Care Home: Beeches House

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What the care home does well "I`m quite happy", "I like living here", "I think it`s very nice, "I`m happy in this house", "it`s better than the other place" and "it`s a nice place to live" were some of the comments received from people who live at the home. All the surveys we received from people who live at the home said that they were happy with the service they were receiving. "They look after my relative" and "my relative is happy" were comments received from family members of people who live there. The service has a warm and homely atmosphere. A real strength of the service is that managers and staff clearly know and relate to the people who live there very well. What has improved since the last inspection? Fire Safety records are well kept and up to date. Washbasins are being replaced as part of the overall maintenance programme. Care plans are being improved and this is helping people who live there to be part of the care planning process. What the care home could do better: The home is in the process of reviewing its fee structure with the Local Authorities who place people there. It is hoped that this will allow for more 11 work with individuals and the purchase of a suitable vehicle for the home. This was an area that care staff said they would like to develop and we think that this will enhance the service already being offered to individuals.Staff supervision is taking place but the frequency of these sessions needs to improve. CARE HOMES FOR OLDER PEOPLE Beeches House 53 Park Hill Carshalton Surrey SM5 3SE Lead Inspector -Jon Fry Key Unannounced Inspection 10:05 7th November 2007 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 Beeches House DS0000007171.V353081.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. Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beeches House Address 53 Park Hill Carshalton Surrey SM5 3SE 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) 020 8401 0071 020 8395 5668 brookcarehomes@blueyonder.co.uk Brook Care Homes Mrs Bridget Teresa Brook Care Home 13 Category(ies) of Learning disability over 65 years of age (13) registration, with number of places Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 5 service users under the age of 65. Date of last inspection 16th February 2007 Brief Description of the Service: Beeches House is a large family-style home located close to the facilities and transport links of Carshalton Beeches. The home provides care and support to people with learning disabilities with the majority of individuals being over the age of 65. The house has five single bedrooms and four double rooms (not all of these are doubly-occupied). There is a large communal lounge, separate kitchen / dining rooms and a garden area. Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We spent six hours at the home and spoke individually with seven people who live there. We also spoke to the owners, the acting manager and two staff members. Records and documents looked at included care plans, staff files and the home’s user guide. Completed surveys were received from eight people who use the service, two relatives or friends of individuals, one care manager and a healthcare professional. What the service does well: What has improved since the last inspection? What they could do better: The home is in the process of reviewing its fee structure with the Local Authorities who place people there. It is hoped that this will allow for more 11 work with individuals and the purchase of a suitable vehicle for the home. This was an area that care staff said they would like to develop and we think that this will enhance the service already being offered to individuals. Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 6 Staff supervision is taking place but the frequency of these sessions needs to improve. 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. Beeches House DS0000007171.V353081.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 Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is available to people about the home. The needs of people using the service are assessed and kept under review to make sure that they are met. EVIDENCE: The statement of purpose and user guide provide good information about the service. This includes a charter of rights for the people using the service and details of how to complain should they need to. We have recommended that the user guide be made available in a variety of different formats such as large print, pictures and audiotape. There have been no new admissions since the February 2007 inspection. We looked at the assessments for two people who already live at the home. These Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 9 were fully completed and documented information about the persons individual support needs. The format in use could be developed to capture more individualised information for any new people coming to live at the home. This may help in then writing person centred care plans for the individual. Beeches House DS0000007171.V353081.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 and 10. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans give good information about the support needs of people using the service and are being developed to be even more person centred. Risk assessments are completed to help people live as independently as they can. Individual healthcare needs are met. EVIDENCE: People we spoke to said they were treated respectfully and politely by care staff. Comments included “they are nice to me” and “polite”. We saw that staff interacted very positively with the people who live there A care manager commented “this is an excellent service that meets our clients needs”. A review was taking place on the day we visited and the visiting care manager said that they were “very happy” with the care being provided. Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 11 One other person was having a meeting with the Court of Protection visitors to help them plan for their future. We saw that the home is actively supporting this person to make choices about their future and achieve their own goals to perhaps live more independently. Care plans are being developed with some very good information being recorded for individuals both about their past and their future hopes and dreams. One person had this information mapped out on a large piece of paper and another individual had a typed plan which contained some very good individualised information. We think that the home should continue to look at ways of individualising the information for everybody living there and helping them to be part of the planning process. Individual risk assessments are on file for each person. We saw that these are kept under review and new assessments are completed when a new activity or area of risk is identified. Appropriate medication policies, procedures and practices are in place. Staff receive training in administering medication and medicines are labelled and stored correctly. We saw that Medication Administration Record Sheets are kept up to date and signed by staff. People living there are supported to see their GP or other healthcare professionals as required. We saw that records are kept of these appointments. Comments from people who live there included “I see the doctor when I need to”, “I went to the hospital for a blood test” and “I just had my flu jab”. We saw that records are kept of these appointments. Beeches House DS0000007171.V353081.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 and 15. