended to the falls prevention team. This made sure that prevention measures were in place to reduce the risk of falling. Nutritional supplements that were prescribed by the GP were now recorded on the drug administration sheets. This was to make sure that the person received them regularly. The Scandia toilet frame had been replaced with a new one. Liquid soap and paper towels were now placed in residents bedrooms to help with the control of infection. Internet access had been provided in the home to allow the manager to keep up to date with the latest legislation and practices. What the care home could do better: Tea time was at 4pm; this was discussed with the manager as it was considered to be too early. Having tea at this time could mean that people were going sixteen hours before their next substantial meal at breakfast. We were made aware that some of the people did have a substantial supper such as toast, `chip butties`, cheese and crackers, crisps and sandwiches. However it was those people who may only have a light snack which causes concern. A recommendation has been made to put back tea time by at least a minimum of half an hour to an hour. The manager should look at training on the Mental Capacity Act and Deprivation of Liberty Safeguards. This should be taken by all staff so that they are aware of people`s rights to make choices for themselves and when this may not be applicable due to their lack of capacity. The floor covering in the entrance hall and corridor leading to the main communal areas should to be replaced as it was looking worn. The home would also benefit from some modernisation with regard to decoration as had been done in the small number of bedrooms that had been re-decorated and recarpeted.Beech HouseDS0000025463.V378087.R01.S.docVersion 5.2The manager is to register with the Care Quality Commission as soon as is practicable and complete the National Vocational Qualification level 4 in management. Key inspection report CARE HOMES FOR OLDER PEOPLE Beech House 68 Manchester Road Heywood Lancashire OL10 2AP Lead Inspector Jacqueline Kelly Key Unannounced Inspection 22nd September 2009 10:30 DS0000025463.V378087.R01.S.do c Version 5.3 Page 1 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. 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. Beech House DS0000025463.V378087.R01.S.doc Version 5.2 Page 2 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 Beech House DS0000025463.V378087.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech House Address 68 Manchester Road Heywood Lancashire OL10 2AP 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) 01706 368710 F/P 01706 368710 beechhousecare@hotmail.co.uk Prylor Properties Ltd Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Beech House DS0000025463.V378087.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 27 Date of last inspection 14th August 2007 Brief Description of the Service: Beech House is a care home providing personal care and accommodation for up to 27 older people and is owned by Prylor Properties Limited. No nursing care is provided. The home is situated approximately one mile from Heywood town centre and is on bus routes to and from Rochdale, Middleton and Bury. The M62 motorway network is within easy driving distance of the home. Beech House is a traditional Victorian style building, which has been converted and extended to provide accommodation in 27 single rooms, one of which has en-suite facilities. The weekly fee is £370.46 to £375.00 as at 12 October 2009. Additional charges are made for private chiropody, hairdressing, newspapers, and toiletries. A combined Service User Guide and Statement of Purpose, is given to new residents. A copy of the most recent inspection report was displayed on the notice board. Beech House DS0000025463.V378087.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 star. This means the people who use this service experience good quality outcomes. The report was written on behalf of the Care Quality Commission therefore throughout the report the terms ‘we’ and ‘us’ are used. We last inspected this service on the 14 August 2007. On the 15 September 2008 we carried out an Annual Service Review. This is a review of good and excellent services that takes place between key inspections. At the time we conducted the review we found no evidence to suggest that our quality rating had changed or that we needed to bring the inspection forward. This was a key inspection and we spent a total of five hours at the home. The owners and manager did not know we were going to visit. Before this key inspection we asked the manager of the home to complete an Annual Quality Assurance Assessment, AQAA, to tell us what they felt they did well, what they needed to do better and to give us current information as to employment of staff and training provided over the past twelve months. The form had been completed honestly and it showed us the manager saw the service being provided the same way as we did. However we felt that more information about how the services were provided and how the service could be improved would have been appropriate. This was discussed with the manager. During the inspection we looked at the care files and care plans of four people. We also looked at the personnel files of the three new staff who had been employed over the past twelve months. We also looked at other documents such as the complaint record, accident record, menus, medication records and training records. We talked to three residents and three care workers as well as the manager. We spoke to the owners who were making their fortnightly visit to the home as they did with all the homes within the company. Questionnaires were sent out to ten people who used the service and to ten staff. We had returned to us six service user surveys and two staff. The information we received was mainly positive from both the care workers and the people who used the service. The majority of the surveys for the people who used the service had been completed by relatives. Comments we received to the question ‘what does the home do well’ were; ‘provide a caring friendly homely atmosphere’; ‘give very personal care’; ‘always very helpful and willing to help in any way’; ‘look after me well’; ‘happy with the way things are’. The staff said; ‘we do our best at all times to meet Beech House DS0000025463.V378087.R01.S.doc Version 5.2 Page 6 the needs of each individual service user - we have a nice friendly atmosphere and most of the service users appear very happy to be here’; ‘friendly well run home - caring staff and people’. There were just three comments where people felt that there could be improvements which were; ‘take out those clients who wish a short walk even if in a wheelchair’; ‘more simple meals fed up of meat every day and potatoes’; and from care workers ‘a laundry person should be