Care Home: Beech Lawn Care Home

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What the care home does well The home provides care in pleasant surroundings and encourages the service users to lead a lifestyle of their choosing. Visitors are made welcome. The home provides service users with a good selection and quality of food. The home makes sure that all the proper checks are carried out before someone starts work. The home make sure that staff are trained to meet the neds of the service users. What has improved since the last inspection? The home have met all of the requirement from the last inspection this has included ensuring there is system in place which monitors the way the home is run. This includes gathering all of the opinions of all those people who have an interest in the care of the service users. This includes GPs District Nurses and other health care professionals. The home has made sure that all of the radiators have covers so the service users do not harm themselves. There ahs been some redecoration of the home and this was in progress during the site visit. What the care home could do better: There is very little that the home could do better as the manager is constantly monitoring the needs of the service users and the service which is provided. It would be good idea to fix a clock in the main dining room as some of the service users were a little disorientated about the time and the routines of the day. CARE HOMES FOR OLDER PEOPLE Beech Lawn Care Home 48 College Street Sutton Hull East Yorkshire HU7 4UP Lead Inspector George Skinn Key Unannounced Inspection 5th February 2008 09:30 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 Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beech Lawn Care Home Address 48 College Street Sutton Hull East Yorkshire HU7 4UP 01482 375165 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) m.ward@beechlawncare.co.uk Beech Lawn Care Home Limited Melanie Jane Ward Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (28), Old age, not falling within any other category (28) Beech Lawn Care Home DS0000060407.V358917.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; Dementia - Code DE(E) and Mental Disorder, excluding learning disability or dementia - Code MD(E) The maximum number of service users who can be accommodated is: 28 15th March 2007 2. Date of last inspection Brief Description of the Service: Beechlawn is a large house set in private gardens; a recent extension has enabled the home to increase the numbers of service users to be able to be cared for to 28. Car parking is available to the front of the home. The home is situated in the village of Sutton, which is close to Hull. The location provides easy access to shops, a post office, churches and health care. Public transport is available close to the home. The home is registered to care for a range of needs. A summary of these is available on page 4 of this report. The fees charged by the home were stated by the registered person during the visit to range from £303.00 to £417.50 with a variable third party top up dependent on service users needs and type of room occupied. Beech Lawn Care Home DS0000060407.V358917.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 that the people who use this service experience good quality outcomes. The key inspection has used information from different sources to provide evidence. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on a pre inspection questionnaire; Comment cards returned from service users, relatives and staff A visit to the home carried out by one inspector. A site visit was carried out which lasted 8 hours. Service users, relatives and staff were spoken with. Records relating to service users, staff and the management activities of the home were inspected. During the visit care practices were observed, where appropriate, and time was also spent watching the general activity within the home The Manager was available to assist throughout the day. What the service does well: What has improved since the last inspection? The home have met all of the requirement from the last inspection this has included ensuring there is system in place which monitors the way the home is run. This includes gathering all of the opinions of all those people who have an interest in the care of the service users. This includes GPs District Nurses and other health care professionals. The home has made sure that all of the radiators have covers so the service users do not harm themselves. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 6 There ahs been some redecoration of the home and this was in progress during the site visit. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People who use this service experience good quality outcomes in this area. Service users’ needs are assessed prior to moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A Statement of Purpose continues to be available which meets with the requirement of the schedule. It contains information on the premises, staffing and procedures in use etc. The information relating to the registration of the manager has now been amended and accurately reflects the management of the home. A Service User Guide is available, which contains details of present service users thoughts on the care they receive. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 9 Local Authority contracts and any third party agreements were seen on the files of individual service users which were looked at. Service user files looked at contained written evidence of assessments being undertaken by both the home and the placing authority. Confirmation is made to the service users, or their relatives, following these assessments that the home can meet their needs and a place is offered Prospective service users and their relatives are able to visit the home and talk to staff and service users prior to any placement-taking place. The home does not provide intermediate care and will avoid emergency placements wherever possible. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use this service experience good quality outcomes in this area All the service users have a plan of care. Service users have full access to all health care provision. Service users are protected by the home medication procedures. Service users are treated with respect and their dignity is up held. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A care plan was available for all service users. Information relating to the service users’ healthcare, personal, and social needs was available in these plans. Written evidence indicated that the plans had been updated regularly by the home on a monthly basis and by the placing authority annually. There was written evidence within the care plans that service users and their relatives had been involved with their formulation. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 11 When interviewed staff members demonstrated a good knowledge of the needs of individual service users. Healthcare needs continue to be met in a proactive manner. Service users commentated on being able to see their GP when they requested or when they required. Risk assessments are held on service users’ files relating to falls, nutrition, dementia and the use of bed rails. The medication system used in the home is the Nomad monitored dosage system. Only those staff trained to administer medication undertake this task. The storage system was seen to be secure; when medication was checked against recordings made it was found to be a robust system ensuring the safety of the service users. All medication is receipted into and out of the building. Observation of staff interaction with service users demonstrated that they treat service users with dignity and spoke to them in an appropriate manner. When spoken with service users were positive about the staffs’ ability to care for them. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service experience good quality outcomes in this area. Service Service Service Service users’ lifestyles match their expectations. users maintain contact with relatives and friends. users can exercise choice over their lives. users receive a well balanced wholesome diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A range of activities continues to be undertaken in the home, music and singing continues to be popular. Planned activities include visiting entertainers and clothes parties. A member of staff is designated on each shift to provide activities for the service users. During the site service users were seen to be participating in various activities which ranged from painting and drawing to sat chatting with the staff. A record of the service users interest is recorded in their care plans. There is also a record of what activities the service users has participated in during the day. Service users are able to choose how to spend their day and can opt in or out of any activity should they so wish. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 13 Many of the service users receive regular visits from friends and family. They are able to meet in private should this be required. Service users’ relatives commented on being able to visit at any time and were positive about the way they were welcomed into the home. A menu is available of planned meals, alternatives can be offered if required. The cook is aware of the individual needs in regard to nutrition for some of the service users. Service users spoken with were complimentary of the food provided. Comments included “the food here is very good”, “there is always plenty of it”, “I once complained of getting too much to eat!” Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good quality outcomes in this area Service users are confident that their concerns and complaint are taken seriously. Service users are protested from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure continues to be available in the home, a copy is also available in the Service User Guide The home continue to have a log of all complaint made; this contains outcomes of the complaint and a note as to whether the complainant was satisfied with this. 3 complaints have been received by the home since the last inspection none of these are outstanding. The CSCI have received no complaints, concerns or allegations about this service since the last inspection. Service users knew who to complain to one said he would “see the boss” if he had any complaints. One service user said he had complained in the past and had been satisfied with the way the manager had handled the complaint and the outcome. Appropriate policies and procedures continue to be available in relation to the protection of vulnerable adults and the Local Adult Protection Procedures are Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 15 also available. Staff members are given guidance on these matters and POVA training has been undertaken as part of staffs’ induction training. When spoken with staff were able to demonstrate a good understating of the procedure for the reporting of any abuse which they may witness. They also commented on the openness of the management style and that the manager was very approachable and supportive. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience good quality outcomes in this area Service users live in a clean, well maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home continues to provide a safe and well maintained environment for the service users to live in. There are ample communal areas fro service users to use, and they are free to choose which area they would like to use during the day. A pleasant and appropriately furnished dining area is available. A routine maintenance programme continues to be undertaken and required maintenance is recorded. A local company visits to undertake minor maintenance on a regular basis. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 17 Service users, following an assessment of risk, are provided with a key for a lockable provision in their room, which can be used to store medication, money and valuables. All bedroom doors are capable of been locked and keys can be provided upon request, again subject to a risk assessment. A separate room is available for hairdressing in the home. The home is clean, hygienic and comfortable, there are no malodours. Domestic support staff are available to ensure cleanliness in the home is kept to a high standard. All of the rooms seen were tidy and clean and each service users bedroom was personalised to a high degree. At the last inspection it was noted that some of the radiators in the home remain uncovered, and that an audit should be undertaken of these to ensure that they are either covered or are of the low surface temperature type. This has been done and all are covered and safe. It was noted that there was no clock in the main dining area, this caused some service users to be confused and disorientated as to whether they had had their lunch or not. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good quality outcomes in this area. Service users’ needs are met by the numbers and skill mix of staff on duty. Service users are protected by the home recruitment and selection procedures. Staff are trained and competent to do their jobs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides staff in enough numbers to meet the needs of the service users. The staff levels are constantly re-assessed according to the needs of the service users and are increased as necessary. Staff files looked at contained evidence of references being taken and checks with the Criminal Records Bureau (CRB) being undertaken prior to the member of staff commencing work at the home. Staff receive induction training which includes all aspects of working with older people including those with dementia. More than 50 of the staff are trained to NVQ level 2, some have achieved NVQ level 3. Staff interviewed confirmed that they receive training which enables them to care for the service users and meet their needs. The staff confirmed that they Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 19 have development interviews once a year and during these areas of training are identified. The home source outside training for the staff to attend via the Local Authority Training Department. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use this service experience good quality outcomes in this area. Service users live in a home which managed by some who is fit to be in charge. The service users live in a home which is run in their best interests. Service users’ financial interests are safeguarded. The health and safety of the service users and staff is promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has submitted an application to the CSCI for registration and is now the registered manager of the home. She stated the she has successfully completed an NVQ level 4 care course, along with the registered managers award, evidence of this needs to be supplied tom the CSCI. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 21 She presently holds a city & guilds 325(2), an NVQ assessor award D32/33 and a direct training certificate. Service users spoken with commented that the manager was approachable and they could go to her if they had any concerns. Staff also commented that the manager was approachable and supportive. The home now has a Quality Assurance scheme in place which consults with the service users, their relatives and any other stakeholders in the service, for example GPs, District Nurses and other visiting health care professionals. The registered owners continue to undertake visit as required by Regulation 26 of the Care Homes Regulations 2001, and were present for a period of time during the site visit. The service users continue to be protected by the homes procedures for handling money. Staff have undertaken mandatory training in moving and handling, Health and safety, infection control, fire and basic food hygiene. The home continue to have in place environmental risk assessments and up policies and procedures in line with changing legislation. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 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 X 13 X 14 X 15 X 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 3 X X 3 Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP31 Regulation 4, 5, 18 & 19 Requirement The registered person must provide evidence of the managers successful completion of the Registered Managers Award. Timescale for action 30/03/08 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 OP19 Good Practice Recommendations It is recommended that a clock be fixed in the main dining room. Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Beech Lawn Care Home DS0000060407.V358917.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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