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are able to take part in activities and be part of the local community. The menu for the home needs to be reviewed. EVIDENCE: “I go out on the buses and to the shops”, “I go to club”, “I like the company” and “I do colouring in and watch TV” were some comments from people who live there. Two people told us that they enjoyed their holiday to Butlins earlier this year. Activities records we looked at included balloon games, skittles, quizzes, making decorations and card games. One person was out independently and two people were attending Day Centres on the day we visited. Staff spoken to said that there were enough activities going on inside the home but they would like to be able to get out more with individuals. This was dependent on having enough staff to allow for more 1-1 time and the home Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 13 getting its own transport. The owners told us that they were in the process of reviewing fee levels with the placing Local Authorities that will hopefully allow the service to develop in this area. People said they enjoyed the food provided to them with comments including “very good”, “the food is very good – especially on Sunday” and “too much”. The menu we saw did not match up with the meals actually being served. The home told us that this was being reviewed and choices were generally made informally. We have recommended that the new menus be presented in picture formats to be more user friendly. A relative was visiting on the day of inspection. They told us that they visited regularly and are always made welcome. Beeches House DS0000007171.V353081.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 and 18. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate procedures are in place for the management of complaints. Training is provided for staff in Safeguarding Adults. EVIDENCE: People spoken with said “no problems” and “if I am unhappy, I speak to Mrs Brook”. A complaints book is kept at the home. There have been no concerns or complaints about the service provided since the last inspection. Staff are trained in Safeguarding Adults and procedures for them to follow are available. Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 15 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, 21, 24 and 26. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals live in a home that is comfortable, safe and well maintained. The communal rooms of the home are welcoming and homely and people’s bedrooms reflect their individual preferences. EVIDENCE: A comfortable and homely environment is provided for the people who live there. The home was clean and hygienic when we visited. We looked at three people’s bedrooms. Each was personalised and decorated to reflect individual taste. We thought that the two toilets on the first floor could be improved to look more homely and less institutional. The acting manager said that they had already started to look at this. Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 16 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. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported by experienced staff who are trained and competent. EVIDENCE: People who live there told us that they like the staff who work there. Comments included “the staff are nice”, “they are nice to me” and “the staff are alright”. One person said that “they keep on” sometimes. The home benefits from having a stable staff team. We saw that staff interacted warmly and positively with people during our visit and demonstrated a good knowledge of their needs. New staff complete the Skills for Care Common Induction programme and NVQ training is made available. Both staff we spoke to said that they were in the process of completing the NVQ Level 2 award. Other training provided for staff includes First Aid, Food Hygiene, Manual handling, medication and abuse awareness. Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 17 Staff members we spoke said that the team worked well together and their comments included “we are all very involved” and “the staff make it excellent here”. Staff recruitment is subject to procedures that include Criminal Record Bureau (CRB) checks. We looked at records kept for three people and these included all the necessary documents. Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 18 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, 36 and 38. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run. Good Health and Safety arrangements are in place. EVIDENCE: An experienced acting manager is in post. The registered manager and general manager were also present during this inspection visit and told us that the management arrangements for the service were being reviewed. Comments from staff about the management of the service included “lovely” and “supportive”. Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 19 Consultation with the people who live there tends to be informal and ongoing. Meetings involving the people who live there take place but we saw these could be held more regularly. Things that were discussed at these meetings included net curtains, holidays and trips out. We have recommended that the service hold these meetings at least monthly and that the minutes record any actions that need to be taken. These can then be reviewed by the manager to make sure that ideas or issues from the people are acted upon. A system for regular individual staff supervision is in place but needs development to make sure that all full time staff receive this at least six times per year. We saw that regular Health and Safety checks are carried out to protect the welfare of people using the service. Good records are kept of these. Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X X 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 3 X X 3 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 2 X 3 Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 21 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 OP36 Regulation 18 (2) Requirement All care staff must received supervision with their line manager at least six times annually (pro-rata for part time staff). This will make sure that staff are adequately supervised and able to do their jobs. Timescale for action 31/01/08 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. 2. 3. 4. Refer to Standard OP1 OP3 OP7 OP13 Good Practice Recommendations The user guide to the home should be made available in a variety of formats such as pictures or audiotape. The service should review the assessment format to make sure that it captures good quality person centred information. The home should continue to develop the care plans to be individualised and in formats that help individuals to take part in the planning process. The service should look at providing more activities DS0000007171.V353081.R01.S.doc Version 5.2 Page 22 Beeches House 5. 6. 7. 8. OP15 OP21 OP31 OP33 outside of the home. The menus should be reviewed and be made available in a picture format for the people living there. The toilets on the first floor should be looked at to see if they could be made more homely. The management arrangements for the home should be finalised. The service should look to hold monthly meetings for the people who live there and any actions required fully recorded in the minutes. Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Beeches House DS0000007171.V353081.R01.S.doc Version 5.2 Page 24 - 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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