employed. Washing would be looked after better if one person was dealing with it. Ironing would be done instead of carers doing it when we get time’. There had been one complaint over the past twelve months which we had been made aware of. The complaint had been resolved to the satisfaction of all concerned. There had been no safeguarding adult protection referrals or investigations. What the service does well: The manager visited everyone in their home or at hospital before they were offered a place at the home. During this visit they were given a service user guide, a copy of the complaints procedure and a copy of the menus. The manager also completed a care needs assessment. This information helped both the service user and their families to make sure that they were able to make an informed choice about the home. Everyone had a care plan which included the information the manager had received during the assessment such as the person’s likes and dislikes, past and current medical history. The care plans were contained in a care file which was well organised with information clear and easily accessible. Medication was stored safely and the records kept were satisfactory. Each of the people who used the service had a key worker who was responsible for their day to day care needs. A photograph of the key worker was displayed in the person’s bedroom with a description of what they did and what they were responsible for. Everyone had a single room which meant that they could receive any visitors in private away from the communal areas. All the people were clean and suitably dressed in their own clothes. People also said that they had a choice of when they went to bed and when the got up. There was an activities organizer who worked three afternoons a week. This person was also a care worker at other times. Outings had taken place to the theatre, pub lunch and a trip to the illuminations at Blackpool was planned with Beech House DS0000025463.V378087.R01.S.doc Version 5.2 Page 7 a fish and chip supper. In house activities took the form of bingo, dominoes card games and an entertainer who conducted sing-a-longs. There was a bowling green next to the home where people went to watch the games weather permitting. Two always, one usually and two sometimes said that the home arranged activities that they could take part in. Monthly visits were made to the home by the local vicar. A small library with large print books was available for anyone who liked reading. The books were changed every month. Visits from relatives and friends were welcomed at all times. The manager was looking at including a ‘healthy eating option’ such as lighter meals which included salads and more fish. The majority of the people we had contact with either through the surveys or during our visit to the home said that they liked the meals at the home. There was just one negative comment which is included in the previous summary section. All of the people who completed a survey form said that there was someone they could talk to informally if they were not happy. The majority also said that they knew how to make a formal complaint. No one we talked to or who completed a survey form (apart from the meals) had any complaints. Many of the staff had worked at the home for a number of years. Staff had received training such as; moving and handling, health and safety, safe handling of medication, dementia care and infection control. Also many staff had a National Vocational Qualification (NVQ) level 2 and or level 3. The new staff had gone through a recruitment and selection procedure which included the completion of an application form and two references. They also had an induction which over a period of twelve weeks which included a two day induction workshop at Oldham College. All the staff had completed a Criminal Record Bureau and Protection of Vulnerable Adults check prior to them starting work. They had also all received training through Rochdale Council on the protection of vulnerable adults. The manager seeks the views of the people who use the service, their relatives and the staff team through resident meetings, resident reviews, staff meetings and staff supervision. During our visit the staff team was seen to treat the people who lived at the home with dignity and respect. The people we spoke with said that the girls were marvellous. From the surveys we had returned to us the majority said that; they always received the care and support they needed; that the staff were always available when they needed them and three always/three usually said that the staff listened and acted on what they said. Over the past twelve months a small number of bedrooms had been redecorated and re-carpeted. Beech House DS0000025463.V378087.R01.S.doc Version 5.2 Page 8 What has improved since the last inspection? What they could do better: Tea time was at 4pm; this was discussed with the manager as it was considered to be too early. Having tea at this time could mean that people were going sixteen hours before their next substantial meal at breakfast. We were made aware that some of the people did have a substantial supper such as toast, ‘chip butties’, cheese and crackers, crisps and sandwiches. However it was those people who may only have a light snack which causes concern. A recommendation has been made to put back tea time by at least a minimum of half an hour to an hour. The manager should look at training on the Mental Capacity Act and Deprivation of Liberty Safeguards. This should be taken by all staff so that they are aware of people’s rights to make choices for themselves and when this may not be applicable due to their lack of capacity. The floor covering in the entrance hall and corridor leading to the main communal areas should to be replaced as it was looking worn. The home would also benefit from some modernisation with regard to decoration as had been done in the small number of bedrooms that had been re-decorated and recarpeted. Beech House DS0000025463.V378087.R01.S.doc Version 5.2 Page 9 The manager is to register with the Care Quality Commission as soon as is practicable and complete the National Vocational Qualification level 4 in management. 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 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. Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 10 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 DS0000025463.V378087.R01.S.doc Version 5.3 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People thinking of moving into the home received enough information to help them make a decision and staff received enough information to understand the person’s needs. EVIDENCE: After the first contact with the home the manager always visited the person either in their home or if in hospital she would visit them there. During this visit the service user guide which had a complaints procedure was given to everyone along with a copy of the menus. This was to help people know what services were provided and help them make a suitable choice. Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 12 The manager completed an admissions/assessment form which was kept on the persons care file and formed the basis of the care plan. The form contained information to help the staff of the home meet the person’s needs. A person likes and dislikes, past and present medical history and name of GP, optician, dentist and social history were all included on the assessment form. The most recent inspection report was displayed on the notice board in the main corridor as was the combined statement of purpose/service user guide. The company did not provide an intermediate care service; this means that short term intensive rehabilitation to enable people to return home was not available. Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care needs were being met by a staff team that respected the people’s privacy and dignity. EVIDENCE: Everyone had a care file. The three that were looked at during our visit were well organised and the information was easily accessible. The care plans told the care workers what the person’s health care needs were and how these would be met. The care file also contained records of GP, district nurse visits and hospital appointments. Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 14 Where people needed help with personal care they had a file which was kept in their bedroom. This file contained an individual personal care sheet for care staff to record that they had completed the necessary tasks such as wash, shave, hair, oral care, cream applied, glasses and hearing aids. Also any other special needs were written on the sheet by the manager. These records were checked by the manager each day. Medication records and storage facilities were looked at during our visit. All the necessary checks and balances were in place to keep people safe and all the records were completed in a satisfactory manner. Each person had a key worker whose picture was displayed in their bedroom with an explanation of what the key worker did and what they were responsible for. Everyone had a single room so they were able to meet their visitors in private if they wanted to. During our visit we saw that the bedroom doors were shut and people knocked before entering. The majority if the staff team had completed training during which the person’s right to have their privacy and dignity respected would have been discussed. All the people looked clean and were suitably dressed in their own clothes. Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 way in which people’s needs are met means they can make choices and maintain their independence. EVIDENCE: There was an activities co-ordinator who was also a care worker but worked three afternoons a week specifically to organise outings and things for people to do in the home. There was a notice informing people of the dates for the next four sessions of bingo and notices for dominoes and cards. A trip to Blackpool to see the illuminations and have fish and chips had been organised for October. Also in November an organist who conducts a sing a long would be attending for bonfire night when there would be fireworks, hot pot and black peas. Other outings had taken place to the theatre, pub lunches and bowling green which was next to the home. Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 16 Regular residents meetings took place and minutes were taken. Menus and activities were amongst the items discussed. Monthly visits were made to the home by the local vicar. A small library with large print books was available for anyone who liked reading. The books were changed every month. Visits from relatives and friends were welcomed at all times. The three people we spoke with said that they could get up and go to bed when they wanted and had a choice in the things they did. They also said that if they did not like what was on the menu they could always have something different. The majority of the people we had contact with said that the food was good. On the day of the visit it was mince meat and dumplings at mid-day with a buffet tea which looked very good with plenty of choice. The manager was looking at introducing a healthy option to the menu. Tea was at 4pm; this was discussed with the manager as it was too early. Having tea at this time could mean that people were going sixteen hours before there next substantial meal at breakfast. We were made aware that some of the people did have a substantial supper such as toast, ‘chip butties’, cheese and crackers, crisps and sandwiches. However it is those people who did not eat a substantial supper late evening and may only have a light snack which causes concern. This is too long and does not comply with best nutritional standards. It was recommended that tea time be put back at least a minimum of half an hour to an hour. Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service were protected by the complaints and safeguarding procedures, which were understood by staff. EVIDENCE: The service user guide had a copy of the complaints procedure and the manager said that people were encouraged to use the complaints system if necessary. We looked at the complaints record which was satisfactory. We and the home had received one complaint in the last 12 months. The complaint was dealt with promptly and resolved to everybody’s satisfaction. There had been no safeguarding of vulnerable adult referrals or investigations. The staff team was encouraged to read all the policies and procedures regarding whistle blowing. The staff had also attended a course on the protection of vulnerable adults which had been presented by a professional training company. During our visit to the home we talked with two members of staff both of whom said that they would report any forms of abuse to the manager. Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 18 All staff had a Criminal Record Disclosure (CRB) check and a Protection of Vulnerable Adults (POVA) first check before commencing work. This was to make sure that wherever possible only suitable people were employed. The manager should look at training on the Mental Capacity Act and Deprivation of Liberty Safeguards. This should be taken by all staff so that they are aware of people’s rights to make choices for themselves and when this may not be applicable due to their lack of capacity Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a suitably adapted, clean, comfortable and reasonably decorated home. EVIDENCE: The original Victorian house had been converted and extended to provide accommodation with twenty-seven single rooms, one of which had en-suite facilities. There were a number of sitting areas including one where smoking was permitted. A garden was available to the front and side of the home and ramped access provided to the front door. Two gazebos had been purchased to enable the people to sit out in the warmer weather. There was a car park for Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 20 approximately five cars and further car parking was available in the lane next to the home. The home is located on a main road approximately a mile from Heywood town centre. A maintenance person was employed who attended to all repairs and decorated the rooms as required. Some of the decoration did look dated and the home would benefit from some modernisation. The bedrooms that had recently been redecorated and had new carpet fitted looked bright, clean and modern. Other bedrooms we saw required new carpet and one bedroom did have an odour problem. The carpet in the entrance hall and the corridor leading to the main areas of the home was looking shabby. It is recommended that this be replaced with new flooring. The other ground floor communal area that had not had new floor covering in the past three years was the hall stairs and landing in the ‘old house’. This should also be considered for replacement. Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 living at Beech House are supported by trained care workers who have gone through a thorough recruitment process so people’s needs are met and they are safe from possible harm or poor practice. EVIDENCE: There was sufficient staff that had the necessary qualifications, training and skills to care for the peoples needs. A rota was in place which showed who was on duty each day and the times that they were working. Two cooks, a maintenance man and domestic staff were also employed. Many of the staff team had taken National Vocational Qualifications (NVQ) both level 2 and level 3 and those who had not taken the qualification were registered to do so. Three staff had been employed over the last twelve months. Their personnel files were looked at and were found to contain all the necessary forms such as Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 22 application forms, references, contracts of employment and Criminal Record Disclosure checks. All new staff had to complete an induction programme which lasted for twelve weeks. The induction also included a two day induction workshop at Oldham College. The manager had in place a staff development programme for the next six months from October onwards. The training included moving and handling, protection of vulnerable adults and safe handling of medicines. Training was done with Oldham College, Rochdale Local Authority and professional trainers from private training companies. Many of the staff had received training in dementia care. Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Beech House is well managed so that it is run in the best interests of the people who live there. EVIDENCE: The manager had been in post for twelve months. She had previous experience of managing a domiciliary care agency and had National Vocational Qualifications (NVQ) level 2, level 3 and was in the process of taking a Level 4 in management. She was also applying through the Care Quality Commission Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 24 to be the registered manager of Beech House. Everyone we had contact with found her to be supportive. There was a quality assurance system which sought the views of the residents, relatives and staff. Regular meetings were organised between the manager and staff team and manager and residents. All meetings were recorded. Reviews also took place which helped people raise any concerns they had about their care with the manager. Questionnaires were also given out to the people who used the service and to their relatives. However these had not yet been distributed for the current year. The manager was to do this within the next few weeks. Neither the owners of the company or the manager handled people’s finances. The manager did however keep small amounts of money for day to day items such as hairdressing, newspapers etc. A record was kept including receipts. Formal supervision which gave the manager and staff time to discuss the care of the people who used the service, their training needs and any areas of concern took place regularly. Both the manager and the two assistant managers were taking an NVQ level 2 in supervision for managers. Once the assistant managers had completed the course they would take over some of the supervision responsibilities from the manager. During our visit we were not aware of any practice which gave us cause for concern regarding the health and safety of either the people or the staff who lived and worked in the home. The owner visited the home (which was one of a number of homes owned by the company) every two weeks. He completed a report once a month which was required under the Care Homes Regulations. We did not see the reports during this visit. All accidents were recorded with any action required and kept on the relevant persons file. Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 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 2 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 3 3 Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP15 Good Practice Recommendations Tea time was at 4pm; this was discussed with the manager as it was considered to be too early. Having tea at this time could mean that people were going sixteen hours before their next substantial meal at breakfast. We were made aware that some of the people did have a substantial supper such as toast, ‘chip butties’, cheese and crackers, crisps and sandwiches. However it was those people who may only have a light snack which causes concern. A recommendation has been made to put back tea time by at least a minimum of half an hour to an hour. The manager should look at training on the Mental Capacity Act and Deprivation of Liberty Safeguards. This should be taken by all staff so that they are aware of people’s rights to make choices for themselves and when this may not be applicable due to their lack of capacity. The floor covering in the entrance hall and corridor leading DS0000025463.V378087.R01.S.doc Version 5.3 Page 27 2. OP17 3. OP19 Beech House 4. OP31 to the main communal areas should to be replaced as it was looking worn. The home would also benefit from some modernisation with regard to decoration as had been done in the small number of bedrooms that had been redecorated and re-carpeted. The manager is to register with the Care Quality Commission as soon as is practicable and complete the National Vocational Qualification level 4 in management. Beech House DS0000025463.V378087.R01.S.doc Version 5.3 Page 28 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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. 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