Care Home: Beech Hurst Nursing Home

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What the care home does well The care needs of all new residents are assessed before they are admitted. This means that the prospective residents will know if care home can meet their needs.Information about the care needs of all new residents is transferred into individual care plans. This means that care staff will know what they are expected to do to meet their needs. All staff receive appropriate training for the work they are expected to do. This means that they have the necessary skills and knowledge to provide good quality care and services to residents. Staff also receive regular supervision from the manager and senior staff. This means that staff are supported and are provided guidance in their work. The manager has set up a system for investigating complaints. This means that residents and their relatives can be confident that any concerns they have will be listened to. Where necessary, the manager will take appropriate action to put right any identified shortfalls in the service provided. A system for reviewing and improving the care and services provided is in place. This also includes the manager meeting with residents and relatives regularly. This means that the manager has a means of ensuring the care home is run in the best interests of residents. What has improved since the last inspection? Improvements have been made to care plans. We found they have now been drawn up from the information gathered when residents are assessed before they move into the care home. What the care home could do better: There are occasions when medication is not given to residents directly from a container clearly marked with directions about how and when the medication is to be given. This means that residents may not always be given medication in accordance with these directions.Social and recreational activities are not always provided to residents as planned. This means that residents social and recreational needs are not always met. CARE HOMES FOR OLDER PEOPLE Beech Hurst Nursing Home Butlers Green Road Haywards Heath West Sussex RH16 4DA Lead Inspector David Bannier Key Unannounced Inspection 8th July 2008 09:15 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 Hurst Nursing Home DS0000024114.V366955.R02.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 Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech Hurst Nursing Home Address Butlers Green Road Haywards Heath West Sussex RH16 4DA 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) 01444 412208 01444 412091 manager.beechhurst@careuk.com manager.burroughs@careuk.com Care UK Community Partnerships Ltd Jacqueline Elizabeth Cox Care Home 60 Category(ies) of Dementia (24), Dementia - over 65 years of age registration, with number (24), Mental disorder, excluding learning of places disability or dementia (12), Mental Disorder, excluding learning disability or dementia - over 65 years of age (12), Old age, not falling within any other category (24), Physical disability (4), Physical disability over 65 years of age (4) Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Accommodation is provided in three units each with its own categories of registration. One unit is for up to 24 service users male and female in the category (OP) of whom 4 persons maybe in the category physical disability age 50 years and over Additionally 4 persons maybe in the category physical disability elderly PD(E) One unit is for up to 24 service users male and female in the categories dementia over the age of 45 years (DE) and dementia over the age of 65 Years (DE(E)) One unit is for up to 12 service users male and female in categories mental disorder over the age of 45 years (MD) and mental disorder over the age of 65 years (MD(E)) A maximum of 60 service users male and female may be accommodated 24th April 2006 2. Date of last inspection Brief Description of the Service: Beech Hurst is a care home registered to provide nursing care and accommodation for up to sixty residents in the categories listed above. The accommodation is laid out in three units to care for the categories of residents separately. The care home is located in Haywards Heath and is a short drive away from shops and other amenities. Beech Hurst consists of a two-storey purpose built building with kitchen and laundry facilities. The majority of the bedrooms are single and all of the rooms have en-suite facilities. Each unit also includes a lounge and dining area to cater for the residents who live there. A vertical passenger lift provides access to each floor. The home has well-maintained and accessible gardens. The range of fees charged by the home is £555 to £900 per week. Chiropody, hairdressing and incidentals such as newspapers and toiletries are not included. The registered provider is Care UK Community Partnerships Ltd. They have identified Mrs Anne Edwards as the responsible individual to represent them. Mrs Edwards is responsible for supervising the management of the care home. The registered manager is Ms Jacqueline Cox and is responsible for the day-toBeech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 5 day management of the home. Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 6 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 inspection has followed the Inspecting for Better Lives methodology and is called a key inspection as it assesses those standards determined by the Commission as key standards. This inspection will also determine the frequency of inspections hereafter. The registered manager returned an Annual Quality Assurance Assessment (AQAA) prior to the inspection. Some residents and staff were sent surveys by the Commission entitled “Have Your Say.” These are designed to enable residents and staff to give their opinions about how the care home is being run. The information received from these documents will be referred to in the report. A visit to the care home was made on Tuesday 8th July 2008. As this was an unannounced inspection we gave the manager and provider no notification of our intention to visit. We spoke to some residents and observed care practices. We also spoke to the relatives of two residents who were visiting the home at the same time. This helped us to form an opinion of what it is like to live in this care home. We also spoke to some staff on duty in order to gain a sense of what it is like to work at the care home. We also viewed some of the accommodation and examined some records. The visit lasted approximately seven and a half hours. Ms Cox was present and kindly assisted us with our enquiries. What the service does well: The care needs of all new residents are assessed before they are admitted. This means that the prospective residents will know if care home can meet their needs. Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 7 Information about the care needs of all new residents is transferred into individual care plans. This means that care staff will know what they are expected to do to meet their needs. All staff receive appropriate training for the work they are expected to do. This means that they have the necessary skills and knowledge to provide good quality care and services to residents. Staff also receive regular supervision from the manager and senior staff. This means that staff are supported and are provided guidance in their work. The manager has set up a system for investigating complaints. This means that residents and their relatives can be confident that any concerns they have will be listened to. Where necessary, the manager will take appropriate action to put right any identified shortfalls in the service provided. A system for reviewing and improving the care and services provided is in place. This also includes the manager meeting with residents and relatives regularly. This means that the manager has a means of ensuring the care home is run in the best interests of residents. What has improved since the last inspection? What they could do better: There are occasions when medication is not given to residents directly from a container clearly marked with directions about how and when the medication is to be given. This means that residents may not always be given medication in accordance with these directions. Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 8 Social and recreational activities are not always provided to residents as planned. This means that residents social and recreational needs are not always met. 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 Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 9 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 Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 10 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 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care needs of all prospective residents have been assessed before they move in. We found no evidence that intermediate care is being provided at Beech Hurst. EVIDENCE: We identified the names of six residents for case tracking purposes. We looked in depth at the care records of four residents. Documents and records seen confirmed that the needs of the identified residents had been appropriately assessed before they have been admitted. The manager also demonstrated they had obtained assessments carried out by the resident’s social worker or health care professional. Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 11 We spoke to residents and noted that they had been well cared for. One resident told us, “The staff are very good – they look after me very well.” Information supplied by the manager prior to our visit confirmed that “Full and comprehensive pre assessments are undertaken for all prospective service users. Stringent admission procedures are adhered to. Prospective service users and their relatives are encouraged to visit the home prior to admission to spend a length of time in the home. The manager or unit managers will undertake pre assessments and will meet prospective service users where they are.” Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 12 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident’s health and personal care needs are set out in an individual plan of care. Residents’ health care needs have been met. Residents are protected by the home’s policies and practices for administering medicines. EVIDENCE: We were given the care records of six residents. We found that they were out of date and had not been reviewed for some time. When we spoke to the manager, we were informed that up to date care records are kept on the home’s computer system. We advised the manager to consider archiving or Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 13 destroying care records which are no longer in use. This will ensure there is no confusion with regard to current care needs of residents. All staff have access to the computer system. The home’s computer has been fitted with a security system. This means that staff can only access information they need to do the work expected of them. Care plans have been drawn up from the information gathered when residents’ needs were assessed. They include information about each resident’s physical needs such as communication, eating and drinking, elimination, personal hygiene, pressure area and wound care, and mobility. They also include information about each resident’s medical history, their current diagnosis and medication requirements. Care plans also include clear instructions to staff so they know what is expected of them in order to meet the identified needs of residents. The care planning system includes risk assessments for skin condition, nutrition, mental health and manual handling. It also records visits to each resident by doctors and other health care professionals together with any treatment prescribed. We were informed that the manager reviews care plans every month. The records seen also provided evidence that this does take place. This means that care plans should reflect residents’ current care needs. One survey returned by a resident confirmed they always receive the care and support they need. The resident commented, “I receive the utmost kindness when I need it most. ” Another survey completed by a resident confirmed they only sometimes receive the care and support they need. This resident commented, “It is hard to speak to staff as usually they are too busy.” We saw that residents we spoke to during our visit were well cared for and were comfortable. They told us the staff were very kind and treated them well. We also spoke to the relatives of two residents. They told us they were very satisfied with the care and services provided at Beech Hurst. One relative told us, “The staff are very kind and caring. We are contacted when mum is ill. We are kept informed when she has to see the doctor and when treatment has been prescribed. We feel we can talk to anyone in the office if we need to.” We saw staff