Care Home: Beech House

Similar services:

• Snydale Care Home
• Abbey The
• Larchfield Manor
• Hawkhills
• Beeches The - North Yorkshire County Council
• Carentan House
• Ravensworth Lodge

What the care home does well Staff are very friendly and open about their practices. They spoke to each person they were caring for with dignity and respect and gave encouragement where it was needed. The records kept on each individual were very detailed and showed how the staff were monitoring their needs and what had taken place for each individual over a period of time. The environment appeared to be a comfortable place in which to live and was adapted to suit peoples individual tastes and needs. Robust systems are in place to ensure staff are safe to work with people prior to their commencement on employment and are then trained and supervised to do their jobs. This will ensure people are being looked after by competent staff and not being put at risk. A quality assurance system is in place to ensure the more senior staff and regional and head office staff are seeking the views of people who live there and are ensuring the home is being run for their benefit. What has improved since the last inspection? There had been no outstanding requirements from the last inspection but the Company had taken on board the recommendation that the key workers and activities organizer work closer together and share information about the people living in the home. What the care home could do better: The Company must ensure that all documentation about the services the home provides is accurate and this should include the Statement of Purpose and Service Users Guide which had incorrect manager details and incorrect address of CQC. To ensure people are not isolated from the local and wider community a more varied program of social activities should be on offer and these to meet everyones needs and expectations. Consideration should be given to those with special needs such as sensory impairment, memory loss and mobility problems. All staff should receive training in dealing with complaints and in recognizing abuse and knowing how to pass this on to the correct agencies. This will ensure people can live free from harm. Training of staff in mandatory topics and to suit individual needs is well documented, but areas of specific training such as dementia and pressure area care need to be made available for all staff. This will ensure people can be looked after by competent staff who know how to do their jobs. To ensure the "Comfort" fund can be accessed by local senior management these accounts should be set up so money can be withdrawn when required and peoples social activites are not hindered by a lack of resources. To ensure the safety of individuals any incident where people have been put at risk must be notified to CQC and all necessary action taken place. This will ensure people are not put at risk of harm. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Beech House Chapel Lane Barton upon Humber North Lincolnshire DN18 5PJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Theresa Bryson     Date: 0 1 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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 House Chapel Lane Barton upon Humber North Lincolnshire DN18 5PJ 01652635049 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : beech.house@fshc.co.uk Tamaris Healthcare (England) Ltd care home 30 Number of places (if applicable): Under 65 Over 65 15 30 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 0 Beech House is situated in the centre of Barton on Humber, close to local shops and amenities. It is registered to provide support and care for up to thirty older people. The home is a mixture of old and new buildings over two floors, serviced by a passenger lift and stairs. There are twenty-two single bedrooms, sixteen of which are en-suite and four double rooms, one of which is en-suite. The upper floor has a further raised level accessed via five stairs. There are two bedrooms and one unassisted bathroom in this area, which is only accessible to more ambulant service users. There are two assisted bathrooms, one of which has a bath lift and the other a parker bath for those less able. A walk in shower room with hairdressing sink is provided on the ground floor. A fourth bathroom is now used as a storeroom. There are a further five single toilets throughout the home. Care Homes for Older People Page 4 of 27 Brief description of the care home The home has two lounges, the larger of the two having two dining tables at one end. There is also a separate dining room. Both lounges have patio doors that have access to a paved area with garden furniture. There is a quiet seating area in the entranceway. The enclosed rear garden is well maintained. Car parking space is available at the front and side of the building. Fees are reviewed on a regular basis. Information about the services the home provides is kept in each of the service users bedrooms. 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: The site visit for this inspection took place over one day in July 2009. Prior to this we sent some surveys out and had five returned from people living in the home, 2 from health professionals and six from staff. we also looked at the service history since the last inspection. The Company sent to us their Annual Quality Assurance Assessment (AQAA) which told us what they had been doing in the last year, what they hoped to achieve and plan for the home in the future and a lot of statistical data. During the site visit we talked to a number of people living their, some visitors and staff and also looked at a number of records and documents. Care Homes for Older People Page 6 of 27 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 following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 27 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. Information is available to ensure people can make informed decision about using the home and they have an holistic assessment prior to admission. Evidence: At the site visit for this inspection the Statement of Purpose and Service Users Guide were seen and both needed changes. There has been a change in manager since the last inspection. The above documents did not reflect this change or the change in CQC address. They need to include these changes so people who are using the service have all the correct information to hand. The rest of the content of these documents did reflect the types of service the home can provide so people could make informed decisions as to whether to use this home. The care plan for the latest admission to the home was checked in depth and found to have all the necessary information to ensure staff could begin their care planning as Care Homes for Older People Page 11 of 27 Evidence: soon as the person had been admitted. Each person has an holistic assessment which looked at potential risks, their well-being, mental health status and abilities. People spoken to said how they valued the fact that staff knew a lot about them prior to admission which had helped them to settle in to the home. The home does not give intermediate care so therefore Standard 6 is not applicable. 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. Accurate records are kept of the current needs of people living in the home to ensure their needs and expectations are being met. Evidence: Prior to the site visit CQC sent out a number of surveys. Five were returned from people using the service and two from health professionals. On the day of the site visit a further seven people living in the home were talked to at length, plus a relative and a visiting health professional. All made positive comments about the home and staff. They told us for example that wouldnt want to move anywhere else andstaff understand what I want and i get it. Others said feel its my home and they look after me quite well. From the health professionals visiting the home they feel they do have the correct information given to them to make decisions about their patients and made comments such as at the moment every-thing is fine. 4 care plans were tracked in depth and were found to contain comprehensive information about each person. For example one person had mobility problems which Care Homes for Older People Page 13 of 27 Evidence: was clearly identified on their care plan and risk assessment. A further long term falls assessment had been completed and there was written evidence of the involvement of other health professionals. There was also a list of equipment in use for this person, which included a handling profile to ensure staff could move this person safely. In another persons file they needed care over a wound on their body. A body map had been completed to identify where the injury was and an initial wound form and on going wound management form were then in place. This ensures staff know how to monitor this individuals condition. There were regular diary and evaluation entries showing the progress being made. The care plans generally were legible and well written and showed that care was being taken to make accurate recordings about a persons health and well being. Input was recorded when people them selves had been included in the care planning process or whether this was the responsibility of their advocate. A senior member of staff helped the inspector to check the medication records. There appeared to be good practices in place and the records appeared accurate. We were informed that the staff were catching up with medication reviews with local GPs but there was an audit trail written to support this statement and where any other action for individuals had taken place, such as review from tablet medication to liquid due to someones ill health. There was also written evidence in place where one person had been reassessed as requiring to self medicate and this was reviewed regularly. To assist them to be safe practioers a through policy and procedure is in place to guide staff as well as an up to date reference book. Staff were observed during the day assisting people with a variety of tasks, including personal care, assisting with reading and liaising with family members and health professionals. On each occasion staff had a very calm manner and showed dignity and respect to each individual they were caring for. People in the home told us staff were very good and I only have to ask and things are done. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A more varied program of activities should be on offer to ensure people are not isolated. More contact should be made with the local and wider community to ensure people lead as full a life as they can. Evidence: Apart from the care plan records which showed where social needs assessments had been completed the home also keeps separate records for social activities which have taken place. These record the type of event, who and how people participated and helps staff to understand what events help people to lead a full and active life, depending on their capabilities. Lots of the events were repetitive and did not fully encompass the diverse needs of a lot of the people currently in the home. There appeared to be little on offer for those with memory impairment, communication difficulties and sensory impairment. This could cause them to become isolated if alternative approaches to social expectations cannot be found.There was little documented evidence that people have access to the local and wider community apart from shopping trips which could also cause them to lead a less than full life. There was ample evidence in peoples bedroom areas that they had been allowed to Care Homes for Older People Page 15 of 27 Evidence: personalize them to suit their tastes and needs, which people told us had helped them settle into the home initially. We had a brief tour of the kitchen area. The local Environmental Health Officer had given the kitchen a 4-star rating in March 2009, which staff were pleased about. This is a rating which the local officers give to show members of the general public how well a service provides food and comments on their hygiene standards and staff training. The highest award in this area is 5-stars. Food was seen being prepared in a safe environment and there was a balanced menu available, with choices for people over a 4-week cycle. The food was being prepared by suitably qualified staff. A lunch time meal was observed and staff were seen to assist people in a calm and dignified manner, giving them encouragement to eat a balanced meal to help their health and well-being. People told us how much they liked the food. Saying no grumbles with the food and quite good choices. One person told us how they had always liked their food and being in the home meant they looked forward to the next meal time. 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. Policies are in place to instruct staff on how to make concerns known so people are free from harm and risk. The knowledge base of staff should be tested to ensure staff are fully aware of these processes. Evidence: Since the last inspection there had been no concerns raised to us and the homes own log showed no concerns since January 2007. The policy manual which was seen did not show the correct address for CQC but gave a detailed procedure for staff to follow, should the need arise. Staff were also verbally able to tell us what to they would do to prevent people from being harmed and how the Company deals with complaints. The staff records showed that most staff had completed up date training in safe guarding adults and that the home had a copy of the Local Authority Guidelines to follow which included how to make a referral. Some staff were unclear about this process and an undertaking was given verbally by senior staff that they would make this known to all staff. Care Homes for Older People Page 17 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. People are able to live in a clean and safe environment. Evidence: A tour of the home took place during the site visit. The home was clean and in a good state of repair. Since the last visit staff were able to point out where new purchases had taken place. This included some new carpets and improvements to one of the lounges and the dining area. The maintenance plan indicated that another lounge was to be completed and that some easy