provided care in a manner that ensured their dignity and privacy has been maintained. Staff were courteous when speaking to residents and ensured doors were closed when personal care was being provided. The majority of surveys returned by staff confirmed they are always given up to date information about the needs of people they support. One survey confirmed that that such information is only sometimes given to them. The member of staff also commented, “For some time we have been working to improve the standard of the care plans, away from clinical nursing plans only and towards person centred care. We are trying to increase the emphasis on Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 14 delivering good standards of care at the core of the individual’s needs and preferences.” Information we received from the manager before our visit confirmed that, “All service users have a care plan based on assessed needs. Care plans are evaluated and updated monthly. Assessments undertaken include weight, nutrition, moving and handling, challenging behaviour and continence. ” Appropriate systems have been put in place for the recording, storing, handling, and disposal of medication. Medication is stored safely and securely. There was no evidence of medication being stock piled. Medication record sheets were seen. They had been maintained in a satisfactory manner and were up to date. Staff training records confirmed that all staff who are responsible for administering medication have received training in this area. We were also shown how staff administer medication. This includes, in some instances, taking medication out of a container marked with directions by the dispensing pharmacist into another, unmarked container, before giving the medication to the resident. This is known as pre administering medication. It is considered to be dangerous, as residents may not be given the right medication. We spoke to the manager about this. The manager agreed to take this up with staff who are responsible for administering medication and will make changes where necessary. Information we received from the manager before our visit confirmed that, “Robust medication management policies and procedures are in place and are adhered to. We have a contract with the local pharmacy for advice and support.” The manager has also identified the following as an area which they could do better, “Ensure that medication is audited each week.” Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with activities that satisfy their recreational interests and needs. Residents maintain contact with family and friends as they wish. Residents are helped to exercise choice and control over their lives. Residents receive a wholesome appealing balanced diet in pleasing surroundings. EVIDENCE: The manager informed us that the care home has appointed two activity coordinators who are responsible for planning and organising activities and outings for residents to enjoy. We were given a copy of an activity programme for the week. Activities planned for the week included reminiscence, music and Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 16 movement, games and quizzes, manicure, gardening and cooking. On the day of our visit a gardening or cooking session was planned for the morning, followed by one to one sessions. However, we found no evidence of such activities taking place. We examined care records and found they included information with regard to residents’ leisure interests and hobbies. Records seen also included details of residents’ preferences with regard to daily routines. We saw several residents were still in bed when we looked around the accommodation. The manager informed us that residents had chosen to get up a later during the morning. One survey returned by a resident informed us that there are never activities arranged by the care home that you can take part in. Another survey stated that activities are always provided. The resident commented, “They usually make one feel quite brisk!” According to the information the manager provided before we visited, what Beech Hurst does well is, “Encourage residents to exercise their choice in relation to mealtimes, times for getting up and retiring to bed and how they spend their time.” Care records also include information about the social network of each resident, including contact they have with family and friends. We saw several people visiting the care home, including the local vicar. We spoke to the relatives of two residents who confirmed they are made welcome when visiting residents. The home’s visitor’s book also indicated residents receive frequent visits from friends and relatives. The main meal is taken at approximately 1pm each day. Food is cooked in a central kitchen and transported in hot trolleys to the dining room of each unit. The meal is served out to residents by care staff. During our visit we saw the meal being served to residents. It consisted of a choice of either roast chicken with gravy, potato, cauliflower and carrots or cheese and potato pie. We noted the meal was presented in an appealing manner to encourage and stimulate residents’ appetite. We saw residents were enjoying the meal provided. Residents also told us that the food is very good. We were given copies of menus that indicated that residents are provided with a varied, nutritious and wholesome diet. We spoke to the cook who informed us of the special diets they are currently providing for. This includes diabetic and gluten free diets. One resident survey confirmed that they usually like the meals at the home. They commented, “The meals are quite good.” Another resident confirmed they sometimes like the meals. This resident commented, “I know we cannot expect home cooking but it could be a little better.” Information supplied by the manager prior to our visit confirmed that the care home, “provides a varied menu and can cater for dietary needs and choices. It Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 17 also provides relaxed mealtimes and sensitive support with eating and drinking.” Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 18 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager has ensured any complaints made by residents, their relatives or friends will be listened to, taken seriously and acted upon. The registered manager has ensured residents are protected from abuse or neglect. EVIDENCE: We saw that the home’s complaint procedure was displayed in each of the units within the care home. However, surveys returned by residents stated that they did not know how to make a complaint. One resident commented, “There is no one to complain to,” whilst another resident commented, “I am quite happy really.” We also spoke to residents and the relatives of two residents, who told us they would speak to the manager if they had any concerns. They also told us they found the manager was approachable and willing to listen. We looked through the record of complaints the manager has Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 19 received. This indicated that complaints have been dealt with appropriately and in accordance with the home’s own complaint procedure. Information supplied by the manager prior to our visit confirmed that all complaints received have been resolved to the satisfaction of the person making the complaint within agreed timescales. This information also confirmed that, “The complaints procedure is publicised throughout the home. The home has an open attitude towards complaints, and the manager and staff encourage complaints and suggestions to be made.” We looked through records of training that all staff have undertaken. This indicated that all staff have been provided training in identifying all forms of abuse and reporting any allegations made. Information provided by the manager prior to our visit confirmed that all staff have undertaken appropriate training. It was also confirmed that policies and procedures have been drawn up that staff are expected to follow, which have been designed to protect vulnerable residents from abuse and neglect. We have been made aware recent instances when the manager has needed to alert the local authority of possible allegations of abuse under local safeguarding adults procedures. The manager and the registered provider collaborated fully with this process. They provided us and the local authority with clear actions plans to ensure residents identified are protected. The outcome of investigations indicated that no further action was required. The manager has also confirmed that, where necessary, “We have learnt from the experience of allegations made and investigated.” Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 20 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered provider has ensured residents live in a safe, well-maintained environment. The registered provider has ensured the home is clean and hygienic. EVIDENCE: We looked at the private accommodation of several residents along with the communal areas, including the dining room and the lounge of each unit. These areas were clean, decorated and furnished in a comfortable manner that met the needs of the residents accommodated. Bedrooms have also been appropriately decorated. Residents have been encouraged to bring personal effects and small items of furniture in order to make bedrooms as individual as possible. Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 21 We spoke to some residents who told us the home was a comfortable place to live. They also confirmed they were satisfied with the accommodation provided. One survey completed by a resident and returned to us confirmed that the home is usually clean. They commented, “The cleaning staff are very good.” Another resident told us the home is only sometimes fresh and clean. They also commented, “We are awaiting fresh paint and carpets and curtains.” We also spoke to the relatives of two residents. They informed us, “Generally, the home is kept clean.” When we arrived, the manager was sorting through curtains. As we walked around the premises the manager also informed us that a programme of redecoration and refurbishment will be starting shortly in order to freshen up the accommodation. Information supplied by the manager prior to our visit also confirmed the improvements planned over the next twelve months. This will include, “All bedrooms to be repainted and upgraded; new flooring in specified areas; new carpets in specified bedrooms; repaint and redecorate corridors, lounges and dining rooms in two of the units. We also visited the kitchen area, the laundry, and several bathrooms. We noted that these areas have been maintained to a satisfactory state of cleanliness. We discussed the importance of ensuring the laundry area is kept clean and hygienic to reduce the risk of cross infection. We noted that a system was in place to ensure dirty and clean laundry is kept separate. Information supplied by the manager prior to our visit confirmed that policies and procedures are in place for staff to follow to ensure the risk of cross infections is reduced. It also confirmed the premises has been visited by the Fire Officer and Environmental Health officer to ensure it is safe and meets requirements in terms of fire safety and health and safety regulations. Equipment such as gas installations, electrical wiring and equipment have been regularly checked and maintained to ensure they are safe to use. Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 22 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered provider has ensured that there are sufficient staff on duty with the appropriate mix of skills to meet the needs of residents accommodated. The registered provider has also ensured residents are in safe hands at all times. Residents are supported and protected by the home’s recruitment policy and practices. EVIDENCE: One resident who returned a survey told us that staff are only sometimes available when they are needed. They also commented, “They are too busy to help.” Another survey returned by a resident told us they are always available when they are needed. They commented, “(Staff are) always at our attention.” Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 23 We were given copies of staff rotas to look through. The staff rota showed that each unit is staffed separately each day and night. There is one trained nurse on each unit from 8am to 8pm each day. From 8pm to 8am each night there are two trained nurses awake and on duty. The manager informed us that one nurse is based in the unit for residents who are elderly frail. A second nurse is based on the unit for residents who have dementia. This nurse is also expected to provide nursing support for the unit accommodating residents with mental illnesses. There are four care assistants from 8am to 8pm each day on the units where residents who are considered elderly frail and residents who have dementia are accommodated. There is one care assistant from 8am to 8pm on the unit where residents with mental illnesses are accommodated. From 8pm to 8am each night there are two waking care assistants on each unit. In addition housekeeping staff are on duty to cook meals, carry out laundry duties and to clean the premises. After looking through a selection of residents’ care records we concluded that staffing levels are sufficient to meet the current needs of residents. Information supplied by the manager prior to our visit confirmed what the care home does well is providing a, “ full complement of staff who are highly skilled, competent and trained. Appropriate skill mix of staff on each shift each day.” We saw the recruitment records of two members of staff who have started working at the care home since our last visit. These records demonstrated that the registered providers have obtained appropriate checks for these staff, including criminal records checks (CRB) and other documentation to confirm their identity. We looked at staff training records. They demonstrated that newly appointed staff undertake structured induction training. This includes providing an understanding of the principles of good care practices and covers the promoting of residents’ rights, independence, choice and dignity. Training records also provided evidence that confirmed staff have been provided with mandatory training such as identifying and reporting abuse, fire safety, health and safety, first aid, infection control and food hygiene. Surveys returned by staff confirmed their employer had carried out appropriate checks and had obtained references before they started work at the care home. They confirmed induction training covered everything they needed to know to do the job when they started. They also confirmed they had been given training which is relevant to their role, helps them understand and meet the needs of residents and keeps them up to date with new ways of working. There was also evidence that demonstrated that staff receive regular support and supervision from the manager. Staff also told us they found the management does provide staff with the support they need. Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 24 Information supplied to us by the manager before our visit confirmed that over 33 of staff have obtained the National Vocational Qualification (NVQ) in Care at Level 2 or above. 58 of staff are currently working towards the same qualification. This information also confirmed that what the care home does well is provide a “Full induction programme for new staff and an in house NVQ training programme.” Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 25 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This care home is being managed by a person who has demonstrated they are competent to do so. The manager has ensured Beech Hurst is being run in the best interests of residents accommodated. Residents’ financial interests are safeguarded. The health, safety and welfare of residents and staff are promoted and protected EVIDENCE: Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 26 The registered provider has appointed Ms Jacqueline Cox to be the manager of Beech Hurst Nursing Home. Ms Cox has demonstrated, via the process of registering with us, that she is fit to be in charge, of good character and is able to discharge her responsibilities fully. We found evidence that the manager holds regular staff meetings. We looked at a selection of the minutes. They indicated that the manager uses meetings to communicate with the staff team. Topics the manager discusses with the staff team include the needs of residents, planned events and other issues about the day to day running of the care home. We also found evidence that the manager holds regular meetings with residents. They are used to discuss planned activities and entertainments, and to discuss any issues related to the day to day running of the care home. The manager informed us that relatives are also invited to attend regular meetings as a means of keeping them informed of plans for the home and to seek their views. We were given copies of the minutes of these meetings as well. We spoke to relatives who confirmed that regular meetings have been held and that they are encouraged to give their opinions and views of future planned improvements to the care home. Information supplied by the manager prior to our visit confirmed, “The manager listens to and involves service users, relatives and staff in the day to day running of the home.” The registered provider has set up a system for monitoring, reviewing and improving the care and services provided by the care home. The system ensures an area concerned with the day-to-day running of the home is audited each month. We were shown the paperwork that is used. We noted that, last month, the admissions process was considered. The records demonstrated that, where a shortfall is identified, an action plan is drawn up and identifies who is responsible for making the improvements required together with a target date for completion and a report of progress made to put right the shortfall. The manager informed us that there is provision for residents to deposit money and valuables for safekeeping. We looked at examples of the records kept of transactions undertaken on behalf of residents. They had been well maintained, were up to date and were accurate. The premises have been well maintained, ensuring a safe environment in which residents can live and staff can work. The registered provider has supplied information that indicates equipment such as boilers; other gas installations and electrical equipment have been regularly serviced and Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 27 maintained. Residents have told us that they are satisfied with the accommodation and services provided. According to training records staff have been provided training in such subjects as fire safety training, moving and handling, food hygiene, infection control, health and safety. Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 28 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 X X 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 4 X X 3 Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 29 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. Refer to Standard Good Practice Recommendations Beech Hurst Nursing Home DS0000024114.V366955.R02.S.doc Version 5.2 Page 30 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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