chairs were due to arrive. A selection of bedrooms were seen, all toilets and bathroom areas and all communal areas. These were tidy and in a good state of repair. There were also notice boards available showing who was the homes Dignity Champion and also one for general information. There was a suggestion box so peoples views could be aired. The gardens were colorful and accessible for wheelchair users. The small car park was free from hazards. The laundry area was outside the main building and was tidy. We were informed there was a system in place to replace torn linen. At the time of the site visit one dryer was out of action but was in the process of being repaired. This was not hampering the provision of clean and ironed laundry. Care Homes for Older People Page 18 of 27 Care Homes for Older People Page 19 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. Staff must be trained to look after people living in the home to prevent them from being put at risk. Evidence: People living in the home had told us through surveys we had received and in conversation of how they liked the staff and how their needs were being met. Making comments such as cannot fault them and the work they do is satisfactory. Some told us that at times there were not too many staff about and at times they had to wait for call bells to be answered for a long time. Staff also told us that at times they were busier than others and they felt rushed Of the 15 staff who we had contact with most told us there were always staffing problems but we get around it. The rota showed that there was some use of agency staff to ensure sufficient were on duty to meet peoples needs. There was no evidence to support that the staffing rota was checked against the dependency levels of people living in the home which could put them at risk if insufficient staff were on duty to meet their needs. We tracked in depth five staff personal files and found sufficient evidence to show that adequate safety checks had been completed prior to their commencement of employment. This ensures people are not put at risk of harm. They are then trained to do their jobs. We were informed that all new staff went Care Homes for Older People Page 20 of 27 Evidence: through induction standards but none were available during our visit as we were told they were out with the staff. The Company keeps a training matrix to ensure all staff complete their mandatory training, training specific to their individual needs and more service specific training tot meet the current needs of people in the home. For this last topic there was little evidence to support that all staff had received training in some areas. For example some staff had received training in dementia care, but not all care staff. Only two people had received training in prevention of pressure damage and only one in diabetes. This could put people at risk of staff are not aware of how to look after them. Care Homes for Older People Page 21 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. Accurate records must be kept to ensure that people live in a safe environment and are free from harm. Evidence: The management of the home has changed since the last inspection. There is now an Acting Manager in place since December 2008. The CQC are still awaiting this persons application and they were informed it is an offense to run a home without a Registered Manager in place.We had been informed by letter of the changes to this and a sister home but no further action had taken place. A full and detailed quality assurance program is in place which is monitored by senior local, regional and head office staff. Audits seen by us included meetings between the Company and staff and residents/relatives, home budget profile and details of the individual Team Audit Process known as TAP. These included work on such diverse subjects as infection control, human resources, care plan documentation and catering. Care Homes for Older People Page 22 of 27 Evidence: The supervision records of staff are also an integral part of this process. Records seen showed staff were receiving supervision to ensure they were safe to work with people in the home. The staff are required to inform CQC when any incidents, accidents and other events occur in the home. On checking the accident records it was seen that an incident had occurred between two people living in the home which should have been notified to us and had not been. This should also have been referred to the local Safe Guarding Adults team but this had also not been completed. After this site visit the necessary referral was made to this team to investigate. This could have put people at risk of harm if the behavior of these people were not monitored. The personal allowance records of people living in the home were checked. These are kept electronically and showed accurate entires with no misuse of funds. The current Acting Manager is still not a signatory on the Comfort fund account which could result in a limited access to these funds which benefit peoples social activities. All safety certificates were seen to ensure the building is a safe place in which to live and work. All were valid except two sets of records. The readings for the water temperatures of outlets used by people living in the home were poor and could cause them to be at risk if the water ran to extremes of temperature.The certificate for checking Legionnella levels in the water was also out of date. The records were also out of date for the calibration of the people weighing scales, by over six months. This could mean that peoples weights could be incorrect which could affect their health. Care Homes for Older People Page 23 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 24 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 1 38 13 Appropriate action must be taken when incidents occur which has caused someone to be harmed. This is to ensure that people are not put at risk. 13/01/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 The information contained within the Statement of Purpose and Service Users Guide should be correct, so people know who to contact should the need arise. A more varied program of activities should be on offer to ensure people do not become isolated. More contact should be made with the local and wider community to ensure people can lead as full a life as their capabilities allow. All information should be correct to enable people to make referrals to the right bodies, should they want to raise concerns. All staff should be aware of how to correctly make a safe guarding referral and all staff should have receive up date training. Page 25 of 27 2 3 12 13 4 16 5 18 Care Homes for Older People 6 35 Appropriate action should be taken to ensure that local senior staff have access to the Comfort fund to enable them to access money for peoples social activities. Accurate records should be kept to ensure all equipment is fir for use. This should include specifically the recording of all water temperature records and the control of Legionella and the use of the people weighing scales. 7 38 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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!